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Tools
New biomarkers for stage determination in Trypanosoma brucei rhodesiense sleeping sickness patients
,
Alexandre Hainard,
John Charles Enyaru,
Enyaru Jc,
Veerle Lejon,
Xavier Robin,
Natacha Turck,
Ngoyi Dm,
Dieudonné Mumba Ngoyi,
Sanjeev Krishna,
Sylvie Bisser,
Bertrand Courtioux,
Philippe Büscher,
Krister Kristensson
and other authors.
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