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

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dc.contributor.author Tiberti, N.
dc.contributor.author Hainard, A.
dc.contributor.author Lejon, V.
dc.contributor.author Courtioux, B.
dc.contributor.author Matovu, E.
dc.contributor.author Enyaru, J. C.
dc.contributor.author Robin, X.
dc.contributor.author Turck, N.
dc.contributor.author Kristensson, K.
dc.contributor.author Ngoyi, D. M.
dc.contributor.author Vatunga, G. M.
dc.contributor.author Krishna, S.
dc.contributor.author Büscher, P.
dc.contributor.author Bisser, S.
dc.contributor.author Ndung'u, J. M.
dc.contributor.author Sanchez, J. C.
dc.date.accessioned 2012-12-14T14:46:26Z
dc.date.available 2012-12-14T14:46:26Z
dc.date.issued 2012
dc.identifier.issn 1932-6203
dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0040909
dc.identifier.other ITG-B3A
dc.identifier.other ITG-B13A
dc.identifier.other
dc.identifier.other
dc.identifier.other
dc.identifier.other DBM
dc.identifier.other U-PARDIA
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other FTA
dc.identifier.other E-only
dc.identifier.other Abstract
dc.identifier.other UPD53
dc.identifier.uri http://hdl.handle.net/10390/7261
dc.description.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/microL) 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. en
dc.language English en
dc.subject Protozoal diseases en
dc.subject Trypanosomiasis, African en
dc.subject Sleeping sickness en
dc.subject Trypanosoma brucei gambiense en
dc.subject Vectors en
dc.subject Tsetse flies en
dc.subject Glossina en
dc.subject Disease progression en
dc.subject Stage determination en
dc.subject Biomarkers en
dc.subject CXCL10 en
dc.subject CXCL13 en
dc.subject ICAM-1 en
dc.subject VCAM-1 en
dc.subject MMP-9 en
dc.subject B2MG en
dc.subject Neopterin en
dc.subject IgM en
dc.subject Classification en
dc.subject Cerebrospinal fluid en
dc.subject CSF en
dc.subject White blood cell count en
dc.subject Specificity en
dc.subject Sensitivity en
dc.subject Laboratory techniques and procedures en
dc.title Cerebrospinal fluid neopterin as marker of the meningo-encephalitic stage of Trypanosoma brucei gambiense sleeping sickness en
dc.type Article-E en
dc.citation.issue 7 en
dc.citation.jtitle PLoS ONE en
dc.citation.volume 7 en
dc.citation.pages e40909 en
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/22815865
dc.citation.jabbreviation PLoS ONE en


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