title: C-reactive protein and interleukin-6 are elevated in onchocerciasis patients after ivermectin treatment.
abstract: Ivermectin treatment of onchocerciasis can induce adverse reactions. Mechanisms underlying these reactions are poorly understood but may include activation of neutrophils. This study investigated the acute-phase response in onchocerciasis patients during 2 days after ivermectin treatment. The acute-phase protein C-reactive protein (CRP) and cytokines that mediate the acute-phase response (tumor necrosis factor-alpha [TNF alpha] and interleukin-6 [IL-6]) were measured in 144 skin snip-positive onchocerciasis patients and 12 skin snip-negative controls who received one dose of ivermectin (150 micrograms/kg). No elevated TNF alpha levels were found, but IL-6 and CRP were elevated in 25.7% and 50.7% of the patients, respectively, after ivermectin treatment. Most patients (89.2%) with raised IL-6 also had raised CRP. Such increases were not observed in controls and in patients were correlated with adverse reactions and microfilarial densities. These findings suggest a possible role of the acute-phase response in microfilarial destruction following ivermectin treatment.
authors.affiliation: Department of Ophthalmo-Immunology, Netherlands Ophthalmic Research Institute, Amsterdam.
authors.forename: F L
authors.initials: FL
authors.lastname: Njoo
authors.forename: C E
authors.initials: CE
authors.lastname: Hack
authors.forename: J
authors.initials: J
authors.lastname: Oosting
authors.forename: L
authors.initials: L
authors.lastname: Luyendijk
authors.forename: J S
authors.initials: JS
authors.lastname: Stilma
authors.forename: A
authors.initials: A
authors.lastname: Kijlstra
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis* / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D005779:Immunodiffusion; D015850:Interleukin-6 / Q000097:blood*; D007559:Ivermectin / Q000009:adverse effects / Q000627:therapeutic use*; D009855:Onchocerciasis / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D012016:Reference Values; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000378:metabolism
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D007559:Ivermectin; D002097:C-Reactive Protein