Wolbachia endobacteria depletion by doxycycline as antifilarial therapy has macrofilaricidal activity in onchocerciasis: a randomized placebo-controlled study.
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.
Hoerauf
Achim
A
Institute for Medical Microbiology, Immunology and Parasitology, University Clinic, Bonn, Sigmund-Freud-Strasse 25, Bonn, Germany. hoerauf@parasit.meb.uni-bonn.de
Specht
Sabine
S
Büttner
Marcelle
M
Pfarr
Kenneth
K
Mand
Sabine
S
Fimmers
Rolf
R
Marfo-Debrekyei
Yeboah
Y
Konadu
Peter
P
Debrah
Alexander Yaw
AY
Bandi
Claudio
C
Brattig
Norbert
N
Albers
Anna
A
Larbi
John
J
Batsa
Linda
L
Taylor
Mark J
MJ
Adjei
Ohene
O
Büttner
Dietrich W
DW
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*
D000900:Anti-Bacterial Agents; D005369:Filaricides; D007559:Ivermectin; D004318:Doxycycline