Clinical Study of Eradicated and Resistant Patients to Treatment with Ivermectin for Strongyloidiasis

Shikiya, K; Zaha, Osamu; Niimura, S; Nakamura, Hiroshi; Nakayoshi, Tomoko; Kochi, Arata; Uehara, Takeshi; Uechi, Hiroyuki; Ohshiro, Junichi; Kinjo, Fukunori

doi:10.11150/kansenshogakuzasshi1970.66.935

Cited by 9 publications

(9 citation statements)

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“…10 In a previous study, we evaluated treatment with ivermectin, using a uniform dose of 6 mg (approximately 100 µg/kg). 3,11 It was administered in two single doses, given 2 weeks apart. The reasons for selecting this regimen involved the following considerations.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart

Zaha

Hirata

Kinjo

et al. 2002

Journal of Infection and Chemotherapy

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Section: Discussionmentioning

confidence: 99%

Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart

Zaha

Hirata

Kinjo

et al. 2002

Journal of Infection and Chemotherapy

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“…However, no differences were observed in peripheral acidophilic counts or serum IgE levels between treated and untreated groups in HTLV-1-infected patients. [1][2][3] In the present study, the long-term anthelmintic rate increased from 50% to 90% in patients positive for anti-HTLV-1 antibody following the use of ivermectin at 200 µg/ kg compared with 110 µg/kg. The remaining 10% of patients positive for anti-HTLV-1 antibody who failed to respond to the anthelmintic treatment required re-treatment.…”

Section: Anthelmintic Effectmentioning

confidence: 85%

“…We reported previously that the long-term response to this regimen is dependent on anti-T lymphotropic virus type I (HTLV-1) antibody status. 1,2 In our experience, approximately 38% of strongyloidiasis patients were anti-HTLV-1 antibody positive, and approximately half were resistant to treatment. The single dose (110 µg/kg) that we used is approximately half the recommended dose (200 µg/kg) used outside Japan; this was apparently the reason for the lower anthelmintic rate.…”

Section: Introductionmentioning

confidence: 96%

Comparison of anthelmintic effects of two doses of ivermectin on intestinal strongyloidiasis in patients negative or positive for anti-HTLV-1 antibody

Zaha

Hirata

Uchima

et al. 2004

Journal of Infection and Chemotherapy

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“…1,2 In Japan, there are many patients with persistent infection in the Southern Islands and Okinawa. 2,3 The factors involved in resistance to treatment remain unknown. Several protocols for treatment have been used, but the efficacy of chemotherapy is not always sufficient to achieve complete treatment.…”

mentioning

confidence: 99%

“…Several protocols for treatment have been used, but the efficacy of chemotherapy is not always sufficient to achieve complete treatment. 2,3 In general, there are 2 factors determining the effectiveness of antimicrobial drugs. The first is its pharmacologic effect, including specific cytotoxicity and pharmacokinetics.…”

mentioning

confidence: 99%

Production of a high level of specific IgG4 antibody associated with resistance to albendazole treatment in HLA-DRB1*0901-positive patients with strongyloidiasis.

Satoh

Toma²,

Sato³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. Strongyloidiasis, a human intestinal infection with Strongyloides stercoralis, is difficult to treat with drugs. The factors influencing this phenomenon remain unclear. To determine the host factors involved in response to treatment, 46 patients with strongyloidiasis were treated with albendazole, followed-up for 1 year, and separated into two groups: cured and non-cured. Serum levels of specific IgA, IgE, IgG, IgG1, and IgG4 antibodies were estimated using S. stercoralis antigen. Significantly higher titers of IgG4 antibody were observed in the non-cured group than in the cured group (P ϭ 0.016). A total of 88 patients were typed for HLA-DRB1 alleles and analyzed for serum levels of antibody. The S. stercoralis-specific IgG4 antibody titers were significantly higher in the HLA-DRB1*0901-positive group than in the negative group (corrected P ϭ 0.044). These results suggest that HLA-DRB1*0901 is a possible genetic marker for resistance to treatment of S. stercoralis that is associated with elevation of S. stercoralis-specific IgG4 antibody titer.Strongyloidiasis is a human intestinal nematode infection caused by Strongyloides stercoralis. It causes chronic bowel problems, especially in immunocompromised hosts, in which systemic migration of larvae provokes a serious illness due to the unique life cycle of autoinfection of this nematode. 1 It is difficult to completely disrupt this process with drugs against S. stercoralis. 1,2 In Japan, there are many patients with persistent infection in the Southern Islands and Okinawa. 2,3 The factors involved in resistance to treatment remain unknown. Several protocols for treatment have been used, but the efficacy of chemotherapy is not always sufficient to achieve complete treatment. 2,3 In general, there are 2 factors determining the effectiveness of antimicrobial drugs. The first is its pharmacologic effect, including specific cytotoxicity and pharmacokinetics. The other factor is host immunity.The purpose of this study was to determine the factors related to host immunity that influence resistance to treatment of S. stercoralis infection. We examined the HLA-DRB1 gene because its shows the most genetic polymorphism in HLA. Here we show that an increased S. stercoralis-specific IgG4 antibody titer is associated with resistance to treatment, and that patients with HLA-DRB1*0901 produce higher levels of specific IgG4 antibody. MATERIALS AND METHODSStudy population. The efficacy of treatment was evaluated in 46 patients with S. stercoralis infection (29 males and 17 females). The mean ages were 66.4 and 67.1 years, respectively. The frequency of HLA-DRB1 alleles were determined in 88 patients (59 males and 29 females, mean ages ϭ 64.9 and 65.1 years, respectively), including 29 patients who were evaluated for efficacy of treatment. All patients in this study were diagnosed with S. stercoralis infection by an agar plate fecal culture as described 4 at the 1994 annual regional health examination performed in Okinawa prefecture, Japan. Informed consent was obtained fr...

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Clinical Study of Eradicated and Resistant Patients to Treatment with Ivermectin for Strongyloidiasis

Cited by 9 publications

References 0 publications

Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart

Efficacy of ivermectin for chronic strongyloidiasis: two single doses given 2 weeks apart

Comparison of anthelmintic effects of two doses of ivermectin on intestinal strongyloidiasis in patients negative or positive for anti-HTLV-1 antibody

Production of a high level of specific IgG4 antibody associated with resistance to albendazole treatment in HLA-DRB1*0901-positive patients with strongyloidiasis.

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