Neopterin and CXCL-13 in Diagnosis and Follow-Up of Trypanosoma brucei gambiense Sleeping Sickness: Lessons from the Field in Angola

Julien Bonnet (1) , Philippe Vignoles (1) , Natalia Tiberti (2) , Vatunga Gedeão (3) , Alexandre Hainard (2) , Natacha Turck (2) , Théophile Josenando (3) , Joseph Ndung’u (3) , Jean-Charles Sanchez (2) , Bertrand Courtioux (1) , Sylvie Bisser (1, 4)

1 NET - Neuroépidémiologie Tropicale
2 Département de science des protéines humaines [Genève]
3 Instituto de Combate e Controlo das Tripanossomiases
4 Institut Pasteur de Guinée

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.

Domaines: Santé publique et épidémiologie

Julien Bonnet, Philippe Vignoles, Natalia Tiberti, Vatunga Gedeão, Alexandre Hainard, et al.. Neopterin and CXCL-13 in Diagnosis and Follow-Up of Trypanosoma brucei gambiense Sleeping Sickness: Lessons from the Field in Angola. BioMed Research International , 2019, 2019, pp.1-9. ⟨10.1155/2019/6070176⟩. ⟨hal-02378676⟩