IgG4 antibodies to the recombinant filarial antigen Wb-Bhp-1 decrease dramatically following treatment of lymphatic filariasis

BACKGROUND: Lymphatic filariasis (LF) is a neglected tropical disease and a major cause of chronic disability. Improved diagnostic tests are needed because of long-term persistence of anti-filarial antibodies or circulating filarial antigenemia after treatments that clear microfilaremia. Here, we assess changes in levels of antibodies to the recombinant filarial antigens Wb-Bhp-1, Wb123, and Bm14 after anti-filarial treatment. METHODOLOGY/PRINCIPAL FINDINGS: IgG4 antibodies to recombinant filarial antigens were assessed by ELISA. We tested serial plasma samples from a clinical trial in Papua New Guinea. Before treatment, 90%, 71% and 99% of participants had antibodies to Wb-Bhp-1, Wb123, and Bm14, respectively. Antibodies to Wb-Bhp-1 and Wb123, but not Bm14, were significantly higher in participants with persistent microfilaremia 24 months after treatment. Antibodies to all three antigens declined significantly by 60 months after treatment with ivermectin, diethylcarbamazine and albendazole despite circulating filarial antigen in 76% of participants. By 60 months follow up, antibodies to Wb-Bhp-1, Wb123, and Bm14 were detected in 17%, 7% and 90% of participants, respectively. Antibodies to Wb-Bhp-1 also declined more rapidly after treatment than antibodies to Bm14 in samples from a clinical trial conducted in Sri Lanka. We also tested archived serum samples from people living in filariasis-endemic communities in Egypt with different infection profiles. Antibodies to Wb-Bhp-1 were detected in 73% of microfilaremic people, 53% of amicrofilaremic people with circulating filarial antigen, and 17.5% of endemic individuals without microfilaria or circulating filarial antigen. Tests performed with legacy samples from India showed that few people with filarial lymphedema had antibodies to these recombinant antigens. CONCLUSIONS: Antibodies to Wb-Bhp-1 and Wb123 are more closely correlated with persistent microfilaremia than circulating filarial antigenemia or antibodies to Bm14, and they clear more rapidly after anti-filarial treatment. Additional studies are needed to assess the value of Wb-Bhp-1 serology as a tool for determining the success of LF elimination efforts

Galaxies and Intergalactic Matter at Redshift z~3: Overview

We present the first results from a survey of the relative spatial distributions of galaxies, intergalactic neutral hydrogen, and intergalactic metals at high redshift. We obtained high-resolution spectra of 8 bright QSOs at 3.1<z<4.1 and spectroscopic redshifts for 431 Lyman-break galaxies (LBGs) at slightly lower redshifts. Comparing the locations of galaxies to the absorption lines in the QSO spectra shows that the intergalactic medium contains less neutral hydrogen than the global average within r<0.5h^-1 comoving Mpc of LBGs and more than average at slightly larger distances 1<r<5 h^-1 comoving Mpc. The intergalactic medium within the largest overdensities at z~3, which will presumably evolve into the intracluster medium by z~0, is rich in neutral hydrogen and CIV. The lack of HI absorption at small distances from LBGs appears unlikely to be produced solely by the Lyman continuum radiation they emit; it may show that the galaxies' supernovae-driven winds maintain their measured outflow velocities of ~600 km/s for a few hundred million years and drive away nearby intergalactic gas. We present correlation functions of galaxies with Lyman-alpha forest flux decrements, with CIV systems, and with other galaxies. We describe the association of galaxies with damped Lyman-a systems and with intergalactic HeII opacity. A strong observed correlation of galaxies with intergalactic metals supports the idea that Lyman-break galaxies' winds have enriched their surroundings.Comment: 32 pages including 26 figures. To appear in Ap