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Johanns SI, Gantin RG, Wangala B, Komlan K, Halatoko WA, Banla M, Karabou P, Luty AJF, Schulz-Key H, Köhler C, Soboslay PT. Onchocerca volvulus-specific antibody and cellular responses in onchocerciasis patients treated annually with ivermectin for 30 years and exposed to parasite transmission in central Togo. PLoS Negl Trop Dis 2022; 16:e0010340. [PMID: 35503786 PMCID: PMC9064110 DOI: 10.1371/journal.pntd.0010340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 03/20/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Annual mass drug administrations (MDA) of ivermectin will strongly reduce Onchocerca volvulus microfilariae (mf) in the skin and in the onchocerciasis patients' eyes. Ivermectin treatment will also affect the expression of immunity in patients, such that activated immune defenses may help control and contribute to clearance of mf of O. volvulus. Longitudinal surveys are a prerequisite to determining the impact of ivermectin on the status of anti-parasite immunity, notably in risk zones where parasite transmission and active O. volvulus infections persist. METHODOLOGY/PRINCIPAL FINDINGS Onchocerciasis patients were treated annually with ivermectin and their Onchocerca volvulus antigen (OvAg) specific IgG and cellular responses were investigated before and at 30 years post initial ivermectin treatment (30yPT). Repeated annual ivermectin treatments eliminated persisting O. volvulus microfilariae (mf) from the skin of patients and abrogated patent infections. The OvAg-specific IgG1 and IgG4 responses were diminished at 30yPT to the levels observed in endemic controls. Prior to starting ivermectin treatment, OvAg-induced cellular productions of IL-10, IFN-γ, CCL13, CCL17 and CCL18 were low in patients, and at 30yPT, cellular cytokine and chemokine responses increased to the levels observed in endemic controls. In contrast, mitogen(PHA)- induced IL-10, IFN-γ, CCL17 and CCL18 cellular production was diminished. This divergent response profile thus revealed increased parasite antigen-specific but reduced polyclonal cellular responsiveness in patients. The transmission of O. volvulus continued at the patients' location in the Mô river basin in central Togo 2018 and 2019 when 0.58% and 0.45%, respectively, of Simulium damnosum s.l. vector blackflies carried O. volvulus infections. CONCLUSIONS/SIGNIFICANCE Repeated annual ivermectin treatment of onchocerciasis patients durably inhibited their patent O. volvulus infections despite ongoing low-level parasite transmission in the study area. Repeated MDA with ivermectin affects the expression of immunity in patients. O. volvulus parasite-specific antibody levels diminished to levels seen in infection-free endemic controls. With low antibody levels, antibody-dependent cellular cytotoxic responses against tissue-dwelling O. volvulus larvae will weaken. O. volvulus antigen inducible cytokine and chemokine production increased in treated mf-negative patients, while their innate responsiveness to mitogen declined. Such lower innate responsiveness in elderly patients could contribute to reduced adaptive immune responses to parasite infections and vaccines. On the other hand, increased specific cellular chemokine responses in mf-negative onchocerciasis patients could reflect effector cell activation against tissue invasive larval stages of O. volvulus. The annual Simulium damnosum s.l. biting rate observed in the Mô river basin was similar to levels prior to initiation of MDA with ivermectin, and the positive rtPCR results reported here confirm ongoing O. volvulus transmission.
