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 Table of Contents    
Year : 2023  |  Volume : 55  |  Issue : 5  |  Page : 341-342

Annual ivermectin treatment, interferon-gamma, and responsiveness to monkeypox infection

1 Private Academic Consultant, Bangkok, Thailand
2 Department of Biological Science, Joseph Ayobaalola University, Ikeji-Arakeji, Nigeria; Department of Community Medicine, Dr. DY Patil Vidhyapeeth, Pune, Maharashtra; Department of Medical Science, Faculty of Medicine, University of Nis, Nis, Serbia; Department of Tropical Medicine, Hainan Medical University, Haikou, China; Research Center, Chandigarh University, Punjab, India

Date of Submission07-Jul-2023
Date of Decision20-Jul-2023
Date of Acceptance29-Aug-2023
Date of Web Publication02-Nov-2023

Correspondence Address:
Rujittika Mungmunpuntipantip
Private Academic Consultant, 111 Bangkok 112, Bangkok 103300
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijp.ijp_433_23

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How to cite this article:
Mungmunpuntipantip R, Wiwanitkit V. Annual ivermectin treatment, interferon-gamma, and responsiveness to monkeypox infection. Indian J Pharmacol 2023;55:341-2

How to cite this URL:
Mungmunpuntipantip R, Wiwanitkit V. Annual ivermectin treatment, interferon-gamma, and responsiveness to monkeypox infection. Indian J Pharmacol [serial online] 2023 [cited 2023 Nov 28];55:341-2. Available from: https://www.ijp-online.com/text.asp?2023/55/5/341/389236

Dear Editor,

Modern clinical practice is highly concerned about novel zoonotic diseases.[1] The spread of monkeypox poses a serious threat to public health throughout Europe.[1] Monkeypox is now a frequent infection, most likely as a result of zoonosis.[1] There is a serious public health danger associated with the spread of monkeypox throughout Europe, America, and Asia.[1] Due to zoonosis, the uncommon monkey pox disease may have returned. Transferring from one person to another is a potential course of action. The medical community is concerned as the number of cases reported in various nations rises, and meticulous planning is required to get ready for a potentially serious outbreak.

The re-emergence of monkeypox in the endemic area before its spread to other settings is an intriguing phenomenon. Many researchers propose a link with the termination of routine smallpox immunization. Smallpox vaccination has been discontinued for many decades, and the diminished innate immunity among the local population may be a factor raising the probability of monkeypox re-emergence. However, the gravity of the problem has only been apparent for a few years. The authors would like to draw attention to another factor that may be associated with lower innate immunity to monkeypox infection. There are several prominent endemic illnesses in Africa. Filariasis is a dangerous parasitic infection. For a few years, annual mass ivermectin therapy has been used to eradicate filarial disease in this area.[2] This parasitic prevention campaign has the potential to drastically lower the prevalence of filariasis in this region.[2]

Ivermectin has immunomodulatory effects when seen from a pharmaceutical perspective. Patients with onchocerciasis were reported to have permanently suppressed filarial infections after receiving repeated annual treatments with ivermectin. Interleukin-10 and interferon-gamma production were found to be reduced after long-term ivermectin usage.[3] According to Johanns et al., after widespread treatment with ivermectin, innate responsiveness decreased. This decreased innate responsiveness in patients may have a negative impact on their ability to mount an effective immune defense against parasites and vaccinations.[3] Interferon-gamma is a significant cytokine whose level falls following mass ivermectin therapy. The cytokine response in monkeypox is important in preventing the pathology brought on by the infection.[4] A significant immunoreactive molecule, interferon-gamma, is present in high levels in severe cases.[5] After mass ivermectin therapy, interferon-gamma levels were low. This could be because the innate monkeypox protective response is weaker. This may possibly be a contributing cause to the rise in monkeypox cases in Africa during the past few years. There is still room for more investigation into the connections between filariasis, ivermectin treatment, and monkeypox in Africa.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Wiwanitkit S, Wiwanitkit V. Atypical zoonotic pox: Acute merging illness that can be easily forgotten. J Acute Dis 2018;7:88-9.  Back to cited text no. 1
  [Full text]  
Brieger WR, Okeibunor JC, Abiose AO, Wanji S, Elhassan E, Ndyomugyenyi R, et al. Compliance with eight years of annual ivermectin treatment of onchocerciasis in Cameroon and Nigeria. Parasit Vectors 2011;4:152.  Back to cited text no. 2
Johanns SI, Gantin RG, Wangala B, Komlan K, Halatoko WA, Banla M, et al. Onchocerca volvulus-specific antibody and cellular responses in onchocerciasis patients treated annually with ivermectin for 30 years and exposed to parasite transmission in central Togo. PLoS Negl Trop Dis 2022;16:e0010340.  Back to cited text no. 3
Earl PL, Americo JL, Moss B. Lethal monkeypox virus infection of CAST/EiJ mice is associated with a deficient gamma interferon response. J Virol 2012;86:9105-12.  Back to cited text no. 4
Johnston SC, Johnson JC, Stonier SW, Lin KL, Kisalu NK, Hensley LE, et al. Cytokine modulation correlates with severity of monkeypox disease in humans. J Clin Virol 2015;63:42-5.  Back to cited text no. 5


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