Mackenzie C D, Williams J F, Sisley B M, Steward M W, O'Day J
Rev Infect Dis. 1985 Nov-Dec;7(6):802-8. doi: 10.1093/clinids/7.6.802.
Different immune responses to Onchocerca volvulus cause considerable variation in clinical manifestations of human onchocerciasis. Onchocercal lesions result from inflammatory reactions involving immunologic mechanisms; the role of the immune system in pathogenesis is emphasized by the phenomena accompanying accelerated worm destruction during microfilaricidal chemotherapy (e.g., eosinophilia, changes in total immunoglobulin level, and anaphylactic symptoms). Although most pathologic changes are associated with the microfilarial stage, the extent to which circulating antibodies are directed against antigens in the adult worm or its uterine constituents is unknown. Microfilarial destruction can be mediated by antibody to the surface-associated antigens of the worms and enhanced by complement; a correlation exists between the presence of these antibodies and punctate keratitis. Heterogeneous immunologic components are associated with the surface of dermal and nodular microfilariae in vivo. Preliminary findings indicate that the level of O. volvulus-specific immune complexes is inversely proportional to the microfilarial load. To monitor a patient's clinical status and immunologic response, a quantitative system dividing symptoms into those associated with active responses to the microfilariae and those representing long-term consequences of these reactions is suggested.
对盘尾丝虫的不同免疫反应导致人类盘尾丝虫病临床表现存在显著差异。盘尾丝虫病变源于涉及免疫机制的炎症反应；在杀微丝蚴化疗期间，伴随蠕虫加速破坏出现的一些现象（如嗜酸性粒细胞增多、总免疫球蛋白水平变化和过敏症状）强调了免疫系统在发病机制中的作用。尽管大多数病理变化与微丝蚴阶段有关，但循环抗体针对成虫或其子宫成分中抗原的程度尚不清楚。微丝蚴的破坏可由针对蠕虫表面相关抗原的抗体介导，并由补体增强；这些抗体的存在与点状角膜炎之间存在相关性。体内真皮和结节性微丝蚴表面存在异质性免疫成分。初步研究结果表明，盘尾丝虫特异性免疫复合物的水平与微丝蚴负荷呈负相关。为监测患者的临床状态和免疫反应，建议采用一种定量系统，将症状分为与对微丝蚴的活跃反应相关的症状和代表这些反应长期后果的症状。
