Abstract
This study examined the development and persistence of immunity in humans presenting defined states of Onchocerca volvulus infection, i.e. in exposed endemic control individuals without microfilaridermia and clinical disease, in patients with patent or post-patent onchocerciasis, and in patients concurrently infected with Mansonella perstans. Onchocerca volvulus antigen (OvAg)-specific cellular reactivity was significantly diminished in microfilariae (mf)-positive patients, while the highest reactivity was measured in exposed but mf-negative endemic controls, those being free of any clinical signs of onchocercal disease. In patients who became post-patent, responses to OvAg were significantly augmented, but did not approach entirely the magnitude observed in endemic controls. In onchocerciasis patients with concurrent mansonelliasis, cellular unresponsiveness to OvAg persisted, even when mf of O. volvulus were eliminated permanently by repeated ivermectin therapy. Cells from mf-positive onchocerciasis patients produced significantly less interferon-gamma (IFN-gamma) (P < 0.01) and interleukin-5 (IL-5) (P < 0.05) in response to OvAg than those taken from endemic controls or post-patent individuals in whom IFN-gamma and IL-5 production was similarly high. In contrast, both OvAg-driven as well as spontaneous IL-10 secretion was higher in mf-positive patients than in endemic controls or post-patent cases. In all individuals examined, serological recognition of OvAg by immunoglobulins was dominated by IgG4; in mf-positive patients OvAg of 205,000-12,000 molecular weight (MW) were strongly bound. In post-patent individuals, and similarly in endemic controls. OvAg recognition by IgG4 varied from intense (with numerous antigens being recognized) to weak or absent antigen binding. Significantly elevated OvAg-specific IgG isotypes were measured in mf-positive onchocerciasis patients in comparison with endemic controls or post-patent individuals (with the exception of IgG3). IgG1, IgG2 and IgE were higher, but IgG4 was lower in endemic controls compared with post-patent onchocerciasis patients. The ratios of IgG4/IgG1 differed (P < 0.001) between endemic controls and mf-positive or post-patent onchocerciasis patients, with IgG4/IgG1 ratios of R < 3.0 being characteristic for endemic controls and post-patent O. volvulus infection. In conclusion, this cross-sectional immunoepidemiological investigation showed that distinct states of O. volvulus infection correlate with a particular cellular and humoral immune response. The mf-free condition appeared to be associated with a vigorous parasite-specific cellular reactivity and a particular cytokine production profile, while concurrent M. perstans infection depressed OvAg-specific cellular responsiveness. Antibody responses, in all likelihood, reflected the intensity and state of infection, and not the degree of acquired immunity protective against parasite aggregation.
Full text
PDF







Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Boyer A. E., Tsang V. C., Eberhard M. L., Zea-Flores G., Hightower A., Pilcher J. B., Zea-Flores R., Zhou W., Reimer C. B. Guatemalan human onchocerciasis. II. Evidence for IgG3 involvement in acquired immunity to Onchocerca volvulus and identification of possible immune-associated antigens. J Immunol. 1991 Jun 1;146(11):4001–4010. [PubMed] [Google Scholar]
- Dafa'alla T. H., Ghalib H. W., Abdelmageed A., Williams J. F. The profile of IgG and IgG subclasses of onchocerciasis patients. Clin Exp Immunol. 1992 May;88(2):258–263. doi: 10.1111/j.1365-2249.1992.tb03070.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- De Sole G., Accorsi S., Cresveaux H., Remme J., Walsh F., Hendrickx J. Distribution and severity of onchocerciasis in southern Benin, Ghana and Togo. Acta Trop. 1992 Dec;52(2-3):87–97. doi: 10.1016/0001-706x(92)90024-r. [DOI] [PubMed] [Google Scholar]
- Elson L. H., Calvopiña M., Paredes W., Araujo E., Bradley J. E., Guderian R. H., Nutman T. B. Immunity to onchocerciasis: putative immune persons produce a Th1-like response to Onchocerca volvulus. J Infect Dis. 1995 Mar;171(3):652–658. doi: 10.1093/infdis/171.3.652. [DOI] [PubMed] [Google Scholar]
- Freedman D. O., Nutman T. B., Ottesen E. A. Protective immunity in bancroftian filariasis. Selective recognition of a 43-kD larval stage antigen by infection-free individuals in an endemic area. J Clin Invest. 1989 Jan;83(1):14–22. doi: 10.1172/JCI113850. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Greene B. M., Fanning M. M., Ellner J. J. Non-specific suppression of antigen-induced lymphocyte blastogenesis in Onchocerca volvulus infection in man. Clin Exp Immunol. 1983 May;52(2):259–265. [PMC free article] [PubMed] [Google Scholar]
- Greene B. M., Taylor H. R., Aikawa M. Cellular killing of microfilariae of Onchocerca volvulus: eosinophil and neutrophil-mediated immune serum-dependent destruction. J Immunol. 1981 Oct;127(4):1611–1618. [PubMed] [Google Scholar]
- Karam M., Schulz-Key H., Remme J. Population dynamics of Onchocerca volvulus after 7 to 8 years of vector control in West Africa. Acta Trop. 1987 Dec;44(4):445–457. [PubMed] [Google Scholar]
