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Veletzky L, Eberhardt KA, Hergeth J, Stelzl DR, Zoleko Manego R, Kreuzmair R, Burger G, Mischlinger J, McCall MBB, Mombo-Ngoma G, Adegnika AA, Agnandji ST, Matsiegui PB, Lell B, Kremsner P, Mordmüller B, Tappe D, Ramharter M. Analysis of diagnostic test outcomes in a large loiasis cohort from an endemic region: Serological tests are often false negative in hyper-microfilaremic infections. PLoS Negl Trop Dis 2024; 18:e0012054. [PMID: 38484012 DOI: 10.1371/journal.pntd.0012054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 03/26/2024] [Accepted: 03/07/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND The parasitic disease loiasis is associated with significant morbidity and mortality. Individuals with hyper-microfilaremia (greater than 20,000 microfilariae per mL of blood) may suffer from serious treatment-related or spontaneous adverse events. Diagnosing loiasis remains complex and primarily relies on direct parasite detection. In this study, we analyzed the performance of various diagnostic tests and the influence of parasitological and clinical factors on test outcomes in samples from individuals living in an endemic region. METHODS Data and samples were collected from rural Gabon. Loiasis was defined as either detectable microfilaremia, or a positive history of eyeworm as assessed by the RAPLOA questionnaire. Diagnostic testing included a quantitative PCR (qPCR) for detection of Loa loa DNA in blood samples, an in-house crude L. loa antigen IgG ELISA, and a rapid test for antibodies against the Ll-SXP-1 antigen (RDT). Sensitivity and specificity were determined for each test and factors potentially influencing outcomes were evaluated in an exploratory analysis. RESULTS ELISA, RDT and qPCR results were available for 99.8%, 78.5%, and 100% of the 1,232 participants, respectively. The ELISA and RDT had only modest diagnostic accuracy. qPCR was specific for L. loa microfilaremia and Cycle threshold values correlated with microfilarial density. Anti-L. loa IgG levels were highest in occult loiasis, and antibody levels correlated inversely with L. loa microfilarial density as did RDT line intensities. Only 84.6% and 16.7% of hyper-microfilaremic individuals tested positive by ELISA (11/13) and RDT (2/12), respectively. CONCLUSION None of the tests demonstrated high sensitivity and specificity for loiasis. Indirect diagnostic assays were characterized by low specificity. Additionally, hyper-microfilaremic individuals often tested negative by RDT and ELISA, indicating that these tests are not suitable for individual case management in endemic populations.
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Affiliation(s)
- Luzia Veletzky
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems, Germany
| | - Kirsten Alexandra Eberhardt
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Daniel Robert Stelzl
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rella Zoleko Manego
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Ruth Kreuzmair
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Gerrit Burger
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Johannes Mischlinger
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Matthew B B McCall
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Radboud University Medical Center, Department of Medical Microbiology, HB Nijmegen, The Netherlands
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Implementation Research, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ayôla Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | - Selidji Todagbe Agnandji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | | | - Bertrand Lell
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Peter Kremsner
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | - Benjamin Mordmüller
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
- Radboud University Medical Center, Department of Medical Microbiology, HB Nijmegen, The Netherlands
| | - Dennis Tappe
- National Reference Centre for Tropical Pathogens, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Michael Ramharter
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems, Germany
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2
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Veletzky L, Eberhardt KA, Hergeth J, Stelzl DR, Zoleko Manego R, Mombo-Ngoma G, Kreuzmair R, Burger G, Adegnika AA, Agnandji ST, Matsiegui PB, Boussinesq M, Mordmüller B, Ramharter M. Distinct loiasis infection states and associated clinical and hematological manifestations in patients from Gabon. PLoS Negl Trop Dis 2022; 16:e0010793. [PMID: 36121900 PMCID: PMC9521832 DOI: 10.1371/journal.pntd.0010793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/29/2022] [Accepted: 09/06/2022] [Indexed: 11/25/2022] Open
