Vincent A L, Ureña Rojas C A, Ayoub E M, Ottesen E A, Harden E G
Department of Internal Medicine, College of Medicine, Health Sciences Center, University of South Florida, Tampa 33612-4799, USA.
J Parasitol. 1998 Jun;84(3):557-61.
This study examined acute-convalescent changes in diagnostic anti-streptococcal antibodies by the anti-streptolysin O (ASO) and anti-DNAase B (ADAB) tests among patients (n 28) with lymphedema and recurrent erisipela of the lower limb, comparing them with endemic normal control residents (n=25). The study was based in Villa Francisca, an urban focus of Bancroftian filariasis in eastern Santo Domingo, capital of the Dominican Republic. The acute signs and symptoms of erisipela were consistent with a diagnosis of bacterial cellulitis. The ASO test was especially successful at demonstrating a rise in mean titer during convalescence, whereas the ADAB produced about the same frequency of significant increases (0.2 log titer) as did the ASO. When subjects were scored as responders if mounting a minimal titer increase by either test, patients were found more frequently positive than were controls (chi2=5.3, P=0.02). About half (54%) of all patients mounted at least a minimal antibody increase. Filaria-specific IgG4 antibodies were absent from all sera of 20 residents of a nonendemic Dominican mountain town but appeared in about two-thirds of the sampled residents of the endemic barrio. Notably however, levels did not change between the acute phase and convalescence. These findings are consistent with the hypothesis that recurrent streptococcal invasion of the lymphatics may be a significant factor triggering or amplifying lymphedema and elephantiasis in patients with chronic filariasis.
本研究通过抗链球菌溶血素O（ASO）和抗DNA酶B（ADAB）试验，检测了28例下肢淋巴水肿和复发性丹毒患者急性恢复期诊断性抗链球菌抗体的变化，并与25名地方性正常对照居民进行了比较。该研究以多米尼加共和国首都圣多明各东部班氏丝虫病的城市疫源地弗朗西斯卡村为基础。丹毒的急性体征和症状与细菌性蜂窝织炎的诊断相符。ASO试验在显示恢复期平均滴度升高方面特别成功，而ADAB试验产生显著升高（滴度升高0.2 log）的频率与ASO试验大致相同。如果通过任何一项试验滴度有最小升高就将受试者记为反应者，那么患者呈阳性的频率高于对照组（χ2=5.3，P=0.02）。所有患者中约一半（54%）至少有最小的抗体升高。在多米尼加一个非地方性山区城镇的20名居民的所有血清中均未检测到丝虫特异性IgG4抗体，但在地方性社区约三分之二的抽样居民中出现。然而，值得注意的是，急性期和恢复期之间水平没有变化。这些发现与以下假设一致，即链球菌反复侵袭淋巴管可能是引发或加重慢性丝虫病患者淋巴水肿和象皮病的一个重要因素。
