Comparing antibody responses to Onchocerca volvulus and non-parasite antigens in placebo-controlled and ivermectin-treated onchocerciasis patients

Abstract

Serum antibodies to parasite‐specific and non‐parasite antigens were evaluated using enzyme‐linked immunosorbent assay (ELISA). Out of the 470 sera collected, 409 were from residents of an onchocerciasis hyper‐endemic area, 55 non‐endemic and 6 European normal sera served as control. The patients' age, sex, skin microfilaria densities, dermal and ocular clinical manifestations (colour of optic disc) have been well characterised. The study population had participated in a placebocontrolled (n=191) trial of ivermectin (Mectizan) treatment (n=218). The parasite antigens are phosphate buffered saline crude extract of adult worms of Onchocerca volvulus, a recombinant antigen (Ov1.9) and a monoclonal antibody purified antigen (Cam 1). The non‐parasite antigens are deoxycholate citrate extract of optic nerve (nerve‐DOC) and commercially available IgA, IgM and IgG were used to assay for rheumatoid factor (Rh‐F) auto‐antibodies. Generally, antibodies to parasite antigens in onchocerciasis patients were remarkably higher than control group (p<0.05) using exact F‐test. There was no significant difference (p>0.05) in antibodies to nerve‐DOC and Rh‐F in patients compared to control. Antibodies increased with increasing skin snip microfilaria load from 0.69+/‐0.28 with 0mf/mg (n=54) as against 0.80+/‐0.26 for those with 4‐20mf/mg. Observed slight negative correlation in IgG antibody levels and severity of disc colour with mean OD values of 0.26+/‐0.22 in those graded as having no optic nerve disease (OND) (disc 1, n=86) and 0.17+/‐0.19 for those with severe changes (disc 3, n=49) was not statistically significant (P>0.05). An age dependent significant decrease (P<0.05) in antibodies were observed with 0.64+/‐0.34 for 15‐30yr old (n=48) compared to 0.48+/‐0.35 for those 50yr (n=50) for PBS with a similar trend for IgG to Ov1.9 and Cam1. In conclusion, serum parasite‐specific and non‐parasite antibodies may not be responsible for the pathology of optic nerve disease. Onchocerciasis patients were apparently not at higher risk of developing rheumatoid arthritis than the control.