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Affiliation(s)
- Saskia I. Johanns
- University Clinics Tübingen, Institute for Tropical Medicine, Eberhard-Karls University, Tübingen, Germany
| | - Richard G. Gantin
- Onchocerciasis Reference Laboratory, Institut National d’Hygiene, Centre Hospitalier Regional, Sokode, Togo
| | - Bawoubadi Wangala
- Onchocerciasis Reference Laboratory, Institut National d’Hygiene, Centre Hospitalier Regional, Sokode, Togo
| | | | | | - Meba Banla
- Centre Hospitalier Universitaire, Université de Lomé, Lomé, Togo
| | | | - Adrian JF Luty
- Université de Paris, Institut de Recherche pour le Développement, Paris, France
| | - Hartwig Schulz-Key
- University Clinics Tübingen, Institute for Tropical Medicine, Eberhard-Karls University, Tübingen, Germany
| | - Carsten Köhler
- University Clinics Tübingen, Institute for Tropical Medicine, Eberhard-Karls University, Tübingen, Germany
| | - Peter T. Soboslay
- University Clinics Tübingen, Institute for Tropical Medicine, Eberhard-Karls University, Tübingen, Germany
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Vieri MK, Hotterbeekx A, Raimon S, Abd-Elfarag G, Mukendi D, Carter JY, Kumar-Singh S, Colebunders R. Cytokines and Onchocerciasis-Associated Epilepsy, a Pilot Study and Review of the Literature. Pathogens 2021; 10:310. [PMID: 33799934 PMCID: PMC7998365 DOI: 10.3390/pathogens10030310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 12/03/2022] Open
Abstract
Neuro-inflammation may be associated with onchocerciasis-associated epilepsy (OAE) but thus far very few immunological studies have been performed in children with this form of epilepsy. In a pilot study we measured the cytokine levels in cerebrospinal fluid (CSF) of persons with OAE from Maridi, South Sudan, and from Mosango, Democratic Republic of the Congo (DRC) and compared these results with cytokine levels in CSF of Africans with non-OAE neurological disorders, and Europeans with epilepsy or other neurological conditions. The following cytokines were studied: IL-6, TNF-α, IL1-β, IL-5, IL-4, IL-13, CCL3 (Mip-1α), VEGF-C, VCAM-1. No cytokine was significantly associated with OAE, although a lower IL-13 level was observed in CSF of persons with OAE compared to African controls. Observed cytokine profiles and neuro-inflammation may be the consequence of long-standing epilepsy, concomitant infections and malnutrition. Ideally cytokine levels should be determined in a prospective study in serum and CSF collected at the time of onset of the first seizures.
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Affiliation(s)
| | - An Hotterbeekx
- Global Health Institute, University of Antwerp, 2610 Antwerp, Belgium;
- Molecular Pathology Group, Laboratory of Cell Biology & Histology, Faculty of Medical and Health Sciences, University of Antwerp, 20610 Antwerp, Belgium;
| | | | - Gasim Abd-Elfarag
- Academic Medical Center, Global Child Health Group, Department of Paediatrics and Department of Global Health, University of Amsterdam, 1105 Amsterdam, The Netherlands;
- Amsterdam Institute for Global Health and Development, 1105 Amsterdam, The Netherlands
| | - Deby Mukendi
- Institut National de Recherche Biomédicale, Av. De la Démocratie N°5345, Kinshasa 1197, Congo;
- Centre Neuro-Psycho Pathologique, Universite’ de Kinshasa, Kinshasa P.O. Box 127, Congo
| | - Jane Y. Carter
- Amref International Headquarters, Nairobi P.O. Box 27691−00506, Kenya;
| | - Samir Kumar-Singh
- Molecular Pathology Group, Laboratory of Cell Biology & Histology, Faculty of Medical and Health Sciences, University of Antwerp, 20610 Antwerp, Belgium;
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3
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Wangala B, Gantin RG, Voßberg PS, Vovor A, Poutouli WP, Komlan K, Banla M, Köhler C, Soboslay PT. Inflammatory and regulatory CCL and CXCL chemokine and cytokine cellular responses in patients with patent Mansonella perstans filariasis. Clin Exp Immunol 2019; 196:111-122. [PMID: 30561772 DOI: 10.1111/cei.13251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2018] [Indexed: 12/17/2022] Open
Abstract
Mansonella perstans (Mp) filariasis is present in large populations in sub-Saharan Africa, and to what extent patent Mp infection modulates the expression of immunity in patients, notably their cellular cytokine and chemokine response profile, remains not well known. We studied the spontaneous and inducible cellular production of chemokines (C-X-C motif) ligand 9 (CXCL9) [monokine induced by interferon (IFN)-γ (MIG)], CXCL-10 [inducible protein (IP)-10], chemokine (C-C motif) ligand 24 (CCL24) (eotaxin-2), CCL22 [macrophage-derived chemokine (MDC)], CCL13 [monocyte chemotactic protein-4 (MCP-4)], CCL18 [pulmonary and activation-regulated chemokine (PARC)], CCL17 [thymus- and activation-regulated chemokine (TARC)] and interleukin (IL)-27 in mansonelliasis patients (Mp-PAT) and mansonelliasis-free controls (CTRL). Freshly