Abstract
Background Loiasis–a filarial disease endemic in Central and West Africa–is increasingly recognized as significant individual and public health concern. While the understanding of the disease characteristics remains limited, significant morbidity and excess mortality have been demonstrated. Here, we characterize clinical and hematological findings in a large cohort from Gabon. Methods Loiasis-related clinical manifestations and microfilaremia, hemoglobin and differential blood counts were recorded prospectively during a cross-sectional survey. For analysis, participants were categorized into distinct infection states by the diagnostic criteria of eye worm history and microfilaremia. Results Analysis of data from 1,232 individuals showed that occurrence of clinical and hematological findings differed significantly between the infection states. Eye worm positivity was associated with a wide range of clinical manifestations while microfilaremia by itself was not. Loa loa infection was associated with presence of eosinophilia and absolute eosinophil counts were associated with extent of microfilaremia (p-adj. = 0.012, ß-estimate:0.17[0.04–0.31]). Conclusions Loiasis is a complex disease, causing different disease manifestations in patients from endemic regions. The consequences for the affected individuals or populations as well as the pathophysiological consequences of correlating eosinophilia are largely unknown. High-quality research on loiasis should be fostered to improve patient care and understanding of the disease. Loiasis is a parasitic disease, endemic in parts of Western and Central Africa. While the disease has traditionally been considered to be benign, only recently significant disease morbidity and mortality have been shown. Most of the knowledge about loiasis, however, stems from reports on returning travelers, while comprehensive data from patients living in endemic areas are missing. Blood microfilaremia and reported eye worm are important diagnostic manifestations of the disease, but they can occur independent of each other in affected individuals. We analyzed hematological and clinical findings according to loiasis infection states, comprising reported eye worm and microfilaremia positivity, in a large group of individuals from a highly endemic area. While we found that all loiasis infection states were significantly associated with absolute blood eosinophilia, the eosinophilia was more pronounced in microfilaremic loiasis. Further, there was an association between the extent of microfilaremia and absolute eosinophilia. Analyzing the frequency of clinical disease manifestations, we found that eye worm positive loiasis was associated with a range of symptoms, but microfilaremic loiasis was not. Summarizing, even in highly endemic populations different loiasis infection states are associated with distinct disease manifestations, underlining that loiasis is a versatile and indeed relevant disease.
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Affiliation(s)
- Luzia Veletzky
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center For Infection Research (DZIF), Hamburg-Borstel-Riems, Germany
- * E-mail: (LV); (MR)
| | - Kirsten Alexandra Eberhardt
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Daniel Robert Stelzl
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rella Zoleko Manego
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | - Ghyslain Mombo-Ngoma
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | - Ruth Kreuzmair
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Gerrit Burger
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | - Ayôla Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | - Selidji Todagbe Agnandji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
| | | | - Michel Boussinesq
- Institut de Recherche pour le Développement (IRD), UMI 233-TransVIHMI-Inserm U1175-University of Montpellier, Montpellier, France
| | - Benjamin Mordmüller
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany & German Center for Infection Research, partner site Tübingen, Tübingen, Germany
- Radboud University Medical Center, Department of Medical Microbiology, Nijmegen, The Netherlands
| | - Michael Ramharter
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Dep. of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center For Infection Research (DZIF), Hamburg-Borstel-Riems, Germany
- * E-mail: (LV); (MR)
