1. Neopterin and CXCL-13 in Diagnosis and Follow-Up of Trypanosoma brucei gambiense Sleeping Sickness: Lessons from the Field in Angola
- Author
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Sylvie Bisser, Jean-Charles Sanchez, Natalia Tiberti, Théophile Josenando, Bertrand Courtioux, Vatunga Gedeão, Alexandre Hainard, Joseph Mathu Ndung'u, Natacha Turck, Julien Bonnet, Philippe Vignoles, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Département de science des protéines humaines [Genève], Université de Genève (UNIGE)-Faculté de médecine [Genève], Instituto de Combate e Controlo das Tripanossomiases, Institut Pasteur de Guinée, and Réseau International des Instituts Pasteur (RIIP)
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,Article Subject ,lcsh:Medicine ,Disease ,Neopterin ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,chemistry.chemical_compound ,Young Adult ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,African trypanosomiasis ,Young adult ,Stage (cooking) ,Aged ,ddc:616 ,Aged, 80 and over ,General Immunology and Microbiology ,business.industry ,lcsh:R ,General Medicine ,Middle Aged ,medicine.disease ,Chemokine CXCL13 ,3. Good health ,030104 developmental biology ,Trypanosomiasis, African ,chemistry ,Angola ,ROC Curve ,Cohort ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Female ,business ,Trypanosomiasis ,030217 neurology & neurosurgery ,Biomarkers ,Fexinidazole ,Research Article ,Follow-Up Studies - Abstract
Human African Trypanosomiasis may become manageable in the next decade with fexinidazole. However, currently stage diagnosis remains difficult to implement in the field and requires a lumbar puncture. Our study of an Angolan cohort of T. b. gambiense-infected patients used other staging criteria than those recommended by the WHO. We compared WHO criteria (cell count and parasite identification in the CSF) with two biomarkers (neopterin and CXCL-13) which have proven potential to diagnose disease stage or relapse. Biological, clinical, and neurological data were analysed from a cohort of 83 patients. A neopterin concentration below 15.5 nmol/L in the CSF denoted patients with stage 1 disease, and a concentration above 60.31 nmol/L characterized patients with advanced stage 2 (trypanosomes in CSF and/or cytorachia higher than 20 cells) disease. CXCL-13 levels below 91.208 pg/mL denoted patients with stage 1 disease, and levels of CXCL-13 above 395.45 pg/mL denoted patients with advanced stage 2 disease. Values between these cut-offs may represent patients with intermediate stage disease. Our work supports the existence of an intermediate stage in HAT, and CXCL-13 and neopterin levels may help to characterize it.
- Published
- 2019
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