Microfilarial clearance in loiasis involves elevation of Th1 and Th2 products and emergence of a specific pattern of T-cell populations.
Diethylcarbamazine (DEC) induced clearance of microfilaraemia in loiasis is associated with severe posttreatment reactions. To define the switch from hypo- to hyper-responsiveness associated with DEC treatment, phenotypic alterations of T-lymphocytes, characterized by flow cytometry, and cytokines, determined by enzyme linked immunosorbent assay, were monitored in a microfilaraemic patient. In contrast to reports on onchocerciasis and lymphatic filariases, no elevation of interleukin (IL)-6 and tumour necrosis factor (TNF)-alpha was observed. The most severe side effects coincided with an elevation of interferon (IFN)-gamma on day 3, followed by IL-10, transforming growth factor (TGF)-beta 2 and macrophage inflammatory protein-1 alpha (MIP-1 alpha) peaking on day 5. Phenotypically, T-cell activation markers CD38, CD54 and CD25 were significantly expressed before treatment, with high CD38 expression still existing one year after clearance of microfilaraemia. Treatment-related increases were observed with anti-CD122, anti-HLA-DR and anti-CD69. CD28 was expressed before treatment on almost 100% of CD4+ and CD8+ T cells and dropped to 20% by day 5, reaching again baseline levels on day 21. Furthermore, there emerged 20% TCR alpha beta+/CD3+ T cells and 10% anti-beta V5(c)+ T cells, altogether indicating a specific pattern of T-helper (Th) 1 and Th2 cytokines as well as expansion of certain pauciclonal T-cell populations in response to microfilarial clearance.
Winkler
S
S
Department of Infectious Diseases, University of Vienna, Austria.
Paiha
S
S
Winkler
H
H
Graninger
W
W
Marberger
M
M
Steiner
G E
GE
D000328:Adult; D000818:Animals; D016207:Cytokines / Q000097:blood; D004049:Diethylcarbamazine / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005369:Filaricides / Q000009:adverse effects / Q000627:therapeutic use; D006790:Host-Parasite Interactions / Q000276:immunology; D006801:Humans; D008117:Loa / Q000187:drug effects / Q000276:immunology / Q000302:isolation & purification; D008118:Loiasis / Q000188:drug therapy / Q000276:immunology* / Q000469:parasitology*; D008213:Lymphocyte Activation; D008842:Microfilariae / Q000187:drug effects / Q000276:immunology / Q000302:isolation & purification; D018417:Th1 Cells / Q000276:immunology*; D018418:Th2 Cells / Q000276:immunology*
D016207:Cytokines; D005369:Filaricides; D004049:Diethylcarbamazine