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Bouchaud O, Matheron S, Loarec A, Dupouy Camet J, Bourée P, Godineau N, Poilane I, Cailhol J, Caumes E. Imported loiasis in France: a retrospective analysis of 167 cases with comparison between sub-Saharan and non sub-Saharan African patients. BMC Infect Dis 2020; 20:63. [PMID: 31959110 PMCID: PMC6971866 DOI: 10.1186/s12879-019-4740-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 12/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Imported loiasis is a rare cause of consultation at the return of stay in central Africa, which often poses difficult diagnostic and therapeutic questions to practitioners especially those who are unaccustomed to tropical medicine. These difficulties can lead to risks for the patients especially if inappropriate treatment is given. Large series of imported loiasis are scarce. METHODS We retrospectively studied the data including outcome in patients diagnosed with imported loiasis between 1993 and 2013 in the Paris area on the basis of a parasitological diagnosis (microfilaremia > 1/ml and/or serologic tests). We compared sub-Saharan and non sub-Saharan African patients. RESULTS Of the 177 identified cases, 167 could be analysed. Sex ratio was 1, mean age 41 years and 83% were sub-Saharan Africans. Cameroon was the main country of exposure (62%). Incubation time may be long (up to 18 months). Of the 167 cases, 57% presented with characteristic symptoms (Calabar swellings, creeping dermatitis, eyeworm) whereas 43% were diagnosed fortuitously. Microfilaremia was evidenced in 105 patients (63%), and specific antibodies in 53%. Compared to sub-Saharan Africans, other patients were presenting less frequently with eyeworm migration and microfilaremia whereas they had higher eosinophilia and positive serology. Prevalence of Calabar swellings was not significantly different between the two groups. Cure rates were 52% with ivermectin alone, and 77% with ivermectin followed by diethylcarbamazine. No severe adverse event was reported. CONCLUSIONS Presentation of imported loiasis varies according to ethnicity. A systematic screening should be recommended in patients with potential exposure in endemic country. Treatment with ivermectin followed by diethylcarbamazine could be a valuable option.
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Affiliation(s)
- Olivier Bouchaud
- Infectious Diseases and Tropical Medicine Department, Avicenne Hospital and Paris 13 University, 93000, Bobigny, France.
| | - Sophie Matheron
- Infectious Diseases and Tropical Medicine Department, Bichat Claude Bernard Hospital and Paris 7 University, 75018, Paris, France
| | - Anne Loarec
- Infectious Diseases and Tropical Medicine Department, Avicenne Hospital and Paris 13 University, 93000, Bobigny, France
| | - Jean Dupouy Camet
- Parasitology Department, Paris Descartes University, 75014, Paris, France
| | - Patrice Bourée
- Parasitology Department, Paris 11 University, 94270, Le Kremlin Bicêtre, France
| | - Nadine Godineau
- Parasitology Department, Saint Denis Hospital, 93200, Saint Denis, France
| | - Isabelle Poilane
- Parasitology Department, Jean Verdier Hospital and Paris 13 University, 93140, Bondy, France
| | - Johann Cailhol
- Infectious Diseases and Tropical Medicine Department, Avicenne Hospital and Paris 13 University, 93000, Bobigny, France
| | - Eric Caumes
- Infectious Diseases and Tropical Medicine Department, Pitié Salpétrière Hospital and University Pierre et Marie Curie, 75013, Paris, France
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4
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Laskar DB, Rose M, Gupta R, Tanowitz HB, Haseeb MA. Case Report: Monoclonal Gammopathy of Undetermined Significance is Associated with Loa loa Infection. Am J Trop Med Hyg 2019; 99:1206-1210. [PMID: 30203743 DOI: 10.4269/ajtmh.18-0351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
A 63-year-old woman who migrated from Nigeria to the United States was found to have an elevated total serum protein, anemia, and eosinophilia. Serum protein electrophoresis (SPEP) and serum protein immunofixation electrophoresis (SPIFE) demonstrated monoclonal immunoglobulin G (IgG) κ restricted bands (IgG 3,820 mg/dL; κ/λ ratio 4.47), indicative of monoclonal gammopathy of unknown significance (MGUS). A rapid diagnostic test (RDT) for malaria was positive for Plasmodium falciparum (BinaxNOW®; Alere Scarborough Inc., Scarborough, ME). Giemsa-stained blood smears were negative for malarial parasites, however, Loa loa microfilariae were identified. Reverse transcription polymerase chain reaction for P. falciparum, Plasmodium ovale, Plasmodium malariae, and Plasmodium vivax yielded a negative result. She was treated for loiasis with diethylcarbamazine and received no malaria medication. Treatment resulted in a resolution of the microfilaremia and eosinophilia, a negative RDT for malaria, and marked reduction in the monoclonal gammopathy. This is the first reported human case of MGUS associated with loiasis and its resolution after antiparasitic treatment.
