How can we avoid lymphoedema in addition to elephantiasis in Lymphatic Flariasisbecome indelible An update of treatment options  in reference to a case report not treated for 3 decade-Review of treatment with historical perspectives

Despite the launching of the National Filarial Control Program over greater than 50% of the century till 2024 Lymphatic Flariasis(LF) continues tobe prevalent worldwide in the  tropical along with sub-tropical areas adding considerable hurdles in the aim of global eradication. Apart from affecting the human beings along with the influence over expenditure correlated with livestock cost works as a key in aiding in morbidities as well as disabilities. Presently the situation has got out of control with the urgent requirement of generation of robust therapeutic approaches possessing effectiveness against the adults stage of the nematodes. Pertaining to this evaluation of a target that guarantees death/ demise of microfilariae in addition to macrofilariae is the initial aim. Apoptosis has been plausible for all the 3 stages of the filarial nematode /parasite- for instance-oocyte, microfilariae(mf) along with adults leading  to filarial demise subsequent to  the  receipt of the signaling from filarial reactive oxygen species (ROS) whose execution utilizes extrinsic as well as    intrinsic pathways. Recent advancements have illustrated the effectiveness of natural and synthetic substances(nanoformulations) possess the capacity of stimulating apoptosis with practically negligible inimical sequelae for  body of host  & having apoptosis induction capacity causing micro along with macrofilaricidal action in micro & macrofilariae.The basic aim of updating this historical knowledge on LF treatment  after no therapy given to the patient presented in Delhi.Till efficacious nanoformulations formed atleast a combination of rifampicin plus  doxycycline or doxycycline  with DECcan be tried if not planning pregnancy in females where all azoles like albendazoles need avoidancedue to teratogenicity.Lot of plant extracts don’t have inimical sequelae.Hopefully, in future we will have different targeted approaches as detailed here

Keywords:  Lymphatic Flariasis(LF); reactive oxygen species (ROS); Oxidative   stress( OS)