Debrah Alexander Y, Mand Sabine, Marfo-Debrekyei Yeboah, Batsa Linda, Pfarr Kenneth, Lawson Bernard, Taylor Mark, Adjei Ohene, Hoerauf Achim
Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Bonn, Germany.
Am J Trop Med Hyg. 2009 Jun;80(6):956-63.
The treatment for hydrocele is expensive, invasive surgery-hydrocelectomy. A drug that could prevent or improve this condition could replace or supplement hydrocelectomy. In Ghana, 42 hydrocele patients participated in a double-blind, placebo-controlled trial of a six-week regimen of doxycycline, 200 mg/day. Four months after doxycycline treatment, patients received 150 mug/kg of ivermectin and 400 mg of albendazole, which is used for mass chemotherapy in this area. Patients were monitored for levels of Wolbachia sp., microfilaremia, antigenemia, plasma levels of vascular endothelial growth factor-A (VEGF-A) and stage/size of the hydrocele. Wolbachia sp. loads/microfilaria, microfilaremia, and antigenemia were significantly reduced in the doxycycline-treated patients compared with the placebo group. The mean plasma levels of VEGF-A were decreased significantly in the doxycycline-treated patients who had active infection. This finding preceded the reduction of the stage of hydrocele. A six-week regimen of doxycycline treatment against filariasis showed amelioration of pathologic conditions of hydrocele patients with active infection.
鞘膜积液的治疗方法是昂贵的侵入性手术——鞘膜切除术。一种能够预防或改善这种病症的药物可以替代或补充鞘膜切除术。在加纳，42名鞘膜积液患者参与了一项双盲、安慰剂对照试验，试验采用每日200毫克强力霉素、为期六周的治疗方案。强力霉素治疗四个月后，患者接受了150微克/千克的伊维菌素和400毫克的阿苯达唑，该剂量用于该地区的大规模化疗。对患者的沃尔巴克氏体属水平、微丝蚴血症、抗原血症、血管内皮生长因子-A（VEGF-A）的血浆水平以及鞘膜积液的分期/大小进行了监测。与安慰剂组相比，强力霉素治疗组患者的沃尔巴克氏体属负荷/微丝蚴、微丝蚴血症和抗原血症显著降低。在有活动性感染的强力霉素治疗组患者中，VEGF-A的平均血浆水平显著下降。这一发现先于鞘膜积液分期的降低。针对丝虫病的六周强力霉素治疗方案显示，活动性感染的鞘膜积液患者的病理状况有所改善。