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Affiliation(s)
- Derek B Laskar
- Department of Pathology, State University of New York, Downstate Medical Center and Kings County Hospital Center, Brooklyn, New York
| | - Michael Rose
- Department of Medicine, State University of New York, Downstate Medical Center and Kings County Hospital Center, Brooklyn, New York
| | - Raavi Gupta
- Department of Pathology, State University of New York, Downstate Medical Center and Kings County Hospital Center, Brooklyn, New York
| | - Herbert B Tanowitz
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.,Department of Pathology, Albert Einstein College of Medicine, Bronx, New York
| | - M A Haseeb
- Department of Medicine, State University of New York, Downstate Medical Center and Kings County Hospital Center, Brooklyn, New York.,Department of Pathology, State University of New York, Downstate Medical Center and Kings County Hospital Center, Brooklyn, New York
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5
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Njambe Priso GD, Lissom A, Ngu LN, Nji NN, Tchadji JC, Tchouangueu TF, Ambada GE, Ngane CSS, Dafeu BL, Djukouo L, Nyebe I, Magagoum S, Ngoh AA, Herve OF, Garcia R, Gutiérrez A, Okoli AS, Esimone CO, Njiokou F, Park CG, Waffo AB, Nchinda GW. Filaria specific antibody response profiling in plasma from anti-retroviral naïve Loa loa microfilaraemic HIV-1 infected people. BMC Infect Dis 2018; 18:160. [PMID: 29618330 PMCID: PMC5885382 DOI: 10.1186/s12879-018-3072-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/26/2018] [Indexed: 12/14/2022] Open
Abstract
Background In West and Central Africa areas of endemic Loa loa infections overlap with regions of high prevalence of human immunodeficiency virus type 1 (HIV-1) infections. Because individuals in this region are exposed to filarial parasites from birth, most HIV-1 infected individuals invariably also have a history of filarial parasite infection. Since HIV-1 infection both depletes immune system and maintains it in perpetual inflammation, this can hamper Loa loa filarial parasite mediated immune modulation, leading to enhanced loaisis. Methods In this study we have assessed in plasma from asymptomatic anti-retroviral (ARV) naïve Loa loa microfilaraemic HIV-1 infected people the filarial antibody responses specific to a filariasis composite antigen consisting of Wbgp29-BmR1-BmM14-WbSXP. The antibody responses specific to the filariasis composite antigen was determined by enzyme linked immunosorbent assay (ELISA) in plasma from ARV naïve Loa loa microfilaraemic HIV-1 infected participants. In addition the filarial antigen specific IgG antibody subclass profiles were also determined for both HIV-1 positive and negative people. Results Both Loa loa microfilaraemic HIV-1 positive and negative individuals showed significantly higher plasma levels of IgG1 (P < 0.0001), IgG2 (P < 0.0001) and IgM (P < 0.0001) relative to amicrofilaraemic participants. A significant increase in IgE (P < 0.0001) was observed exclusively in Loa loa microfilaraemic HIV-1 infected people. In contrast there was a significant reduction in the level of IgG4 (p < 0.0001) and IgG3 (P < 0.0001) in Loa loa microfilaraemic HIV-1 infected individuals. Conclusions Loa loa microfilaraemia in ARV naïve HIV-1 infected people through differential reduction of plasma levels of filarial antigen specific IgG3, IgG4 and a significant increase in plasma levels of filarial antigen specific IgE could diminish Loa loa mediated immune-regulation. This in effect can result to increase loaisis mediated immunopathology in antiretroviral naive HIV-1 infected people.
