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PubMed1996

Onchocerciasis in Ecuador: evolution of chorioretinopathy after amocarzine treatment.

AIMS: To investigate the impact of the macrofilaricidal drug, amocarzine, on the evolution of chorioretinopathy in onchocerciasis. METHODS: A prospective uncontrolled cohort study was performed using subjects infected with Onchocerca volvulus in a hyperendemic onchocerciasis focus in Esmeraldas Province in Ecuador. Study subjects were recruited into four cohorts in which ophthalmic and parasitological data were collected for 2, 3, 4, and 5 years respectively. RESULTS: Complete ophthalmic follow up was obtained for 294 individuals in the four cohorts. The incidence of retinal pigment epithelial atrophy tended to remain constant between cohorts while that of chorioretinal scarring with a greater observation period. The incidence rate of cases with new or extending chorioretinal lesions was greater with an increasing period of follow up. An association was seen between the cumulative microfilarial loads in the skin and the development of new chorioretinal lesions (p < 0.05). No relation was noted between cumulative microfilarial loads and the progression of existing disease. CONCLUSION: Amocarzine therapy did not prevent the natural evolution of chorioretinal disease. It was suggested that ocular microfilariae were necessary for the induction of chorioretinopathy in previously unaffected eyes and that extension of existing disease might also be related to the presence of ocular microfilariae or to other immunological mechanisms.

Adolescent↗
PubMed1999

An essential role for antibody in neutrophil and eosinophil recruitment to the cornea: B cell-deficient (microMT) mice fail to develop Th2-dependent, helminth-mediated keratitis.

Invasion of the corneal stroma by neutrophils and eosinophils and subsequent degranulation disrupts corneal clarity and can result in permanent loss of vision. In the current study, we used a model of helminth-induced inflammation to demonstrate a novel role for Ab in mediating recruitment of these inflammatory cells to the central cornea. C57BL/6 and B cell-deficient (microMT) mice were immunized s. c. and injected intrastromally with Ags from the parasitic helminth Onchocerca volvulus (which causes river blindness). C57BL/6 mice developed pronounced corneal opacification, which was associated with an Ag-specific IL-5 response and peripheral eosinophilia, temporal recruitment of neutrophils and eosinophils from the limbal vessels to the peripheral cornea and subsequent migration to the central cornea. In contrast, the corneas of microMT mice failed to develop keratitis after intrastromal injection of parasite Ags unless Ags were injected with immune sera. Eosinophils were recruited from the limbal vessels to the peripheral cornea in microMT mice, but failed to migrate to the central cornea, whereas neutrophil recruitment was impaired at both stages. With the exception of IL-5, T cell responses and peripheral eosinophils were not significantly different between C57BL/6 and microMT mice. Taken together, these findings not only demonstrate that Ab is required for the development of keratitis, but also show that recruitment of neutrophils to the cornea is Ab-dependent, whereas eosinophil migration is only partially dependent upon Ab interactions.

Animals↗
PubMed2002

Cystatins of filarial nematodes up-regulate the nitric oxide production of interferon-gamma-activated murine macrophages.

Cystatins of two filarial nematodes were studied with regard to their capacity to up-regulate the production of nitric oxide (NO) in vitro, and the effects were analysed. Recombinant cystatin of the human pathogenic filaria Onchocerca volvulus and of the rodent filaria Acanthocheilonema viteae significantly enhanced the NO production of interferon (IFN)-gamma-activated macrophages of BALB/c and C3H/HeJ mice. Truncated cystatins lacking the N-terminal protease inhibitory active site, and showing marginal protease inhibitory activity, up-regulated the NO production to the same extent as the full-length proteins, indicating that the effect on the NO production is independent of cysteine protease inhibition. NO did not contribute to the suppression of proliferative T cell responses exerted by filarial cystatins, as shown in other studies, since NO synthase inhibitors did not restore proliferative responses. The up-regulation of NO production induced by filarial cystatins was partly dependent on the production of interleukin-10 and tumour necrosis factor-alpha, since depletion of both cytokines by antibodies led to a diminution of the enhanced NO production by 22-48%. Our data suggest that filarial cystatins are potent triggers of the production of NO, a mediator which was shown to have a role as an effector molecule against filarial worms in vitro and in vivo.