isolated peripheral mononuclear blood cells (PBMC) were stimulated with helminth, protozoan and bacterial antigens and mitogen [phytohaemagglutinin (PHA)]. PBMC from Mp-PAT produced spontaneously (without antigen stimulation) significantly higher levels of eotaxin-2, IL-27, IL-8, MCP-4 and MDC than cells from CTRL, while IFN-γ-IP-10 was lower in Mp-PAT. Helminth antigens activated IL-27 and MCP-4 only in CTRL, while Ascaris antigen, Onchocerca antigen, Schistosoma antigen, Entamoeba antigen, Streptococcus antigen, Mycobacteria antigen and PHA stimulated MIG release in CTRL and Mp-PAT. Notably, Entamoeba antigen and PHA strongly depressed (P < 0·0001) eotaxin-2 (CCL24) production in both study groups. Multiple regression analyses disclosed in Mp-PAT and CTRL dissimilar cellular chemokine and cytokine production levels being higher in Mp-PAT for CCL24, IL-27, IL-8, MCP-4, MDC and PARC (for all P < 0·0001), at baseline (P < 0·0001), in response to Entamoeba histolytica strain HM1 antigen (EhAg) (P < 0·0001), Onchocerca volvulus adult worm-derived antigen (OvAg) (P = 0·005), PHA (P < 0·0001) and purified protein derivative (PPD) (P < 0·0001) stimulation. In Mp-PAT with hookworm co-infection, the cellular chemokine production of CXCL10 (IP-10) was diminished. In summary, the chemokine and cytokine responses in Mp-PAT were in general not depressed, PBMC from Mp-PAT produced spontaneously and selectively inducible inflammatory and regulatory chemokines and cytokines at higher levels than CTRL and such diverse and distinctive reactivity supports that patent M. perstans infection will not polarize innate and adaptive cellular immune responsiveness in patients.
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Affiliation(s)
- B Wangala
- National Institute of Hygiene, Onchocerciasis Reference Laboratory, Sokodé, Togo
| | - R G Gantin
- National Institute of Hygiene, Onchocerciasis Reference Laboratory, Sokodé, Togo.,Institute for Tropical Medicine, University Clinics of Tübingen, Tübingen, Germany
| | - P S Voßberg
- National Institute of Hygiene, Onchocerciasis Reference Laboratory, Sokodé, Togo.,Institute for Tropical Medicine, University Clinics of Tübingen, Tübingen, Germany
| | - A Vovor
- Centre Hospitalier Universitaire Sylvanus Olympio, Laboratory for Hematology, Université de Lomé, Togo
| | - W P Poutouli
- Faculté de Sciences, Université de Lomé, Lomé, Togo
| | - K Komlan
- National Institute of Hygiene, Onchocerciasis Reference Laboratory, Sokodé, Togo
| | - M Banla
- National Institute of Hygiene, Onchocerciasis Reference Laboratory, Sokodé, Togo.,Centre Hospitalier Universitaire Campus, Université de Lomé, Togo
| | - C Köhler
- Institute for Tropical Medicine, University Clinics of Tübingen, Tübingen, Germany
| | - P T Soboslay
- National Institute of Hygiene, Onchocerciasis Reference Laboratory, Sokodé, Togo.,Institute for Tropical Medicine, University Clinics of Tübingen, Tübingen, Germany
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Mansonella perstans, Onchocerca volvulus and Strongyloides stercoralis infections in rural populations in central and southern Togo. Parasite Epidemiol Control 2018; 3:77-87. [PMID: 29774301 PMCID: PMC5952658 DOI: 10.1016/j.parepi.2018.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 03/12/2018] [Accepted: 03/12/2018] [Indexed: 11/22/2022] Open
Abstract
Background Mansonella perstans, Onchocerca volvulus and Strongyloides stercoralis are widespread helminth parasites in the tropics. Their distribution remains difficult to determine as it may change during national disease control programs and with regional mass drug administration (MDA). Epidemiological surveys are of importance to evaluate the geographical distribution of these helminth parasites and the diseases they may cause, however, up to date epidemiological evaluations on M. perstans and S. stercoralis in Togo are rare, and surveys on O. volvulus are important especially under the aspect of MDA of ivermectin which is performed since decades. Methods Dry blood samples (n = 924) were collected from rural populations in the Régions Central and Plateaux in Togo, and analyzed by parasite-specific real-time PCR and ELISA techniques. Results Dry blood samples from 733 persons where investigated by real-time PCR tested for DNA of blood-circulating M. perstans microfilaria, and a prevalence of 14.9% was detected. Distinct differences were observed between genders, positivity was higher in men increasing with age, and prevalence was highest in the Région Plateaux in Togo. IgG4 responses to O. volvulus antigen (OvAg) were studied in 924 persons and 59% were found positive. The distribution of parasite infestation between age and gender groups was higher in men increasing with age, and regional differences were detected being highest in the Région Plateaux. The diagnostic approach disclosed 64,5% positive IgG4 responses to S. stercoralis infective third-stage larvae-specific antigen (SsL3Ag) in the