Strong association of interleukin-6 and lipopolysaccharide-binding proteinwith severity of adverse reactions after diethylcarbamazine treatment of microfilaremic patients
M. Haarbrink et al., Strong association of interleukin-6 and lipopolysaccharide-binding proteinwith severity of adverse reactions after diethylcarbamazine treatment of microfilaremic patients, J INFEC DIS, 182(2), 2000, pp. 564-569
To assess the involvement of inflammatory mediators in the development of a
dverse reactions in filarial patients undergoing treatment, 29 microfilarem
ic subjects were treated with diethylcarbamazine (DEC). Before and at seria
l time points after initiation of treatment, plasma levels of inflammatory
mediators and DEC were measured, and adverse reactions were recorded. Patie
nts experienced no or mild, moderate, or severe adverse reactions. Increasi
ng pretreatment microfilarial counts were associated with escalating severi
ty of adverse reactions. Plasma concentrations of DEC were not different am
ong patients suffering from varying degrees of illness. Interleukin (IL)-6,
IL-10, lipopolysaccharide-binding protein (LBP), and soluble tumor necrosi
s factor receptors (sTNF-Rs) increased after treatment. IL-6 and LBP, howev
er, showed the strongest association with adverse reactions. Increasing lev
els of these molecules were closely correlated with the mounting severity o
f adverse reactions, which raises the possibility that they play an importa
nt role in systemic inflammation that arises after DEC treatment of filaria
l patients.