Adjuvants, Immunologic↗
PubMed1994

OvGalBP, a filarial antigen with homology to vertebrate galactoside-binding proteins.

The increased incidence of "allergic" symptomatology and clinical complications seen in non-endemic individuals with loiasis, as compared to natives of endemic areas, is thought to reflect a heightened immune response to filarial antigens. To identify antigens involved in this hyperresponsiveness, a cDNA library constructed from adult female RNA from the related filarial parasite, Onchocerca volvulus, was screened with serum from a North American who acquired loiasis in West Africa. Sequence analysis of one of the identified clones, OvGalBP, revealed significant homology to the vertebrate S-type lectins, a family of thiol-dependent, metal-independent galactoside binding lectins, which includes an IgE-binding protein thought to be involved in IgE regulation. The 1100-bp insert of OvGalBP contains the entire protein coding region and has a 3' poly(A) tail. The two amino acid consensus sequences (WGxExR and HFNPRF) found in all of the S-type lectins are present. Purified recombinant protein expressed as a fusion with glutathione-S-transferase (OvGalBP-GST) was recognized by sera from a majority of filaria-infected patients but not by putatively immune individuals from an endemic area or by unexposed endemic and non-endemic controls. Interestingly, OvGalBP-GST specifically bound IgE (and not IgG) in a lactose-inhibitable manner, suggesting a potential role for this protein in the pathophysiology of human filarial infection.

Amino Acid Sequence↗
PubMed2001

Analysis of the effects of rotational larviciding on aquatic fauna of two Guinean rivers: the case of permethrin.

Within the Onchocerciasis Control Programme about 50,000 km of west African rivers have been regularly sprayed with larvicides to control the vector of dermal filariasis caused by Onchocerca volvulus. Since the beginning of the programme invertebrates and fish data were collected to monitor adverse effects on non-target organisms. The regular series of biological and hydrological data collected in two Guinean rivers were analysed to evaluate the effects of rotational larviciding with particular attention to permethrin, as preliminary acute toxicology tests and semi-field experiments suggest it has stronger effects on non-target fauna in respect to other larvicides. Invertebrates and fish variations in biomass and species richness are seasonal and flow-related and the results presented here do not support any evidence of specific effects of permethrin application on the biological targets monitored. Larvicide applications influence community structures, putting pressure on some taxonomic groups, causing, for example, the rarefaction of some taxa. In spite of the above results, the scarcity of some invertebrate systematic units does not result in a significant reduction of total invertebrate density because of the corresponding increase in other systematic units. In nature the studied aquatic communities would rarely be in equilibrium because of frequent natural stresses, such as drought and spate events, the biological variations discussed are to be considered ecologically acceptable.

Animals↗
PubMed2005

[Ivermectin].

Initial clinical trials in 1980 showed that ivermectin was remarkably effective against Onchocerca volvulus. Some 25 years after more than 50 million people are treated annually with Mectizan mainly within the framework of the African Programme for Onchocerciasis Control (APOC). This success has been possible thanks to Merck Mectizan Donation Program and to distribution through a novel strategy based on the strong involvement of endemic communities. In the last few years Mectizan has been used in combination with albendazole to control lymphatic filariasis on a large-scale basis in African countries. More recently ivermectin (under the tradename Stromectol) received market approval in France for treatment of gastrointestinal strongyloidiasis and scabies. Clinical trials are under way to evaluate the activity of ivermectin on nematodes (Loa loa, Mansonella sp., intestinal nematodes, cutaneous and visceral larva migrans) and ectoparasites (Pediculus humanus capitis, Phtirius pubis, Tunga penetrans, myiases). Trials are also ongoing to explain the mechanisms underlying the severe adverse events sometimes observed in patients presenting high Loa loa microfilaraemia and to develop preventive measures. Fundamental research will provide a better understanding of the mode of action of ivermectin at the molecular and cellular level, evaluate the risk of resistance of human parasites, and to determine the extent to which ivermectin could be used in association with other agents for the treatment of nonparasitic diseases.