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Affiliation(s)
- Ghislain Donald Njambe Priso
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Abel Lissom
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Loveline N Ngu
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of biochemistry, University of Yaounde I, Yaounde, Cameroon
| | - Nadesh N Nji
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon
| | - Jules Colince Tchadji
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Thibau Flaurant Tchouangueu
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of biochemistry, University of Dschang, Yaounde, Cameroon
| | - Georgia E Ambada
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Carole Stéphanie Sake Ngane
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of Microbiology, University of Yaounde I, Yaounde, Cameroon.,Department of biochemistry, University of Yaounde I, Yaounde, Cameroon
| | - Brigitte Laure Dafeu
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Larissa Djukouo
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of biochemistry, University of Yaounde I, Yaounde, Cameroon
| | - Inès Nyebe
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of Microbiology, University of Yaounde I, Yaounde, Cameroon
| | - Suzanne Magagoum
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Apeh Alfred Ngoh
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of biomedical sciences, University of Dschang, Dschang, Cameroon
| | - Ouambo Fotso Herve
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.,Department of medical laboratory sciences, University of Buea, Buea, Cameroon
| | - Rosario Garcia
- CSCB (Centre de santé catholique de Bikop), Bikop, Cameroon
| | - Anna Gutiérrez
- CSCB (Centre de santé catholique de Bikop), Bikop, Cameroon
| | | | - Charles O Esimone
- Department of Pharmaceutical Microbiology & Biotechnology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Flobert Njiokou
- Department of animal biology and Phisiology, University of Yaounde I, Yaounde, Cameroon
| | - Chae Gyu Park
- Laboratory of Immunology, Brain Korea 21 PLUS Project for Medical Science, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Alain Bopda Waffo
- Department of Biological Sciences, College STEM, 1627 Hall Street, Montgomery, AL, 36101, USA.,Center for NanoBiotechnology Research, 1627 Harris Way, Montgomery, AL, 36104, USA
| | - Godwin W Nchinda
- Laboratory of vaccinology/biobanking, CIRCB, Messa, Yaounde, Cameroon.
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6
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Whittaker C, Walker M, Pion SD, Chesnais CB, Boussinesq M, Basáñez MG. The Population Biology and Transmission Dynamics of Loa loa. Trends Parasitol 2018; 34:335-350. [DOI: 10.1016/j.pt.2017.12.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 12/10/2017] [Accepted: 12/11/2017] [Indexed: 11/27/2022]
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7
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Londono-Renteria B, Cardenas JC, Troupin A, Colpitts TM. Natural Mosquito-Pathogen Hybrid IgG4 Antibodies in Vector-Borne Diseases: A Hypothesis. Front Immunol 2016; 7:380. [PMID: 27746778 PMCID: PMC5040711 DOI: 10.3389/fimmu.2016.00380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/08/2016] [Indexed: 12/24/2022] Open
Abstract
Chronic exposure to antigens may favor the production of IgG4 antibodies over other antibody types. Recent studies have shown that up to a 30% of normal human IgG4 is bi-specific and is able to recognize two antigens of different nature. A requirement for this specificity is the presence of both eliciting antigens in the same time and at the same place where the immune response is induced. During transmission of most vector-borne diseases, the pathogen is delivered to the vertebrate host along with the arthropod saliva during blood feeding and previous studies have shown the existence of IgG4 antibodies against mosquito salivary allergens. However, there is very little ongoing research or information available regarding IgG4 bi-specificity with regard to infectious disease, particularly during immune responses to vector-borne diseases, such as malaria, filariasis, or dengue virus infection. Here, we provide background information and present our hypothesis that IgG4 may not only be a useful tool to measure exposure to infected mosquito bites, but that these bi-specific antibodies may also play an important role in modulation of the immune response against malaria and other vector-borne diseases in endemic settings.