surveyed regions. Antigen cross reactivity of SsL3Ag with parasite co-infections may limit the calculated prevalence. Singly IgG4 positive for SsL3Ag were 13.9%, doubly positive for OvAg and SsL3Ag were 35.5% and triply positive for M. perstans, O. volvulus and S. stercoralis were 9.9%. Conclusions Mansonelliasis, onchocerciasis and strongyloidiasis remain prevalent in the surveyed regions, yet with local differences. Our observations suggest that transmission of M. perstans, O. volvulus and S. stercoralis may be ongoing. The degree of positive test results in the examined rural communities advocate for the continuation of MDA with ivermectin and albendazole, and further investigations should address the intensity of transmission of these parasites.
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Komlan K, Vossberg PS, Gantin RG, Solim T, Korbmacher F, Banla M, Padjoudoum K, Karabou P, Köhler C, Soboslay PT. Onchocerca volvulus infection and serological prevalence, ocular onchocerciasis and parasite transmission in northern and central Togo after decades of Simulium damnosum s.l. vector control and mass drug administration of ivermectin. PLoS Negl Trop Dis 2018; 12:e0006312. [PMID: 29494606 PMCID: PMC5849363 DOI: 10.1371/journal.pntd.0006312] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 03/13/2018] [Accepted: 02/12/2018] [Indexed: 11/18/2022] Open
Abstract
Background Mass drug administration (MDA) of ivermectin has become the main intervention to control onchocerciasis or “river blindness”. In Togo, after many years of MDA, Onchocerca volvulus infection has declined dramatically, and elimination appears achievable, but in certain river basins the current situation remains unknown. We have conducted parasitological, serological, ophthalmological, and entomological assessments in northern and central Togo within the river basins of Ôti, Kéran and Mô. Methodology/Principal findings Examinations were completed in 1,455 participants from 11 onchocerciasis sentinel villages, and O. volvulus transmission by Simulium damnosum sensu lato (s.l.) was evaluated. In children (aged 1–10 years), the prevalence of microfilariae (Mf) was 2.3% and in adults it ranged from 5.1 to 13.3%. Positive IgG4 responses to O. volvulus adult (crude) worm antigen (OvAg) and the recombinant Ov16 antigen were in all-ages 48.7% and 34.4%, and 29.1% and 14.9% in children, respectively. In the river basin villages of Kéran, Mô and Ôti, the IgG4 seroprevalences to OvAg in children were 51.7%, 23.5% and 12.7%, respectively, and to the Ov16 antigen 33.3% (Kéran) and 5.2% (Ôti). Onchocerciasis ocular lesions (punctate keratitis, evolving iridocyclitis and chorioretinitis) were observed in children and young adults. O. volvulus-specific DNA (Ov150) was detected by poolscreen in vector samples collected from Tchitchira/Kéran(22.8%), Bouzalo/Mô(11.3%), Baghan/Mô(2.9%) and Pancerys/Ôti(4.9%); prevalences of O. volvulus infection in S. damnosum s.l. were, respectively, 1%, 0.5%, 0.1% and 0.2%. Conclusions/Significance In the northern and central river basins in Togo, interruption of O. volvulus transmission has not yet been attained. Patent O. volvulus infections, positive antibody responses, progressive ocular onchocerciasis were diagnosed, and parasite transmission by S. damnosum s.l. occurred close to the survey locations. Future interventions may require approaches selectively targeted to non-complying endemic populations, to the seasonality of parasite transmission and national onchocerciasis control programs should harmonize cross-border MDA as a coordinated intervention. Mass drug administration (MDA) with ivermectin has become the main tool in the efforts to control and eliminate onchocerciasis (“river blindness”). In some areas, and after many years of MDA, levels of Onchocerca volvulus infection (the causative parasite) have declined greatly, and elimination appears achievable. In certain river basins of northern and central Togo, the present epidemiological situation remains unknown. The guidelines of the World Health Organization recommend that before ivermectin MDA can be stopped, interruption of O. volvulus transmission must be demonstrated. To this end, parasitological, serological, ophthalmological, and entomological assessments were conducted in the Ôti, Kéran and Mô river basins. O. volvulus infections and positive antibody responses were found in children aged ≤10 years and adults. Progressive ocular onchocerciasis was diagnosed, and parasite transmission by Simulium damnosum s.l. (the disease vector) occurred close to the survey locations. Thus, O. volvulus transmission continues in northern and central Togo, and future interventions may require approaches selectively adapted to seasonal migration of non-complying endemic populations in and out of the river basins, as well as seasonal transmission by the vectors. National control programmes should harmonize cross-border MDA as a coordinated intervention.