Animals↗
PubMed1998

Resistance of filarial nematode parasites to oxidative stress.

All filariae examined to date express a comprehensive repertoire of both cytoplasmic and secreted anti-oxidant enzymes, although significant differences exist between species and life-cycle stages. Adult Brugia malayi, Dirofilaria immitis and Onchocerca volvulus secrete CuZn superoxide dismutases, and the former two species also secrete a selenocysteine-independent glutathione peroxidase. This enzyme has been localised to the cuticular matrix of B. malayi, and the preferential reduction of fatty acid- and phospholipid hydroperoxides suggests that it may protect cuticular membranes from oxidative damage rather than directly metabolise hydrogen peroxide. Adult O. volvulus may compensate for an apparent deficiency in expression of this enzyme via a secreted variant of glutathione S-transferase. Recent studies have identified a highly expressed family of enzymes collectively termed peroxiredoxins, which most probably play an essential role in reduction of hydroperoxides. Data from cDNA cloning exercises indicate that all filarial species examined thus far express at least two peroxiredoxin variants which have been localised to diverse tissues. In-vitro studies have shown that B. malayi are particularly resistant to oxidative stress, and that the parasites do not rely solely on enzymatic mechanisms of defence. Cuticular lipids are relatively resistant to lipid peroxidation due to the low unsaturation indices of the constituent fatty acyl residues, but complete protection is afforded by the presence of alpha-tocopherol, presumably assimilated from host extracellular fluids. Brugia malayi are also relatively resistant to nitric oxide-mediated toxicity, and this may be due in part to incomplete dependence on aerobic metabolism. Little is known of potential mechanisms for detoxification of nitric oxide derivatives and adaptive responses to oxidative stress in general, and these represent goals for future research.

Animals↗
PubMed1995

The chemotherapy of onchocerciasis. XIX: The clinical and laboratory tolerance of high dose ivermectin.

Ivermectin is the drug of choice for the treatment of onchocerciasis. However at the recommended dose of 150 micrograms/kg, it neither kills nor permanently sterilises the adult worms. We investigated whether high doses given with and without a preceding 150 micrograms/kg 'clearing' dose would be tolerable as well as effective against the adult worms. Seventy-five healthy males with moderate to heavy infections with Onchocerca volvulus were enrolled in a double-blind trial to receive one of the following treatment regimens: 150 micrograms/kg followed by placebo (9 patients); 400 micrograms/kg with (9 patients) or without (16 patients) a clearing dose; 600 micrograms/kg with (8 patients) or without (16 patients) a clearing dose and 800 micrograms/kg with (8 patients) or without (9 patients) a clearing dose. Detailed examinations were conducted before and at various times after treatment. A preliminary report on the clinical and laboratory safety as at 30 days is presented. All the regimens were well tolerated. No clinical or laboratory drug related effects were observed. The overall severity of the Mazzotti reaction was similar in all groups. Ocular reactions were minimal and there were no changes in ocular function or in fluorescein angiograms. The groups were similar in the extent of microfilaricidal activity; there was however a suggestion that microfilariae were killed more rapidly at 400 micrograms/kg and 600 micrograms/kg but not at 800 micrograms/kg. This needs further study. Single doses of ivermectin up to 800 micrograms/kg are well tolerated; no special precautions for treatment monitoring are required and a 'clearing' dose is not necessary.

Animals↗
PubMed2001

Antibody responses in onchocerciasis as a function of age and infection intensity.

