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Cerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of Trypanosoma brucei gambiense sleeping sickness.

Tiberti, N; Hainard, A; Lejon, V; Courtioux, B; Matovu, E; Enyaru, JC; Robin, X; Turck, N; Kristensson, K; Ngoyi, DM; et al. Tiberti, N; Hainard, A; Lejon, V; Courtioux, B; Matovu, E; Enyaru, JC; Robin, X; Turck, N; Kristensson, K; Ngoyi, DM; Vatunga, GML; Krishna, S; Büscher, P; Bisser, S; Ndung'u, JM; Sanchez, J-C (2012) Cerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of Trypanosoma brucei gambiense sleeping sickness. PLoS One, 7 (7). e40909. ISSN 1932-6203 https://doi.org/10.1371/journal.pone.0040909
SGUL Authors: Krishna, Sanjeev

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Abstract

BACKGROUND: Sleeping sickness, or human African trypanosomiasis (HAT), is a protozoan disease that affects rural communities in sub-Saharan Africa. Determination of the disease stage, essential for correct treatment, represents a key issue in the management of patients. In the present study we evaluated the potential of CXCL10, CXCL13, ICAM-1, VCAM-1, MMP-9, B2MG, neopterin and IgM to complement current methods for staging Trypanosoma brucei gambiense patients. METHODS AND FINDINGS: Five hundred and twelve T. b. gambiense HAT patients originated from Angola, Chad and the Democratic Republic of the Congo (D.R.C.). Their classification as stage 2 (S2) was based on the number of white blood cells (WBC) (>5/µL) or presence of parasites in the cerebrospinal fluid (CSF). The CSF concentration of the eight markers was first measured on a training cohort encompassing 100 patients (44 S1 and 56 S2). IgM and neopterin were the best in discriminating between the two stages of disease with 86.4% and 84.1% specificity respectively, at 100% sensitivity. When a validation cohort (412 patients) was tested, neopterin (14.3 nmol/L) correctly classified 88% of S1 and S2 patients, confirming its high staging power. On this second cohort, neopterin also predicted both the presence of parasites, and of neurological signs, with the same ability as IgM and WBC, the current reference for staging. CONCLUSIONS: This study has demonstrated that neopterin is an excellent biomarker for staging T. b. gambiense HAT patients. A rapid diagnostic test for detecting this metabolite in CSF could help in more accurate stage determination.

Item Type: Article
Additional Information: © 2012 Tiberti et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Adult, Biomarkers, Cohort Studies, Female, Humans, Immunoglobulin M, Leukocyte Count, Male, Meningoencephalitis, Neopterin, Reproducibility of Results, Trypanosoma brucei gambiense, Trypanosomiasis, African, Humans, Trypanosoma brucei gambiense, Trypanosomiasis, African, Meningoencephalitis, Neopterin, Immunoglobulin M, Biological Markers, Leukocyte Count, Cohort Studies, Reproducibility of Results, Adult, Female, Male, MD Multidisciplinary, General Science & Technology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: PLoS One
ISSN: 1932-6203
Language: eng
Dates:
DateEvent
18 July 2012Published
15 June 2012Accepted
Publisher License: Creative Commons: Attribution 4.0
PubMed ID: 22815865
Web of Science ID: WOS:000306548900059
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110815
Publisher's version: https://doi.org/10.1371/journal.pone.0040909

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