Abstract. The frequency of cytokine-producing peripheral blood mononuclear cells was assessed in 28 subjects with microfilaremic loiasis and in 14 amicrofilaremic individuals. In addition, a subgroup of seven microfilaremic individuals coinfected with Plasmodium malariae was evaluated. By using flow cytometry for the intracellular detection of cytokines, a more pronounced T helper (Th)2 cell-type response with the expansion of interleukin (IL)-4, IL-10, and IL-13 expressing CD4 ϩ cells in the microfilaremic compared with the amicrofilaremic group was noted. Expression of IL-5 was equivalent in both groups as was the frequency of Th2-type cytokines expressing CD8 ϩ cells and of Th1-type cytokines (interferon [IFN]-␥, IL-2, IFN-␥/IL-2) producing CD4 ϩ and CD8 ϩ cells. Th0-type cytokineexpressing cells, represented by IL-4/IFN-␥, IL-10/IFN-␥, and IL-13/IFN-␥, were equally distributed within groups. Coinfection of P. malariae did not significantly alter the cytokine expression compared with microfilaremic individuals without P. malariae infections. By identifying a large panel of cytokine-producing T cell subpopulations, a Th2-driven immune response in microfilaremic Loa loa patients was noted.Loiasis is a parasitic infection caused by the filarial nematode Loa loa, which is endemic in rain forest areas of Central and West Africa. Infective larvae are transmitted by diurnal bites of flies of the genus Chrysops and, over a period of several months, develop into mature, adult worms that may liberate microfilariae into the bloodstream. Among individuals infected with L. loa, clinically distinct subgroups can be identified with manifestations ranging from asymptomatic microfilaremia to a hyperresponsive state characterized by more frequent episodes of local angioedema (Calabar swellings) and pronounced eosinophilia in the absence of microfilariae. In endemic areas, only a minority of infected people have detectable microfilariae in blood. 1 However, the majority of infected subjects, including most visitors to endemic areas, remain amicrofilaremic and are more likely to have a hyper-responsive syndrome. 2 The apparent differences in clinical presentation are thought to reflect the diversity of the immune response of the host to filarial antigen, with diminished humoral and cellular reactivity in the presence of circulating microfilariae. Most previous results on L. loa-host relationship were derived from studying temporary residents of areas of endemicity. These amicrofilaremic patients had elevated serum parasite-specific immunoglobulin (IgE and IgG) levels, augmented filaria-specific lymphocyte proliferative responses, and an increase in the ratio of CD4 ϩ /CD8 ϩ T cells. 3,4 Immune mechanisms activated in individuals continuously exposed to infection have been studied far more extensively in other filarial species. In particular, the categorization of T helper (Th) cells into at least two functionally different subsets on the basis of their cytokine profiles has provided a useful framework for the understanding of im...