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Affiliation(s)
- Kossi Komlan
- Onchocerciasis Reference Laboratory, National Institute of Hygiene, Sokodé, Togo
| | - Patrick S. Vossberg
- Institute for Tropical Medicine, University of Tübingen, University Clinics, Tübingen, Germany
| | - Richard G. Gantin
- Onchocerciasis Reference Laboratory, National Institute of Hygiene, Sokodé, Togo
- Institute for Tropical Medicine, University of Tübingen, University Clinics, Tübingen, Germany
| | - Tchalim Solim
- Centre Hospitalier Universitaire Campus, Université de Lomé, Lomé, Togo
| | - Francois Korbmacher
- Institute for Tropical Medicine, University of Tübingen, University Clinics, Tübingen, Germany
| | - Méba Banla
- Centre Hospitalier Universitaire Campus, Université de Lomé, Lomé, Togo
| | | | | | - Carsten Köhler
- Institute for Tropical Medicine, University of Tübingen, University Clinics, Tübingen, Germany
| | - Peter T. Soboslay
- Onchocerciasis Reference Laboratory, National Institute of Hygiene, Sokodé, Togo
- Institute for Tropical Medicine, University of Tübingen, University Clinics, Tübingen, Germany
- * E-mail:
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Cellular cytokine and chemokine responses to parasite antigens and fungus and mite allergens in children co-infected with helminthes and protozoa parasites. JOURNAL OF INFLAMMATION-LONDON 2015; 12:5. [PMID: 25698903 PMCID: PMC4334608 DOI: 10.1186/s12950-015-0050-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 01/04/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND In sub-Saharan Africa poly-parasite infections are frequently observed in children, and with poly-parasitism modulating immune mechanisms, mediated by cytokines and chemokines, are required to prevent overwhelming inflammation and host tissue damage. We analyzed in children co-infected with helminthes and protozoan parasites their cellular production of regulatory and pro-inflammatory cytokines and chemokines in response to parasite antigens and allergens. METHODS Intestinal and intravascular parasite infections were detected in stool and urines samples. The in vitro cellular cytokine and chemokine responses of peripheral blood mononuclear cells (PBMC) to parasite antigens and allergens were analysed in children (n = 87) with single and poly-parasite infection, and skin prick test reactivity to fungus and mite allergens was determined in singly and poly-parasitized children (n = 509). RESULTS In children Entamoeba histolytica/dispar (62%), Necator americanus (31%), Schistosoma haematobium (28%), S. mansoni (21%), Hymenolepis nana (2%) and Strongyloides stercoralis (1%) were diagnosed. Singly infected were 37%, 47% were positive for 2 or more parasite species and 16% were infection-free. When PBMC were stimulated in vitro with parasite antigens and allergens, regulatory-type cytokine IL-27 and alarmin-type IL-33 enhanced with poly-parasite infections whilst IL-10 and pro-inflammatory MIP3-α/CCL20 and MIG/CXCL9 were produced in similar amounts in singly or poly-parasitized children. The co-stimulation in vitro of PBMC with mite allergens and Ascaris lumbricoides antigens depressed the allergen-induced pro-inflammatory IL-27, IL-33 and MIP3-α/CCL20 responses while regulatory IL-10 remained unaffected. Post albendazole and/or praziquantel treatment, the cellular release of IL-10, IL-33, MIP3-α/CCL20 and MIG/CXCL9 lessened significantly in all children infection groups. Skin prick test (SPT) reactivity to fungus Aspergillus fumigatus and mite Dermatophagoides pteronyssinus allergens was investigated in 509 children, and positive SPT responses were found in 23% of the infection-free, and in 47%, 53% and 56% of the singly, doubly and poly-parasite infected, respectively. CONCLUSIONS In children co-infected with helminthes and protozoan parasites a mixed cellular response profile of both inflammatory and regulatory chemokines and cytokines was stimulated by individual antigens and allergens, pro-inflammatory cytokines and chemokines enhanced with an increasing number of parasite infections, and in poly-parasitized children skin prick test reactivity to allergens extracts was highest.
