@article{fdi:010061574,
  title = {{N}eopterin is a cerebrospinal fluid marker for treatment outcome evaluation in patients affected by {T}rypanosoma brucei gambiense sleeping sickness},
  author = {{T}iberti, {N}. and {L}ejon, {V}eerle and {H}ainard, {A}. and {C}ourtioux, {B}. and et al.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {P}ost-therapeutic follow-up is essential to confirm cure and to detect early treatment failures in patients affected by sleeping sickness ({HAT}). {C}urrent methods, based on finding of parasites in blood and cerebrospinal fluid ({CSF}) and counting of white blood cells ({WBC}) in {CSF}, are imperfect. {N}ew markers for treatment outcome evaluation are needed. {W}e hypothesized that alternative {CSF} markers, able to diagnose the meningo-encephalitic stage of the disease, could also be useful for the evaluation of treatment outcome. {M}ethodology/{P}rincipal findings: {C}erebrospinal fluid from patients affected by {T}rypanosoma brucei gambiense {HAT} and followed for two years after treatment was investigated. {T}he population comprised stage 2 ({S}2) patients either cured or experiencing treatment failure during the follow-up. {I}g{M}, neopterin, {B}2{MG}, {MMP}-9, {ICAM}-1, {VCAM}-1, {CXCL}10 and {CXCL}13 were first screened on a small number of {HAT} patients (n = 97). {N}eopterin and {CXCL}13 showed the highest accuracy in discriminating between {S}2 cured and {S}2 relapsed patients ({AUC} 99% and 94%, respectively). {W}hen verified on a larger cohort (n = 242), neopterin resulted to be the most efficient predictor of outcome. {H}igh levels of this molecule before treatment were already associated with an increased risk of treatment failure. {A}t six months after treatment, neopterin discriminated between cured and relapsed {S}2 patients with 87% specificity and 92% sensitivity, showing a higher accuracy than white blood cell numbers.  {C}onclusions/{S}ignificance: {I}n the present study, neopterin was highlighted as a useful marker for the evaluation of the post-therapeutic outcome in patients suffering from sleeping sickness. {D}etectable levels of this marker in the {CSF} have the potential to shorten the follow-up for {HAT} patients to six months after the end of the treatment.},
  keywords = {{TRYPANOSOMIASE} {HUMAINE} ; {DIAGNOSTIC} ; {METHODE} {BIOLOGIQUE} ; {BIOMARQUEUR} ; {FLUIDE} {CEREBROSPINAL} ; {AFRIQUE} {SUBSAHARIENNE}},
  booktitle = {},
  journal = {{PL}o{S} {N}eglected {T}ropical {D}iseases},
  volume = {7},
  numero = {2},
  pages = {e2088 [9  en ligne]},
  ISSN = {1935-2727},
  year = {2013},
  DOI = {10.1371/journal.pntd.0002088},
  URL = {https://www.documentation.ird.fr/hor/fdi:010061574},
}