Greene B M, Taylor H R, Brown E J, Humphrey R L, Lawley T J
J Infect Dis. 1983 May;147(5):890-7. doi: 10.1093/infdis/147.5.890.
Diethylcarbamazine (DEC) therapy for Onchocerca volvulus infection results in frequent ocular and systemic complications, but the pathogenesis of these complications is unclear. Twenty men with O. volvulus infection were treated over a period of six months with DEC given daily for one week and weekly thereafter. Major systemic and ocular complications included proteinuria, severe pruritus, visual field constriction, optic nerve pallor, chorioretinitis, anterior uveitis, and punctate keratitis. Levels of circulating immune complexes (CICs) were increased (greater than 11% [125I]C1q binding) in 14 of the 20 men prior to treatment. Persons with pretreatment C1q binding activity of greater than 30% were at increased risk to develop constriction of visual fields (P less than 0.05) and proteinuria (P less than 0.015). Linear regression analysis revealed a striking correlation between pretreatment levels of CICs and the total number of both systemic and ocular complications (P less than 0.001) and ocular complications alone (P less than 0.005). These results suggest that CICs may be important in the pathogenesis of the delayed systemic and ocular complications following DEC therapy for O. volvulus infection.
乙胺嗪（DEC）治疗盘尾丝虫感染常导致眼部和全身并发症，但这些并发症的发病机制尚不清楚。20名盘尾丝虫感染者在6个月的时间里接受了乙胺嗪治疗，开始时每天给药1周，之后每周给药1次。主要的全身和眼部并发症包括蛋白尿、严重瘙痒、视野缩小、视神经苍白、脉络膜视网膜炎、前葡萄膜炎和点状角膜炎。20名男性中有14名在治疗前循环免疫复合物（CIC）水平升高（大于11%[125I]C1q结合）。治疗前C1q结合活性大于30%的人发生视野缩小（P<0.05）和蛋白尿（P<0.015）的风险增加。线性回归分析显示，治疗前CIC水平与全身和眼部并发症总数（P<0.001）以及仅眼部并发症（P<0.005）之间存在显著相关性。这些结果表明，CICs可能在DEC治疗盘尾丝虫感染后延迟出现的全身和眼部并发症的发病机制中起重要作用。
