1921
Volume 81, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

In a placebo controlled trial, the effects of 21- and 10-day doxycycline treatments (200 mg/day) followed by single dose diethylcarbamazine (administered 4 months post treatment) on depletion of endobacteria from , filaricidal activity, and amerlioration of scrotal lymph vessel dilation were studied in 57 men from Orissa, India. The 21-day doxycycline course reduced in by 94% before diethylcarbamazine administration. After 12 months, all patients with this treatment were amicrofilaremic and different from the 10-day doxycycline (42.9%) and placebo (37.5%) groups, and significantly fewer were positive for scrotal worm nests (6.7%) compared with 10-day doxycycline (60%) and placebo (66.7%). Average scrotal lymph vessel diameters were reduced from 0.7 cm pre-treatment to 0.02 cm in patients after 21 days of treatment, while no significant changes were seen in the other groups. This latter feature confirms the beneficial effects of doxycycline on lymphatic dilation and thus adds to the existing evidence that doxycycline, in addition to being macrofilaricidal, may be used to prevent or reverse lymphatic pathology.

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References

  1. WHO, 2007. Global programme to eliminate lymphatic filariasis. Wkly Epidemiol Rec 82: 361–380.
  2. Dreyer G, Addiss D, Williamson J, Noroes J, 2006. Efficacy of co-administered diethylcarbamazine and albendazole against adult Wuchereria bancrofti. Trans R Soc Trop Med Hyg 100: 1118–1125.
  3. Hussein O, Setouhy ME, Ahmed ES, Kandil AM, Ramzy RM, Helmy H, Weil GJ, 2004. Duplex Doppler sonographic assessment of the effects of diethylcarbamazine and albendazole therapy on adult filarial worms and adjacent host tissues in bancroftian filariasis. Am J Trop Med Hyg 71: 471–477.
  4. Ottesen EA, Duke BO, Karam M, Behbehani K, 1997. Strategies and tools for the control/elimination of lymphatic filariasis. Bull World Health Organ 75: 491–503.
  5. WHO, 2004. Towards a strategic plan for research to support the global program to eliminate lymphatic filariasis. Summary of immediate needs and opportunities for research on lymphatic filariasis, Philadelphia, PA, December 9–10, 2003. Am J Trop Med Hyg 71: 1–46.
  6. Hoerauf A, Mand S, Adjei O, Fleischer B, Büttner DW, 2001. Depletion of Wolbachia endobacteria in Onchocerca volvulus by doxycycline and microfilaridermia after ivermectin treatment. Lancet 357: 1415–1416.
  7. Hoerauf A, Volkmann L, Hamelmann C, Adjei O, Autenrieth IB, Fleischer B, Büttner DW, 2000. Endosymbiotic bacteria in worms as targets for a novel chemotherapy in filariasis. Lancet 355: 1242–1243.
  8. Debrah A, Mand S, Marfo-Debrekyei Y, Batsa L, Pfarr K, Büttner M, Adjei O, Büttner DW, Hoerauf A, 2007. Macrofilaricidal activity after four weeks doxycycline treatment of Wuchereria bancrofti. Trop Med Int Health 12: 1433–1441.
  9. Debrah AY, Mand S, Specht S, Marfo-Debrekyei Y, Batsa L, Pfarr K, Larbi J, Lawson B, Taylor M, Adjei O, Hoerauf A, 2006. Doxycycline reduces plasma VEGF-C/sVEGFR-3 and improves pathology in lymphatic filariasis. PLoS Pathog 2: e92.
  10. Turner JD, Mand S, Debrah AY, Muehlfeld J, Pfarr K, McGarry HF, Adjei O, Taylor MJ, Hoerauf A, 2006. A randomized, double-blind clinical trial of a 3-week course of doxycycline plus albendazole and ivermectin for the treatment of Wuchereria bancrofti infection. Clin Infect Dis 42: 1081–1089.
  11. Hoerauf A, Mand S, Fischer K, Kruppa T, Marfo-Debrekyei Y, Debrah AY, Pfarr KM, Adjei O, Büttner DW, 2003. Doxycycline as a novel strategy against bancroftian filariasis-depletion of Wolbachia endosymbionts from Wuchereria bancrofti and stop of microfilaria production. Med Microbiol Immunol (Berl) 192: 261–273.
  12. Dreyer G, Amaral F, Noroes J, Medeiros Z, Addiss D, 1995. A new tool to assess the adulticidal efficacy in vivo of antifilarial drugs for bancroftian filariasis. Trans R Soc Trop Med Hyg 89: 225–226.
  13. Faris R, Hussain O, El Setouhy M, Ramzy RM, Weil GJ, 1998. Bancroftian filariasis in Egypt: visualization of adult worms and subclinical lymphatic pathology by scrotal ultrasound. Am J Trop Med Hyg 59: 864–867.
  14. Mand S, Marfo-Debrekyei Y, Dittrich M, Fischer K, Adjei O, Hoerauf A, 2003. Animated documentation of the filaria dance sign (FDS) in bancroftian filariasis. Filaria J 2: 3.
  15. Debrah A, Mand S, Toliat MR, Marfo-Debrekyei Y, Batsa L, Nurnberg P, Lawson B, Adjei O, Hoerauf A, Pfarr K, 2007. Plasma vascular endothelial growth factor-A (VEGF-A) and VEGF-A gene polymorphism are associated with hydrocele development in lymphatic filariasis. Am J Trop Med Hyg 77: 601–608.