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Affiliation(s)
- Berlin Londono-Renteria
- Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine , Columbia, SC , USA
| | - Jenny C Cardenas
- Clinical Laboratory, Hospital Los Patios , Los Patios , Colombia
| | - Andrea Troupin
- Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine , Columbia, SC , USA
| | - Tonya M Colpitts
- Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine , Columbia, SC , USA
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8
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Achary KG, Mandal NN, Mishra S, Mishra R, Sarangi SS, Satapathy AK, Kar SK, Bal MS. In utero sensitization modulates IgG isotype, IFN-γ and IL-10 responses of neonates in bancroftian filariasis. Parasite Immunol 2014; 36:485-93. [PMID: 24902619 DOI: 10.1111/pim.12121] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 05/31/2014] [Indexed: 11/26/2022]
Abstract
In utero exposure has been considered as a risk factor for filarial infection. To evaluate the influence of maternal infection on filarial-specific IgG subclass response in neonates and their correlation with plasma levels IL-10 and interferon-γ, 145 pairs of mothers and their respective cord bloods were examined. Transplacental transfer of circulating filarial antigen (CFA) was observed in 34·8% cord bloods from CFA positive mothers. Filarial-specific IgG1, IgG2 and IgG4 responses of cord bloods were found to be positively correlated with CFA of mothers. In contrast, IgG3 responses negatively correlated with CFA of mothers. The % of similarity of recognition pattern in the cord blood with maternal blood was high for IgG3 response than IgG4 in all three groups. An increased levels of IL-10 and decreased levels of interferon gamma (IFN-γ) were observed in cord blood of infected mothers. Interferon gamma was positively correlated with IgG3 and negatively correlated with IgG4 level. On the other hand, IL-10 was positively correlated with IgG4 and CFA, indicating that cytokines may play a role in modulating the immune responses in cord bloods of sensitized foetus. The findings of the study reveal that in utero tolerance or sensitization may influence the filarial-specific immunity to infection in neonates.
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Affiliation(s)
- K G Achary
- Division of Immunology, Regional Medical Research Center (Indian Council of Medical Research), Bhubaneswar, Odisha, India
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Adjobimey T, Hoerauf A. Induction of immunoglobulin G4 in human filariasis: an indicator of immunoregulation. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2011; 104:455-64. [PMID: 20863434 PMCID: PMC3065634 DOI: 10.1179/136485910x12786389891407] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Filarial parasites are known to induce a large range of immunoregulatory mechanisms, including the induction of alternatively activated macrophages and regulatory T cells. These mechanisms are used to evade and down-modulate the host's immune system, to support parasite survival. Several reports have focused on some of these mechanisms, in humans and murine models, but the complex immunoregulatory networks associated with filarial infections remain unclear. Recent publications have conferred a role for regulatory T cells in the ability of helminth parasites to modulate human immune responses, such cells promoting the induction of the non-complement-fixing immunoglobulin G4 (IgG4). High plasma concentrations of IgG4 have been reported in hypo-responsive and asymptomatic cases of helminth infection. In both human lymphatic filariasis and onchocerciasis, the asymptomatic infections are characterised by high plasma concentrations of IgG4 (compared with those of IgE) and of the complement-fixing antibodies IgG1, IgG2 and IgG3. In asymptomatic filarial infection, elevations in IgG4 are also often associated with high worm loads and with high plasma levels of the immunomodulatory interleukin-10. Here, various aspects of the induction of IgG4 in humans and it roles in the immunomodulation of the human responses to filarial parasites are reviewed.
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Affiliation(s)
- T Adjobimey
- Institute for Medical Microbiology, Immunology and Parasitology, University Clinic Bonn, Germany
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10
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Production and immunological characterization of a recombinant subunit of aLoa loapolyprotein antigen. Parasitology 2010; 137:1119-28. [DOI: 10.1017/s0031182009991740] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SUMMARYDiagnosis of loiasis and analysis of the specific immune response are limited by a paucity of parasite material. To circumvent this problem, aLoa loaantigen has been expressed in a prokaryote vector (pTrcHis). Immunization of Balb/c mice with this soluble recombinant protein produced a strong antibody response, with antibodies recognizing 2 major bands of 38 and 20 kDa in a native crude extract ofLoa loaadult worms and microfilariae on Western blots. The target molecule was located mainly in the hypodermis and cuticle of the adult worm. Analysis of human IgG subclasses against this antigen by enzyme-linked immunosorbent assay (ELISA) showed IgG1, IgG2 and IgG3 but not IgG4 reactivity. IgG2 against this recombinant antigen was 100% specific for loiasis when tested against samples from European donor individuals. The same IgG2 antibodies showed 91% specificity for loiasis by comparison withWuchereria bancrofti,Onchocerca volvulus,Mansonnella perstansand other helminth infections. Furthermore, the IgG2 antibody level correlated with the density ofLoa loamicrofilariae (r=0·400;P=0·02). This recombinant 15r3 molecule and specific IgG2 assay may be useful for monitoring control programmes.