Onchocerciasis is caused by the filarial nematode Onchocerca volvulus and is a major public health problem in West and Central Africa. With only partial and long-term treatment currently available, there is a need to develop a suitable vaccine. We analysed the antibody response to infective L3 larvae because this stage is thought to be associated with host protective immunity. In addition, we have related our findings to the age, gender and current infection intensity of our participants: variables that may significantly influence antibody production. Interestingly, whilst 90% of our study group were seropositive for adult specific immunoglobulin (Ig)E, only 23% produced L3 specific IgE. This is in contrast to IgG4 where seropositivity was comparable at 96% and 92%, respectively. Furthermore, IgG levels were significantly affected by age and the intensity of infection but unaffected by host gender. This finding is independent for the IgG subclass (IgG1, IgG2, IgG3 and IgG4) and its specificity (L3 versus adult antigen). In summary, we show that L3 larvae induce little specific IgE and the antibody response shows a different isotype balance than that against adult antigens. Both host and parasite variables can influence antibody production in this disease.

Adolescent↗
PubMed2001

CXC chemokine receptor 2 but not C-C chemokine receptor 1 expression is essential for neutrophil recruitment to the cornea in helminth-mediated keratitis (river blindness).

Infiltration of neutrophils and eosinophils into the mammalian cornea can result in loss of corneal clarity and severe visual impairment. To identify mediators of granulocyte recruitment to the corneal stroma, we determined the relative contribution of chemokine receptors CXC chemokine receptor (CXCR)-2 (IL-8R homologue) and CCR1 using a murine model of ocular onchocerciasis (river blindness) in which neutrophils and eosinophils migrate from peripheral vessels to the central cornea. CXCR2(-/-) and CCR1(-/-) mice were immunized s.c. and injected into the corneal stroma with Ags from the parasitic helminth Onchocerca volvulus. We found that production of macrophage-inflammatory protein (MIP)-2, KC, and MIP-1 alpha was localized to the corneal stroma, rather than to the epithelium, which was consistent with the location of neutrophils in the cornea. CCR1 deficiency did not inhibit neutrophil or eosinophil infiltration to the cornea or development of corneal opacification. In marked contrast, neutrophil recruitment to the corneas of CXCR2(-/-) mice was significantly impaired (p < 0.0001 compared with control, BALB/c mice) with only occasional neutrophils detected in the central cornea. Furthermore, CXCR2(-/-) mice developed only mild corneal opacification compared with BALB/c mice. These differences were not due to impaired KC and MIP-2 production in the corneal stroma of CXCR2(-/-) mice, which was similar to BALB/c mice. Furthermore, although MIP-1 alpha production was lower in CXCR2(-/-) mice than BALB/c mice, eosinophil recruitment to the cornea was not impaired. These observations demonstrate the critical role for CXCR2 expression in neutrophil infiltration to the cornea and may indicate a target for immune intervention in neutrophil-mediated corneal inflammation.

Animals↗
PubMed2004

Incidence of blindness during the Onchocerciasis control programme in western Africa, 1971-2002.

BACKGROUND: Infection with Onchocerca volvulus is associated with the prevalence of severe visual impairment and blindness. However, longitudinal studies of the incidence of blindness caused by onchocerciasis are scarce. METHODS: The relationship, at the individual level, between infection with O. volvulus microfilariae and bilateral blindness was examined, by use of data collected, during the Onchocerciasis Control Programme in western Africa (OCP), from 2315 villages in 11 countries. The data were analyzed by Poisson maximum-likelihood techniques with adjustment for overdispersion. RESULTS: A total of 297,756 persons were eligible for follow-up in the cohort, and, during 1971-2001, these persons accumulated 367,788 person-years of follow-up without blindness. A total of 673 bilateral cases of blindness occurred during this period; 29.7% were caused by onchocerciasis. After ivermectin therapy was introduced (during 1988-2001), only 19.6% of cases were caused by onchocerciasis. The incidence of blindness was significantly and positively associated with increasing microfilarial burden (P<.001). Overall, female subjects had an ~40% lower risk of becoming blind than did male subjects (P<.001). After an initially high incidence of blindness at the beginning of the OCP, the rate of blindness from causes other than onchocerciasis remained approximately constant during follow-up. CONCLUSIONS: We demonstrate, in a comprehensive data set and in both sexes, a direct relationship between microfilarial load and the incidence of blindness.