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The adulticide effect of a combination of doxycycline and ivermectin in Dirofilaria immitis-experimentally infected dogs is associated with reduction in local T regulatory cell populations. Vet Parasitol 2014; 205:208-10. [DOI: 10.1016/j.vetpar.2014.06.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 06/09/2014] [Accepted: 06/10/2014] [Indexed: 01/11/2023]
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Arndts K, Specht S, Debrah AY, Tamarozzi F, Klarmann Schulz U, Mand S, Batsa L, Kwarteng A, Taylor M, Adjei O, Martin C, Layland LE, Hoerauf A. Immunoepidemiological profiling of onchocerciasis patients reveals associations with microfilaria loads and ivermectin intake on both individual and community levels. PLoS Negl Trop Dis 2014; 8:e2679. [PMID: 24587458 PMCID: PMC3930501 DOI: 10.1371/journal.pntd.0002679] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 12/19/2013] [Indexed: 11/19/2022] Open
Abstract
Mass drug administration (MDA) programmes against Onchocerca volvulus use ivermectin (IVM) which targets microfilariae (MF), the worm's offspring. Most infected individuals are hyporesponsive and present regulated immune responses despite high parasite burden. Recently, with MDA programmes, the existence of amicrofilaridermic (a-MF) individuals has become apparent but little is known about their immune responses. Within this immunoepidemiological study, we compared parasitology, pathology and immune profiles in infection-free volunteers and infected individuals that were MF(+) or a-MF. The latter stemmed from villages in either Central or Ashanti regions of Ghana which, at the time of the study, had received up to eight or only one round of MDA respectively. Interestingly, a-MF patients had fewer nodules and decreased IL-10 responses to all tested stimuli. On the other hand, this patient group displayed contrary IL-5 profiles following in vitro stimulation or in plasma and the dampened response in the latter correlated to reduced eosinophils and associated factors but elevated neutrophils. Furthermore, multivariable regression analysis with covariates MF, IVM or the region (Central vs. Ashanti) revealed that immune responses were associated with different covariates: whereas O. volvulus-specific IL-5 responses were primarily associated with MF, IL-10 secretion had a negative correlation with times of individual IVM therapy (IIT). All plasma parameters (eosinophil cationic protein, IL-5, eosinophils and neutrophils) were highly associated with MF. With regards to IL-17 secretion, although no differences were observed between the groups to filarial-specific or bystander stimuli, these responses were highly associated with the region. These data indicate that immune responses are affected by both, IIT and the rounds of IVM MDA within the community. Consequently, it appears that a lowered infection pressure due to IVM MDA may affect the immune profile of community members even if they have not regularly participated in the programmes.