- King C. L., Mahanty S., Kumaraswami V., Abrams J. S., Regunathan J., Jayaraman K., Ottesen E. A., Nutman T. B. Cytokine control of parasite-specific anergy in human lymphatic filariasis. Preferential induction of a regulatory T helper type 2 lymphocyte subset. J Clin Invest. 1993 Oct;92(4):1667–1673. doi: 10.1172/JCI116752. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lüder C. G., Schulz-Key H., Banla M., Pritze S., Soboslay P. T. Immunoregulation in onchocerciasis: predominance of Th1-type responsiveness to low molecular weight antigens of Onchocerca volvulus in exposed individuals without microfilaridermia and clinical disease. Clin Exp Immunol. 1996 Aug;105(2):245–253. doi: 10.1046/j.1365-2249.1996.d01-747.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Maizels R. M., Bundy D. A., Selkirk M. E., Smith D. F., Anderson R. M. Immunological modulation and evasion by helminth parasites in human populations. Nature. 1993 Oct 28;365(6449):797–805. doi: 10.1038/365797a0. [DOI] [PubMed] [Google Scholar]
- Murdoch M. E. The skin and the immune response in onchocerciasis. Trop Doct. 1992;22 (Suppl 1):44–55;61-2. doi: 10.1177/00494755920220S109. [DOI] [PubMed] [Google Scholar]
- Nutman T. B., Steel C., Ward D. J., Zea-Flores G., Ottesen E. A. Immunity to onchocerciasis: recognition of larval antigens by humans putatively immune to Onchocerca volvulus infection. J Infect Dis. 1991 May;163(5):1128–1133. doi: 10.1093/infdis/163.5.1128. [DOI] [PubMed] [Google Scholar]
- Ottesen E. A. Immune responsiveness and the pathogenesis of human onchocerciasis. J Infect Dis. 1995 Mar;171(3):659–671. doi: 10.1093/infdis/171.3.659. [DOI] [PubMed] [Google Scholar]
- Ottesen E. A. The Wellcome Trust Lecture. Infection and disease in lymphatic filariasis: an immunological perspective. Parasitology. 1992;104 (Suppl):S71–S79. doi: 10.1017/s0031182000075259. [DOI] [PubMed] [Google Scholar]
- Pearlman E., Lass J. H., Bardenstein D. S., Kopf M., Hazlett F. E., Jr, Diaconu E., Kazura J. W. Interleukin 4 and T helper type 2 cells are required for development of experimental onchocercal keratitis (river blindness). J Exp Med. 1995 Oct 1;182(4):931–940. doi: 10.1084/jem.182.4.931. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Plier D. A., Awadzi K., Freedman D. O. Immunoregulation in onchocerciasis: persons with ocular inflammatory disease produce a Th2-like response to Onchocerca volvulus antigen. J Infect Dis. 1996 Aug;174(2):380–386. doi: 10.1093/infdis/174.2.380. [DOI] [PubMed] [Google Scholar]
- Remme J., De Sole G., van Oortmarssen G. J. The predicted and observed decline in onchocerciasis infection during 14 years of successful control of Simulium spp. in west Africa. Bull World Health Organ. 1990;68(3):331–339. doi: 10.1089/ten.2005.11.1105. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schulz-Key H., Albrecht W., Heuschkel C., Soboslay P. T., Banla M., Görgen H. Efficacy of ivermectin in the treatment of concomitant Mansonella perstans infections in onchocerciasis patients. Trans R Soc Trop Med Hyg. 1993 Mar-Apr;87(2):227–229. doi: 10.1016/0035-9203(93)90504-j. [DOI] [PubMed] [Google Scholar]
- Soboslay P. T., Dreweck C. M., Hoffmann W. H., Lüder C. G., Heuschkel C., Görgen H., Banla M., Schulz-Key H. Ivermectin-facilitated immunity in onchocerciasis. Reversal of lymphocytopenia, cellular anergy and deficient cytokine production after single treatment. Clin Exp Immunol. 1992 Sep;89(3):407–413. doi: 10.1111/j.1365-2249.1992.tb06971.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Soboslay P. T., Dreweck C. M., Taylor H. R., Brotman B., Wenk P., Greene B. M. Experimental onchocerciasis in chimpanzees. Cell-mediated immune responses, and production and effects of IL-1 and IL-2 with Onchocerca volvulus infection. J Immunol. 1991 Jul 1;147(1):346–353. [PubMed] [Google Scholar]
- Soboslay P. T., Lüder C. G., Hoffmann W. H., Michaelis I., Helling G., Heuschkel C., Dreweck C. M., Blanke C. H., Pritze S., Banla M. Ivermectin-facilitated immunity in onchocerciasis; activation of parasite-specific Th1-type responses with subclinical Onchocerca volvulus infection. Clin Exp Immunol. 1994 May;96(2):238–244. doi: 10.1111/j.1365-2249.1994.tb06548.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Steel C., Guinea A., Ottesen E. A. Evidence for protective immunity to bancroftian filariasis in the Cook Islands. J Infect Dis. 1996 Sep;174(3):598–605. doi: 10.1093/infdis/174.3.598. [DOI] [PubMed] [Google Scholar]
- Ward D. J., Nutman T. B., Zea-Flores G., Portocarrero C., Lujan A., Ottesen E. A. Onchocerciasis and immunity in humans: enhanced T cell responsiveness to parasite antigen in putatively immune individuals. J Infect Dis. 1988 Mar;157(3):536–543. doi: 10.1093/infdis/157.3.536. [DOI] [PubMed] [Google Scholar]
- de Almeida A. B., Maia e Silva M. C., Maciel M. A., Freedman D. O. The presence or absence of active infection, not clinical status, is most closely associated with cytokine responses in lymphatic filariasis. J Infect Dis. 1996 Jun;173(6):1453–1459. doi: 10.1093/infdis/173.6.1453. [DOI] [PubMed] [Google Scholar]