  16. Hoerauf A, 2008. Filariasis: new drugs and new opportunities for lymphatic filariasis and onchocerciasis. Curr Opin Infect Dis 21: 673–681.
  17. Debrah AY, Mand S, Marfo-Debrekyei Y, Batsa L, Pfarr K, Lawson B, Taylor M, Adjei O, Hoerauf A, 2009. Reduction in levels of plasma vascular endothelial growth factor-A and improvement in hydrocele patients by targeting endosymbiotic Wolbachia sp. in Wuchereria bancrofti with doxycycline. Am J Trop Med Hyg 80: 956–963.
  18. Taylor MJ, Makunde WH, McGarry HF, Turner JD, Mand S, Hoerauf A, 2005. Macrofilaricidal activity following doxycycline treatment of Wuchereria bancrofti: a double-blind randomised controlled trial. Lancet 365: 2116–2121.
  19. Kazura J, Greenberg J, Perry R, Weil G, Day K, Alpers M, 1993. Comparison of single-dose diethylcarbamazine and ivermectin for treatment of bancroftian filariasis in Papua New Guinea. Am J Trop Med Hyg 49: 804–811.
  20. El Setouhy M, Ramzy RM, Ahmed ES, Kandil AM, Hussain O, Farid HA, Helmy H, Weil GJ, 2004. A randomized clinical trial comparing single- and multi-dose combination therapy with diethylcarbamazine and albendazole for treatment of bancroftian filariasis. Am J Trop Med Hyg 70: 191–196.
  21. Kshirsagar NA, Gogtay NJ, Garg BS, Deshmukh PR, Rajgor DD, Kadam VS, Kirodian BG, Ingole NS, Mehendale AM, Fleckenstein L, Karbwang J, Lazdins-Helds JK, 2004. Safety, tolerability, efficacy and plasma concentrations of diethylcarbamazine and albendazole co-administration in a field study in an area endemic for lymphatic filariasis in India. Trans R Soc Trop Med Hyg 98: 205–217.
  22. Sunish IP, Rajendran R, Mani TR, Dash AP, Tyagi BK, 2006. Evidence for the use of albendazole for the elimination of lymphatic filariasis. Lancet Infect Dis 6: 125–126.
  23. Hoerauf A, Specht S, Buttner M, Pfarr K, Mand S, Fimmers R, Marfo-Debrekyei Y, Konadu P, Debrah AY, Bandi C, Brattig N, Albers A, Larbi J, Batsa L, Adjei O, Buttner DW, 2008. Wolbachia endobacteria depletion by doxycycline as antifilarial therapy has macrofilaricidal activity in onchocerciasis: a randomized placebo-controlled study. Med Microbiol Immunol (Berl) 197: 295–311.
  24. Santos MD, Vermeersch H, Remon JP, Schelkens M, De Backer P, Van Bree HJ, Ducatelle R, Haesebrouck F, 1996. Pharmacokinetics and bioavailability of doxycycline in turkeys. J Vet Pharmacol Ther 19: 274–280.
  25. Noroes J, Dreyer G, Santos A, Mendes VG, Medeiros Z, Addiss D, 1997. Assessment of the efficacy of diethylcarbamazine on adult Wuchereria bancrofti in vivo. Trans R Soc Trop Med Hyg 91: 78–81.
  26. Weil GJ, Ramzy RM, El Setouhy M, Kandil AM, Ahmed ES, Faris R, 1999. A longitudinal study of bancroftian filariasis in the Nile Delta of Egypt: baseline data and one-year follow-up. Am J Trop Med Hyg 61: 53–58.
  27. Mand S, Debrah A, Batsa L, Adjei O, Hoerauf A, 2004. Reliable and frequent detection of adult Wuchereria bancrofti in Ghanaian women by ultrasonography. Trop Med Int Health 9: 1111–1114.
  28. Helmy H, Weil GJ, Ellethy AS, Ahmed ES, Setouhy ME, Ramzy RM, 2006. Bancroftian filariasis: effect of repeated treatment with diethylcarbamazine and albendazole on microfilaraemia, antigenaemia and antifilarial antibodies. Trans R Soc Trop Med Hyg 100: 656–662.
  29. Meyrowitsch DW, Simonsen PE, Magesa SM, 2004. Long-term effect of three different strategies for mass diethylcarbamazine administration in bancroftian filariasis: follow-up at 10 years after treatment. Trans R Soc Trop Med Hyg 98: 627–634.
  30. Njenga SM, Wamae CN, Njomo DW, Mwandawiro CS, Molyneux DH, 2008. Impact of two rounds of mass treatment with diethylcarbamazine plus albendazole on Wuchereria bancrofti infection and the sensitivity of immunochromatographic test in Malindi, Kenya. Trans R Soc Trop Med Hyg 102: 1017–1024.
  31. Peixoto CA, Figueiredo-Silva J, 2001. Fine structure of intrascrotal lymphatic vessels infected by Wuchereria bancrofti adult worms. J Submicrosc Cytol Pathol 33: 125–131.
  32. Dreyer G, Noroes J, Figueredo-Silva J, Piessens WF, 2000. Pathogenesis of lymphatic disease in bancroftian filariasis: a clinical perspective. Parasitol Today 16: 544–548.
  33. Freedman DO, Bui T, De Almeida Filho PJ, Braga C, Maia e Silva MC, Maciel A, Furtado AF, 1995. Lymphoscintigraphic assessment of the effect of diethylcarbamazine treatment on lymphatic damage in human bancroftian filariasis. Am J Trop Med Hyg 52: 258–261.
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  • Received : 23 Mar 2009
  • Accepted : 13 Jul 2009

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