Courtioux Bertrand, Bisser Sylvie, M'belesso Pascal, Ngoungou Edgard, Girard Murielle, Nangouma Auguste, Josenando Théophile, Jauberteau-Marchan Marie-Odile, Bouteille Bernard
IENT EA 3174 Neuroparasitologie et Neuroépidémiologie Tropicale, Faculty of Medicine, Limoges, France.
J Clin Microbiol. 2005 Sep;43(9):4789-95. doi: 10.1128/JCM.43.9.4789-4795.2005.
Human African trypanosomiasis (HAT) or sleeping sickness is a disease characterized by a hemolymphatic stage 1 followed by a meningoencephalitic stage 2 which is fatal without specific treatment. Furthermore, due to the toxicity of drugs used to treat stage 2 (mainly melarsoprol) accurate staging is required. Actual criteria employed during field surveys are not sensitive enough for precise staging. Antineurofilament (anti-NF) and antigalactocerebrosides (anti-GalC) antibodies have been identified in cerebrospinal fluid (CSF) as potential markers of central nervous system (CNS) involvement. We describe a dot enzyme-linked immunosorbent assay (dot-ELISA) to detect anti-GalC and anti-NF antibodies and its value in staging. NF- and GalC-dotted nitrocellulose strips were first developed in our laboratory. They were then evaluated in Angola and Central African Republic on 140 CSF samples. Compared to our staging criteria (i.e., CSF cell count > or = 20 cells/microl, CSF immunoglobulin M concentration > or = 100 mg/liter, and/or the presence of trypanosomes in the CSF), combined detection of both CSF anti-NF and CSF anti-GalC by dot-ELISA showed 83.2% sensitivity and 100.0% specificity. Dot-ELISA could be a useful test to diagnose CNS involvement in HAT in the less-equipped laboratories or in the field situation and to improve patient treatment.
人类非洲锥虫病（HAT）即昏睡病，其特征是先经历1期血淋巴期，随后进入2期脑膜脑炎期，若不进行特异性治疗则会致命。此外，由于用于治疗2期的药物（主要是美拉胂醇）具有毒性，因此需要进行准确的分期。现场调查中使用的现行标准对于精确分期不够敏感。抗神经丝（抗-NF）和抗半乳糖脑苷脂（抗-GalC）抗体已在脑脊液（CSF）中被鉴定为中枢神经系统（CNS）受累的潜在标志物。我们描述了一种用于检测抗-GalC和抗-NF抗体的斑点酶联免疫吸附测定法（dot-ELISA）及其在分期中的价值。NF和GalC斑点硝酸纤维素条最初是在我们实验室研制的。然后在安哥拉和中非共和国对140份脑脊液样本进行了评估。与我们的分期标准（即脑脊液细胞计数≥20个/微升、脑脊液免疫球蛋白M浓度≥100毫克/升和/或脑脊液中存在锥虫）相比，通过dot-ELISA联合检测脑脊液抗-NF和脑脊液抗-GalC显示出83.2%的灵敏度和100.0%的特异性。Dot-ELISA可能是一种有用的检测方法，可用于在设备较差的实验室或现场情况下诊断HAT患者的CNS受累情况，并改善患者治疗。
