Cerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of Trypanosoma brucei gambiense sleeping sickness.
<h4>Background</h4>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 pre...
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2012
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oai:doaj.org-article:98e89d11d8f640b8b48b57de96fd1d1d2021-11-18T07:12:01ZCerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of Trypanosoma brucei gambiense sleeping sickness.1932-620310.1371/journal.pone.0040909https://doaj.org/article/98e89d11d8f640b8b48b57de96fd1d1d2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22815865/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods and findings</h4>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.<h4>Conclusions</h4>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.Natalia TibertiAlexandre HainardVeerle LejonBertrand CourtiouxEnock MatovuJohn Charles EnyaruXavier RobinNatacha TurckKrister KristenssonDieudonné Mumba NgoyiGedeão M L VatungaSanjeev KrishnaPhilippe BüscherSylvie BisserJoseph Mathu Ndung'uJean-Charles SanchezPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 7, p e40909 (2012) |
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Medicine R Science Q Natalia Tiberti Alexandre Hainard Veerle Lejon Bertrand Courtioux Enock Matovu John Charles Enyaru Xavier Robin Natacha Turck Krister Kristensson Dieudonné Mumba Ngoyi Gedeão M L Vatunga Sanjeev Krishna Philippe Büscher Sylvie Bisser Joseph Mathu Ndung'u Jean-Charles Sanchez Cerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of Trypanosoma brucei gambiense sleeping sickness. |
| description |
<h4>Background</h4>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.<h4>Methods and findings</h4>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.<h4>Conclusions</h4>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. |
| format |
article |
| author |
Natalia Tiberti Alexandre Hainard Veerle Lejon Bertrand Courtioux Enock Matovu John Charles Enyaru Xavier Robin Natacha Turck Krister Kristensson Dieudonné Mumba Ngoyi Gedeão M L Vatunga Sanjeev Krishna Philippe Büscher Sylvie Bisser Joseph Mathu Ndung'u Jean-Charles Sanchez |
| author_facet |
Natalia Tiberti Alexandre Hainard Veerle Lejon Bertrand Courtioux Enock Matovu John Charles Enyaru Xavier Robin Natacha Turck Krister Kristensson Dieudonné Mumba Ngoyi Gedeão M L Vatunga Sanjeev Krishna Philippe Büscher Sylvie Bisser Joseph Mathu Ndung'u Jean-Charles Sanchez |
| author_sort |
Natalia Tiberti |
| title |
Cerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of Trypanosoma brucei gambiense sleeping sickness. |
| title_short |
Cerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of Trypanosoma brucei gambiense sleeping sickness. |
| title_full |
Cerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of Trypanosoma brucei gambiense sleeping sickness. |
| title_fullStr |
Cerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of Trypanosoma brucei gambiense sleeping sickness. |
| title_full_unstemmed |
Cerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of Trypanosoma brucei gambiense sleeping sickness. |
| title_sort |
cerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of trypanosoma brucei gambiense sleeping sickness. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2012 |
| url |
https://doaj.org/article/98e89d11d8f640b8b48b57de96fd1d1d |
| work_keys_str_mv |
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