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Affiliation(s)
- Kathrin Arndts
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
| | - Sabine Specht
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
| | - Alexander Y. Debrah
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
- Faculty of Allied Health Sciences and School of Medical Sciences of Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francesca Tamarozzi
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Ute Klarmann Schulz
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
- Institute of Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Bonn, Germany
| | - Sabine Mand
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
| | - Linda Batsa
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Alexander Kwarteng
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
| | - Mark Taylor
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Ohene Adjei
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
- Faculty of Allied Health Sciences and School of Medical Sciences of Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Coralie Martin
- UMR 7245 MCAM MNHN CNRS, Museum National d'Histoire Naturelle, Paris, France
| | - Laura E. Layland
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
| | - Achim Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, Bonn, Germany
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Abstract
Lymphatic filariasis and onchocerciasis are diseases of severe morbidity that affect the poorest of the poor in the world. The diseases are caused by filarial nematodes that are transmitted by mosquitoes or biting blackflies and are endemic to more than 80 countries worldwide, mainly in the tropics and sub-tropics. Current control programs aim to eliminate the diseases by distributing antifilarial drugs. However, the primary effect of the drugs is to kill the microfilariae in the blood or skin, thus preventing uptake by the obligate insect vector. Since the adult worms live 10 years or longer, drug distribution requires many years of treatment, which is a heavy burden on the burgeoning health care systems. Sub-optimal response, possible resistance and inadequate population coverage lessen the chances for successful elimination in all endemic areas. The search for new drugs that could enhance elimination by permanently sterilizing or killing adult worms has identified the Wolbachia intracellular bacteria of filarial nematodes as a target. Depleting the obligate endosymbionts from the worms with doxycycline or rifampicin causes a permanent block in oogenesis, embryogenesis and development, and in slow death of the adult worms. These two antibiotics are suitable for individual drug administration, but caveats exist for their inclusion in broader drug administration programs. Here we review Wolbachia as targets for antifilarial drug discovery and highlight the natural product corallopyronin A as an effective drug that is currently being developed specifically for use against filarial nematodes.
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Relationship between pro-and anti-inflammatory cytokines profiles and some haematological parameters in some Cameroonians infected with Onchocerca volvulus. ASIAN PAC J TROP MED 2012; 5:713-7. [PMID: 22805723 DOI: 10.1016/s1995-7645(12)60112-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 05/15/2012] [Accepted: 07/15/2012] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To investigate the relationship between white blood cells, lymphocytes, monocytes, and Interleukin(IL)-1 α, IL-6, IL-10 and IL-13 production in Cameroonians with Onchocerca volvulus (O. volvulus) infection. METHODS A total of 357 individuals from five sites at Upper Sanga, Lekkie, Nyong, Kelle and Sanaga Maritime divisions and located along Sanaga valley of Sanaga River in South Cameroon were screened for the presence of O. volvulus using the skin snip. The levels of the interleukins (IL-) namely IL-1 α, IL-6, IL-10 and IL-13 were evaluated using enzyme linked immunoabsorbent assay techniques. Haematological parameters were evaluated using standard laboratory automated analyser. RESULTS O. volvulus microfilariae were found in skin tissues of 85 (23.81%) volunteers. The mean interleukin (IL-) levels in the O. volvulus control and infected individuals were IL-1 α in (1.65 ± 0.79 and 2.31 ± 0.5) pg/mL; IL-6 in (278.36 ± 55.34 and 201.74 ± 34.56) pg/mL; IL-10 in (436.03 ± 208.64 and 418.49 ± 147.88) pg/mL and IL-13 in (8.98 ± 7.28 and 38.06 ± 11.92) pg/mL. There was a negative correlation between monocyte counts and IL-10 concentration in positive individuals. A negative correlation of IL-6 with white blood cell and lymphocyte counts was observed (P<0.05). The level of IL-13 was positively associated with microfilarial load (P<0.05). CONCLUSIONS We observed depressed IL-6 and raised IL-13 concentrations in the sera of individuals with onchocerciasis which implicate these interleukins in the immunological responses of the disease. Therefore, these IL-6 and IL-13 are associated with O. volvulus infection among Cameroonians.
