Open AccessNew biomarkers for stage determination in Trypanosoma brucei rhodesiense sleeping sickness patients
Author(s) -
Tiberti Natalia,
Matovu Enock,
Hainard Alexandre,
Enyaru John Charles,
Lejon Veerle,
Robin Xavier,
Turck Natacha,
Ngoyi Dieudonné Mumba,
Krishna Sanjeev,
Bisser Sylvie,
Courtioux Bertrand,
Büscher Philippe,
Kristensson Krister,
Ndung'u Joseph Mathu,
Sanchez JeanCharles
Publication year - 2013
Publication title -
clinical and translational medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
H-Index - 1
ISSN - 2001-1326
DOI - 10.1186/2001-1326-2-1
Subject(s) - african trypanosomiasis , neopterin , stage (stratigraphy) , medicine , trypanosoma brucei rhodesiense , receiver operating characteristic , gastroenterology , immunology , population , trypanosomiasis , biology , paleontology , environmental health
Abstract Accurate stage determination is crucial in the choice of treatment for patients suffering from sleeping sickness, also known as human African trypanosomiasis (HAT). Current staging methods, based on the counting of white blood cells (WBC) and the detection of parasites in the cerebrospinal fluid (CSF) have limited accuracy. We hypothesized that immune mediators reliable for staging T. b. gambiense HAT could also be used to stratify T. b. rhodesiense patients, the less common form of HAT. A population comprising 85 T. b. rhodesiense patients, 14 stage 1 (S1) and 71 stage 2 (S2) enrolled in Malawi and Uganda, was investigated. The CSF levels of IgM, MMP‐9, CXCL13, CXCL10, ICAM‐1, VCAM‐1, neopterin and B2MG were measured and their staging performances evaluated using receiver operating characteristic (ROC) analyses. IgM, MMP‐9 and CXCL13 were the most accurate markers for stage determination (partial AUC 88%, 86% and 85%, respectively). The combination in panels of three molecules comprising CXCL13‐CXCL10‐MMP‐9 or CXCL13‐CXCL10‐IgM significantly increased their staging ability to partial AUC 94% ( p value < 0.01). The present study highlighted new potential markers for stage determination of T. b. rhodesiense patients. Further investigations are needed to better evaluate these molecules, alone or in panels, as alternatives to WBC to make reliable choice of treatment.