title: Wolbachia endobacteria depletion by doxycycline as antifilarial therapy has macrofilaricidal activity in onchocerciasis: a randomized placebo-controlled study.
abstract: In a randomized, placebo-controlled trial in Ghana, 67 onchocerciasis patients received 200-mg/day doxycycline for 4-6 weeks, followed by ivermectin (IVM) after 6 months. After 6-27 months, efficacy was evaluated by onchocercoma histology, PCR and microfilariae determination. Administration of doxycycline resulted in endobacteria depletion and female worm sterilization. The 6-week treatment was macrofilaricidal, with >60% of the female worms found dead, despite the presence of new, Wolbachia-containing worms acquired after the administration of doxycycline. Doxycycline may be developed as second-line drug for onchocerciasis, to be administered in areas without transmission, in foci with IVM resistance and in areas with Loa co-infections.
authors.affiliation: Institute for Medical Microbiology, Immunology and Parasitology, University Clinic, Bonn, Sigmund-Freud-Strasse 25, Bonn, Germany. hoerauf@parasit.meb.uni-bonn.de
authors.forename: Achim
authors.initials: A
authors.lastname: Hoerauf
authors.forename: Sabine
authors.initials: S
authors.lastname: Specht
authors.forename: Marcelle
authors.initials: M
authors.lastname: Büttner
authors.forename: Kenneth
authors.initials: K
authors.lastname: Pfarr
authors.forename: Sabine
authors.initials: S
authors.lastname: Mand
authors.forename: Rolf
authors.initials: R
authors.lastname: Fimmers
authors.forename: Yeboah
authors.initials: Y
authors.lastname: Marfo-Debrekyei
authors.forename: Peter
authors.initials: P
authors.lastname: Konadu
authors.forename: Alexander Yaw
authors.initials: AY
authors.lastname: Debrah
authors.forename: Claudio
authors.initials: C
authors.lastname: Bandi
authors.forename: Norbert
authors.initials: N
authors.lastname: Brattig
authors.forename: Anna
authors.initials: A
authors.lastname: Albers
authors.forename: John
authors.initials: J
authors.lastname: Larbi
authors.forename: Linda
authors.initials: L
authors.lastname: Batsa
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Taylor
authors.forename: Ohene
authors.initials: O
authors.lastname: Adjei
authors.forename: Dietrich W
authors.initials: DW
authors.lastname: Büttner
mesh_terms: D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004318:Doxycycline / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005369:Filaricides / Q000627:therapeutic use*; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017181:Onchocerca volvulus / Q000187:drug effects* / Q000382:microbiology; D009855:Onchocerciasis / Q000188:drug therapy* / Q000469:parasitology; D020577:Wolbachia / Q000187:drug effects*
chemical_list: D000900:Anti-Bacterial Agents; D005369:Filaricides; D007559:Ivermectin; D004318:Doxycycline