Adolescent↗
PubMed2002

Onchocerciasis in West Africa after 2002: a challenge to take up.

Initially planned for a 20 year life time, the Onchocerciasis Control Programme in West Africa (OCP) will have finally continued its activities for nearly three decades (vector control alone from 1975 to 1989, then vector control and/or therapeutic treatment until 2002). Although onchocerciasis is no longer a problem of public health importance nor an obstacle to socio-economic development in the OCP area, the control of this filariasis is not over because OCP never aimed at eradication, neither of the parasite (Onchocerca volvulus), nor of its vector (Simulium damnosum s.l.). In 2003, the eleven Participating countries of OCP will take over the responsibility of carrying out the residual activities of monitoring and the control of this disease. This mission is of great importance because any recrudescence of the transmission could lead in the long run to the reappearance of the clinical signs of onchocerciasis, if not its most serious manifestations. For epidemiological and operational reasons, and given the disparity in national health policies and infrastructures, the capacities of the countries to take over the residual activities of monitoring and control of onchocerciasis are very unequal. Indeed, the interventions to be carried out are very different from one country to another and the process of integrating the residual activities into the national health systems is not taking place at the same pace. This inequality among the countries vis-a-vis the challenges to be met does not, however, prejudge the epidemiological situation after 2002 whose evolution will also depend on the effectiveness of the provisions made before that date by OCP, then after 2002, by the Regional Office for Africa of the World Health Organization which is currently setting up a sub-regional multidisease surveillance centre.

Africa, Western↗
PubMed2002

The variant Arg110Gln of human IL-13 is associated with an immunologically hyper-reactive form of onchocerciasis (sowda).

Onchocerca volvulus infection usually results in a predominantly immunopermissive reaction called generalized onchocerciasis and characterized by high microfilarial burden and immunological tolerance to the worms. Rarely, however, infection leads to the sowda form of the disease displaying low microfilarial numbers, i.e. microfilarial control, and a T helper 2 (Th2)-type immune response including high immunoglobulin (Ig)E levels, and interleukin (IL)-13 being one of the key cytokines. The aim of this study was to investigate a possible association of a variant of the IL-13 gene, which confers an IgE-independent risk for asthma and atopy, with the immunologically hyper-reactive sowda form of onchocerciasis. Genotyping for the IL-13 variant Arg110Gln revealed a highly significant association of Arg110Gln with the sowda form (relative risk of 2.98, n = 19 patients), whereas the frequency of the variant was significantly lower in patients with generalized onchocerciasis (n = 92 individuals). Sowda patients had higher IgE levels than those with generalized onchocerciasis. Logistic regression analysis revealed that IgE and IL-13 are independent variables, each increasing the relative risk for sowda. Arg110Gln has been suggested to lead to enhanced IL-13 signaling and thus may be involved in shifting the immune reaction towards the hyper-reactivity characteristic for the sowda form, thereby promoting defense mechanisms.

Alleles↗
PubMedDate not supplied

Onchocerciasis hyperendemic in the Unturán Mountains: the value of recombinant antigens in describing a new transmission area in southern Venezuela.

