Jm. Ndunigu et al., TOTAL PROTEIN AND WHITE CELL CHANGES IN THE CEREBROSPINAL-FLUID OF VERVET MONKEYS INFECTED WITH TRYPANOSOMA RHODESIENSE AND THE POSTTREATMENT REACTION, Journal of protozoology research, 4(4), 1994, pp. 124-135
In an attempt to elucidate the events leading to the development of po
st-treatment reactive encephalopathy in human African trypanosomiasis
(HAT), a group of vervet monkeys (Cercopithecus Aethiops) were experim
entally infected with Trypanosoma rhodesiense. When terminally sick on
day 42, they were treated with either diminazene aceturate (Berenil(R
)), suramin or melarsoprol. Trypanosomes appeared in the cerebrospinal
fluid (CSF) by day 14 of infection and increased in numbers with prog
ress of the disease. However, only marginal increases in CSF total pro
teins and white cells occurred during the same period. Treatment with
Berenil resulted in persistence and increase in numbers of CSF trypano
somes, a dramatic increase in proteins and white cells, culminating in
clinical encephalitis. Suramin cleared CSF trypanosomes within 4 week
s, with marginal increase in proteins and white cells up to 8 weeks af
ter treatment, followed thereafter by a gradual and prolonged fall to
preinfection levels. Melarsoprol eliminated trypanosomes from the CSF
in less than a week but the white cell and protein levels increased fo
r another 4 weeks before finally falling. The post-treatment increase
in white cell numbers and total proteins was therefore dependent on th
e trypanocidal drug, and was highest and most prolonged when Berenil w
as used and lowest with suramin. The present studies demonstrate that
trypanocidal treatment of infected animals is followed by a post-treat
ment reaction in the central nervous system, the severity of which is
related to the drug used and the presence of trypanosomes in the CSF.
The vervet monkey therefore appears to be a good model for studying fo
r the reaction in HAT.