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11
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Pion SDS, Filipe JAN, Kamgno J, Gardon J, Basáñez MG, Boussinesq M. Microfilarial distribution of Loa loa in the human host: population dynamics and epidemiological implications. Parasitology 2006; 133:101-9. [PMID: 16764737 DOI: 10.1017/s0031182006000035] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Revised: 01/10/2006] [Accepted: 01/10/2006] [Indexed: 11/05/2022]
Abstract
Severe adverse events (SAEs) following ivermectin treatment may occur in people harbouring high Loa loa microfilarial (mf) densities. In the context of mass ivermectin distribution for onchocerciasis control in Africa, it is crucial to define precisely the geographical distribution of L. loa in relation to that of Onchocerca volvulus and predict the prevalence of heavy infections. To this end, we analysed the distribution of mf loads in 4183 individuals living in 36 villages of central Cameroon. Mf loads were assessed quantitatively by calibrated blood smears, collected prior to ivermectin distribution. We explored the pattern of L. loa mf aggregation by fitting the (zero-truncated) negative binomial distribution and estimating its overdispersion parameter k by maximum likelihood. The value of k varied around 0.3 independently of mf intensity, host age, village and endemicity level. Based on these results, we developed a semi-empirical model to predict the prevalence of heavy L. loa mf loads in a community given its overall mf prevalence. If validated at the continental scale and linked to predictive spatial models of loiasis distribution, this approach would be particularly useful for optimizing the identification of areas at risk of SAEs and providing estimates of populations at risk in localities where L. loa and O. volvulus are co-endemic.
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Affiliation(s)
- S D S Pion
- Laboratoire mixte IRD (Institut de Recherche pour le Développement) - CPC (Centre Pasteur du Cameroun) d'Epidémiologie et de Santé publique, Centre Pasteur du Cameroun, BP 1274, Yaoundé, Cameroun.
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Pion DSS, Gardon J, Kamgno J, Gardon-Wendel N, Chippaux JP, Boussinesq M. Structure of the microfilarial reservoir of Loa loa in the human host and its implications for monitoring the progr,ammes of Community-Directed Treatment with Ivermectin carried out in Africa. Parasitology 2005; 129:613-26. [PMID: 15552406 DOI: 10.1017/s0031182004005694] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This paper describes the structure of the microfilarial reservoir of Loa loa in an endemic population of central Cameroon. The possible effects of age and sex on the prevalence and intensity of microfilaraemia have been explored. Logistic analysis showed that the prevalence of microfilaraemia increased significantly with age, reaching 60 % in the oldest males. This result suggests that the figure commonly reported, according to which only one third of the infected individuals were microfilaraemic, should be reconsidered; in addition, as part of surveys of loiasis, crude microfilaraemia prevalence values should be replaced by adjusted ones. The intensity of infection did not show any age-specific change. As a result, even if the oldest members of the male population are clearly the most at risk of developing post-ivermectin serious adverse reactions, especially Loa-encephalopathy, the other members of the population are not risk-free. Therefore, in those areas where the African Programme for Onchocerciasis Control is undertaking regular mass distributions of ivermectin for onchocerciasis control, and where loiasis is co-endemic, no subpopulation should be excluded from surveillance and monitoring during community directed treatments with ivermectin.
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Affiliation(s)
- D S S Pion
- Laboratoire Mixte IRD-CPC (Institut de Recherche pour le Développement--Centre Pasteur du Cameroun) d'Epidimiologie et de Santé Publique, Centre Pasteur du Cameroun, Yaoundé, Cameroun.
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