A recently described hyperendemic onchocerciasis area, located in the Unturán Mountains (between the Siapa and Orinoco basins) of southern Venezuela was studied using a cocktail of 3 low molecular weight onchocercal recombinant antigens (OvMBP/10, OvMBP/11, and OvMBP/29). The resulting seroepidemiological data were compared with those from a hypoendemic community (Altamira) situated in the northern coastal mountain range. Parasitological (skin biopsy) and serological (enzyme-linked immunosorbent assay, ELISA) methods for the specific diagnosis of Onchocerca volvulus in these 2 very different endemic areas were, respectively, 88% and 96% sensitive in Unturán, and 57% and 91% sensitive in Altamira. The mean microfilarial load, the mean optical density (OD), and the seropositivity rates all increased significantly with age in both communities. The serological variables (mean OD and prevalence of anti-O. volvulus antibodies) were both significantly higher in Unturán than in Altamira for children and young adults (aged < 25 years), although above this age no differences between communities were detected. Seroprevalence had already reached 50% in the under 15 year-olds examined at Unturán but was just 5% at Altamira for the same age-class. The prevalence of specific antibodies (mainly a marker of exposure to risk of infection) exceeded 85% in the remaining age-categories at the hyperendemic area. This is in agreement with the high community microfilarial load recorded in Unturán (> 20 mf/mg) and the presence of sclerosing keratitis and hanging groin, suggesting that onchocerciasis is a public health problem in this community. The ELISA test used here, based on a cocktail of 3 low molecular weight onchocercal recombinant antigens, appears, therefore, to constitute a practical tool for the description of endemicity levels in remote areas, particularly given the fact that finger-prick blood samples are routinely taken from children in the Upper Orinoco region for surveys of malaria incidence. Such studies could aid in defining the true extent of the Amazon focus (still unknown) and providing priority indicators for the selection of communities where onchocerciasis control programmes should be implemented.

Adult↗
PubMed1999

Onchocerciasis modulates the immune response to mycobacterial antigens.

Chronic helminth infection induces a type-2 cellular immune response. In contrast to this, mycobacterial infections commonly induce a type-1 immune response which is considered protective. Type-2 responses and diminished type-1 responses to mycobacteria have been previously correlated with active infection states such as pulmonary tuberculosis and lepromatous leprosy. The present study examines the immune responses of children exposed to both the helminth parasite Onchocerca volvulus and the mycobacterial infections, Mycobacterium tuberculosis and M. leprae. Proliferation of peripheral blood mononuclear cells (PBMC) and production of IL-4 in response to both helminth and mycobacterial antigen (PPD) decreased dramatically with increasing microfilarial (MF) density. Although interferon-gamma (IFN-gamma) production strongly correlated with cellular proliferation, it was surprisingly not related to MF density for either antigen. IL-4 production in response to helminth antigen and PPD increased with ascending children's age. IFN-gamma and cellular proliferation to PPD were not related to age, but in response to helminth antigen were significantly higher in children of age 9-12 years than children of either the younger age group (5-8 years) or the older group (13-16 years). Thus, there was a MF density-related down-regulation of cellular responsiveness and age-related skewing toward type 2 which was paralleled in response to both the helminth antigen and PPD. This parasite-induced immunomodulation of the response to mycobacteria correlates with a previous report of doubled incidence of lepromatous leprosy in onchocerciasis hyperendemic regions. Moreover, this demonstration that helminth infection in humans can modulate the immune response to a concurrent infection or immunological challenge is of critical importance to future vaccination strategies.

Adolescent↗
PubMed2002

Can ivermectin mass treatments eliminate onchocerciasis in Africa?

