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Macrofilaricidal activity and amelioration of lymphatic pathology in bancroftian filariasis after 3 weeks of doxycycline followed by single-dose diethylcarbamazine.

Identifieur interne : 006245 ( Main/Merge ); précédent : 006244; suivant : 006246

Macrofilaricidal activity and amelioration of lymphatic pathology in bancroftian filariasis after 3 weeks of doxycycline followed by single-dose diethylcarbamazine.

Auteurs : Sabine Mand [Allemagne] ; Kenneth Pfarr ; Prakash K. Sahoo ; Ashok K. Satapathy ; Sabine Specht ; Ute Klarmann ; Alexander Y. Debrah ; Balachandran Ravindran ; Achim Hoerauf

Source :

RBID : pubmed:19815891

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English descriptors

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 Wolbachia endobacteria from Wuchereria bancrofti, filaricidal activity, and amerlioration of scrotal lymph vessel dilation were studied in 57 men from Orissa, India. The 21-day doxycycline course reduced Wolbachia in W. bancrofti 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.

DOI: 10.4269/ajtmh.2009.09-0155
PubMed: 19815891

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Le document en format XML

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<term>Anthelmintics (therapeutic use)</term>
<term>Anti-Bacterial Agents (administration & dosage)</term>
<term>Anti-Bacterial Agents (therapeutic use)</term>
<term>Diethylcarbamazine (administration & dosage)</term>
<term>Diethylcarbamazine (therapeutic use)</term>
<term>Double-Blind Method</term>
<term>Doxycycline (administration & dosage)</term>
<term>Doxycycline (therapeutic use)</term>
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<term>Elephantiasis, Filarial (drug therapy)</term>
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<term>Antibactériens (administration et posologie)</term>
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<term>Antihelminthiques (administration et posologie)</term>
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<term>Diéthylcarbamazine (administration et posologie)</term>
<term>Diéthylcarbamazine (usage thérapeutique)</term>
<term>Doxycycline (administration et posologie)</term>
<term>Doxycycline (usage thérapeutique)</term>
<term>Filariose lymphatique (traitement médicamenteux)</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Mâle</term>
<term>Méthode en double aveugle</term>
<term>Wuchereria bancrofti</term>
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<term>Antihelminthiques</term>
<term>Diéthylcarbamazine</term>
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<term>Antihelminthiques</term>
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<term>Double-Blind Method</term>
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<term>Calendrier d'administration des médicaments</term>
<term>Humains</term>
<term>Jeune adulte</term>
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<div type="abstract" xml:lang="en">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 Wolbachia endobacteria from Wuchereria bancrofti, filaricidal activity, and amerlioration of scrotal lymph vessel dilation were studied in 57 men from Orissa, India. The 21-day doxycycline course reduced Wolbachia in W. bancrofti 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.</div>
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