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Paradigm lost: how parasite control may alter pattern and process in human helminthiases. Trends Parasitol 2012; 28:161-71. [DOI: 10.1016/j.pt.2012.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Revised: 02/07/2012] [Accepted: 02/07/2012] [Indexed: 11/22/2022]
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Chemokines and cytokines in patients with an occult Onchocerca volvulus infection. Microbes Infect 2011; 14:438-46. [PMID: 22202179 DOI: 10.1016/j.micinf.2011.12.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 11/26/2011] [Accepted: 12/05/2011] [Indexed: 11/24/2022]
Abstract
Repeated ivermectin treatment will clear microfilaria (Mf) of Onchocerca volvulus from skin and eyes of onchocerciasis patients while adult filaria remains alive and reproductive, and such occult O. volvulus infection may persist for years. To investigate the effect of residual adult filaria on the immune response profile, chemokines and cytokines were quantified 1) in onchocerciasis patients who developed an occult O. volvulus infection (Mf-negative) due to repeated ivermectin treatments, 2) patients who became Mf-negative without ivermectin treatments due to missing re-infection, and 3) endemic and non-endemic O. volvulus Mf-negative controls. With occult O. volvulus infection, serum levels of pro-inflammatory chemokines MCP-1/CCL2, MIP-1α/CCL3, MIP-1β/CCL4, MPIF-1/CCL23 and CXCL8/IL-8 enhanced and approached higher concentrations as determined in infection-free controls, whilst regulatory and Th2-type cytokines and chemokines MCP-4/CCL13, MIP-1δ/CCL15, TARC/CCL17 and IL-13 lessened. Levels of Eotaxin-2/CCL24, MCP-3/CCL7 and BCA-1/CXCL13 remained unchanged. At 3 days post-initial ivermectin treatment, MCP-1/CCL2, MCP-4/CCL13, MPIF-1/CCL23 and Eotaxin-2/CCL24 were strongly enhanced, suggesting that monocytes and eosinophil granulocytes have mediated Mf clearance. In summary, with occult and expiring O. volvulus infections the serum levels of inflammatory chemokines enhanced over time while regulatory and Th2-type-promoting cytokines and chemokines lessened; these changes may reflect a decreasing effector cell activation against Mf of O. volvulus, and in parallel, an enhancing inflammatory immune responsiveness.
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Kocherscheidt L, Agossou A, Gantin RG, Hamm DM, Banla M, Soboslay PT. Cytokine and chemokine responses in adults, newborns and children exposed to Entamoeba histolytica/dispar, Onchocerca volvulus and Plasmodium falciparum. Pediatr Allergy Immunol 2010; 21:e756-63. [PMID: 20408971 DOI: 10.1111/j.1399-3038.2010.01048.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Cytokine and chemokine response profiles were studied in newborns, 10-yr-old children and post partum mothers. All study groups were repeatedly exposed to Entamoeba histolytica, Onchocerca volvulus and Plasmodium falciparum infections as indicated by their Immunoglobulin (IgG) responses to parasite-specific antigens. As key indicators for regulatory and pro-inflammatory cytokine and chemokine responses, Interferon (IFN)gamma and regulatory IL-10 were investigated, along with the chemokines MIP-1 alpha/CCL3, MIP-1 beta/CCL4, MDC/CCL22 and TARC/CCL17. Entamoeba histolytica antigens (EhAg) strongly activated pro-inflammatory MIP-1 alpha/CCL3 and MIP-1 beta/CCL4 responses of similar magnitude in mothers, children and neonates alike. Plasmodium falciparum antigens (PfAg) enhanced MIP-1 alpha/CCL3, MIP-1 beta/CCL4 and MDC/CCL22 production in neonates, but did not trigger these chemokines in mothers or 10-yr-old children. Onchocerca volvulus antigens (OvAg) activated IFN-gamma and TARC/CCL17 production in mothers but not in neonates and children. Crude IL-10 production [i.e., without subtracting spontaneous cellular release (baseline)] was highest in mothers and somewhat lower in neonates, while the lowest IL-10 amounts of all were released by peripheral blood mononuclear cells from 10-yr-old children. In summary, strong inflammatory chemokine responses to plasmodia and ameba antigens in newborns and 10-yr-old children suggest that adequately balanced immune regulatory mechanisms may not have developed yet in these age groups and that repeated exposure to parasite infections and immune maturation during childhood is required to generate similar cytokine and chemokine profiles as in adults.
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Affiliation(s)
- Lars Kocherscheidt
- Institute for Tropical Medicine, University Clinics of Tübingen, Wilhelmstr., Tübingen, Germany
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Soboslay PT, Gantin RG, Banla M, Karabou PK, Agossou A, Douti JK, Djassoa G, Heuschkel C, Schulz-Key H, Hamm DM, Stingl P. Applied field research for comprehensive helminth infection control. Wien Klin Wochenschr 2010; 122 Suppl 1:27-30. [DOI: 10.1007/s00508-010-1332-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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