OBJECTIVE: To elucidate the conditions in which mass treatment with ivermectin reduces the transmission of Onchocerca volvulus sufficiently to eliminate infection from an African community. METHODS: ONCHOSIM, a microsimulation model for onchocerciasis transmission, was used to explore the implications of different treatment intervals, coverage levels and precontrol endemicities for the likelihood of elimination. FINDINGS: Simulations suggested that control strategies based exclusively on ivermectin mass treatments could eliminate onchocerciasis. The duration of treatment required to eliminate infection depended heavily on the treatment programme and precontrol endemicity. In areas with medium to high levels of infection, annual mass treatments with 65% coverage for at least 25 years were necessary. Model predictions suggested that durations exceeding 35 years would be required if there were much heterogeneity in exposure to vector bites and, consequently, wide individual variation in microfilaria counts. If the treatment interval were reduced from 12 to 6 months the time for completion of the programme could be more than halved and elimination could be accomplished in areas of hyperendemicity, provided that the effects of each treatment would be the same as with annual treatments. However, it was doubtful whether high coverage levels could be sustained long enough to achieve worldwide eradication. CONCLUSION: Elimination of onchocerciasis from most endemic foci in Africa appears to be possible. However, the requirements in terms of duration, coverage, and frequency of treatment may be prohibitive in highly endemic areas.

Africa↗
PubMed2003

Hr44 secreted with exosomes: loss from ciliary epithelium in response to inflammation.

PURPOSE: Hr44 is a target antigen for cross-reactive antibodies to the Onchocerca volvulus antigen Ov39. This study was undertaken to determine the epitopes recognized by antibodies to hr44, including Ov39/hr44 cross-reacting antibodies, and to use these antibodies to determine the distribution of hr44 in normal and inflamed intraocular epithelia and ARPE-19 cell cultures. METHODS: Epitopes were identified with a peptide-based ELISA and competition ELISA. Immunostaining for hr44 and CD63 was conducted on control and inflamed ocular tissues. Exosomes were isolated from ARPE-19 cell cultures and analyzed by Western blot and electron microscopy. RESULTS: Linear epitopes and the Ov39 cross-reactive epitope of hr44 were identified. Immunohistology indicated that hr44 is present in vesicular structures of the iris and ciliary body and is lost from the epithelial layers of inflamed eyes coincidentally with CD63. A 66-kDa variant of hr44 is present in exosomes purified from ARPE-19 cell culture supernatants. CONCLUSIONS: Because hr44 is a component of exosomes produced by ARPE-19 cells, the coincident loss of hr44 and CD63 in inflamed epithelia indicates that exosomes may be released from intraocular epithelia in response to inflammation. This notion suggests that exosomes shed by intraocular epithelial cells influence T-cell survival and antigen presentation in the eye without direct cell-cell contact and have a role in the maintenance of ocular immune privilege.

Animals↗
PubMed1997

IL-12 exacerbates helminth-mediated corneal pathology by augmenting inflammatory cell recruitment and chemokine expression.

Corneal inflammation (keratitis) is a major cause of visual impairment in Onchocerca volvulus infection. Previous studies showed that onchocercal keratitis can be induced in mice following s.c. immunization and intracorneal injection with soluble O. volvulus Ags (OvAg), and that the inflammatory response is dependent on T cells and IL-4. Since recombinant IL-12 impairs IL-4-dependent, Th2-mediated responses in other parasitic infections and in models of allergic asthma, the present study was undertaken to determine the effect of IL-12 on onchocercal keratitis. Mice were injected i.p. with IL-12 or saline at the time of initial sensitization to OvAg. Surprisingly, IL-12 treatment caused significant exacerbation of corneal pathology, which was associated with increased eosinophil and mononuclear cell infiltration into the corneal stroma. Consistent with the well-documented effect of IL-12 on Th1 cell development, corneas of IL-12-treated animals had elevated expression of the Th1 cytokine IFN-gamma and diminished expression of the Th2 cytokines IL-4, IL-5, IL-10, and IL-13. However, corneas from these animals also had marked elevation of alpha- and beta-chemokines known to be active on eosinophils and mononuclear cells, including IFN-gamma-inducible protein (IP)-10, macrophage inflammatory protein-1alpha, macrophage inflammatory protein-1beta, JE/monocyte chemotactic protein-1, RANTES (regulated upon activation, normal T expressed and secreted), and eotaxin. Together, these data indicate that IL-12 exacerbates OvAg-mediated corneal pathology by enhancing chemokine expression and recruitment of inflammatory cells.

Animals↗