Necessity of Antibody Response in the Treatment of African Trypanosomiasis with Alpha-difluoromethylornithine

The role of the immune system in the clearance of Trypanosoma brucei brucei from the bloodstream during alpha-difluoromethylornithine (DFMO) treatment was studied by determining the effects of dexamethasone on immune and therapeutic responses in rats infected with T.b. brucei. Normal DFMO-treated animals exhibited strong antibody responses to trypanosomes and were cured of T. b. brucei infection by a 7-day regimen of 2% DFMO in drinking water. Animals pretreated with dexamethasone were not cured by the same level of DFMO treatment. Nonetheless, in rats pretreated with dexamethasone, trypanosomes were cleared from blood during treatment with DFMO, but all immunocompromised animals eventually succumbed to relapses of the infection. Athymic (nude) mice were cured of T. b. brucei infection by a 72-hr course of treatment with 2% DFMO in their drinking water. These findings suggest that relatively low levels of T-cell-independent, antitrypanosomal antibodies are adequate to clear the bloodstream of parasites during DFMO therapy but that an intact immune response is necessary for cures of the disease to be obtained.