| Autor: |
Greene, Sarah E., Huang, Yuefang, Fischer, Kerstin, Rosa, Bruce A., Martin, John, Mitreva, Makedonka, Yates, Devyn, Wanji, Samuel, Kamgno, Joseph, Budge, Philip J., Weil, Gary J., Fischer, Peter U. |
| Předmět: |
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| Zdroj: |
PLoS Neglected Tropical Diseases; 9/3/2024, Vol. 18 Issue 9, p1-15, 15p |
| Abstrakt: |
Background: Loiasis is a disease caused by the nematode Loa loa. Serious adverse events sometimes occur in people with heavy L. loa microfilaremia after ivermectin treatment. In regions of Central Africa where loiasis is endemic, this significantly impedes global elimination programs for lymphatic filariasis and onchocerciasis that use mass distribution of ivermectin. Improved diagnostic tests to identify individuals at increased risk of serious adverse events could facilitate efforts to eliminate lymphatic filariasis and onchocerciasis in this region. Methods and findings: We previously identified the L. loa protein Ll-Bhp-1 in loiasis patient sera. Here, we further characterize Ll-Bhp-1 and report development of an antigen capture ELISA to detect this antigen. This assay detected Ll-Bhp-1 in 74 of 116 (63.8%) loiasis patient sera. Ll-Bhp-1 levels were significantly correlated with L. loa microfilarial counts, and the sensitivity of the assay was highest for samples from people with high counts, (94% and 100% in people with ≥20,000 and ≥50,000 microfilaria per milliliter of blood, respectively). The antigen was not detected in 112 sera from people with other filarial infections, or in 34 control sera from the USA. Conclusions: This Ll-Bhp-1 antigen assay is specific for loiasis, and highly sensitive for identifying people with high L. loa microfilarial counts who are at increased risk for serious adverse events after ivermectin treatment. L. loa antigen detection has the potential to facilitate loiasis mapping efforts and programs to eliminate lymphatic filariasis and onchocerciasis in Central Africa. Author summary: Lymphatic filariasis and onchocerciasis are major neglected tropical diseases that have been targeted for elimination by the World Health Organization. Elimination campaigns for these infections using mass drug administration have had a huge impact in Africa. However, they face a major challenge in 11 countries in Central Africa where there is co-endemic loiasis, another filarial infection caused by the parasite Loa loa. The anti-filarial medication ivermectin that is used in elimination programs can cause serious and fatal adverse drug events in people with heavy loiasis infections, or high blood microfilarial counts. These programs would benefit from practical and affordable screening tests to detect people at high risk of adverse events from ivermectin. Furthermore, loiasis itself causes a variety of negative health outcomes and improved diagnostic tests would help control this infection. Here, we report the development of a sandwich immunoassay that detects the L. loa protein Ll-Bhp-1 in human serum samples. This assay is specific for L. loa infection and is highly sensitive in people with high microfilarial counts. Further work is needed to refine this prototype test and to determine whether antigen testing for loiasis can facilitate filarial eliminations efforts in Central Africa. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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