Detection of light subunit neurofilament and glial fibrillary acidic protein in cerebrospinal fluid of Trypanosoma brucei gambiense-infected patients

Light subunit neurofilament (NFL) and glial fibrillary acidic protein (GFAP ) concentrations were determined in cerebrospinal fluid (CSF) of 34 patient s with human African trypanosomiasis (HAT), five serologically positive but parasitologically unconfirmed individuals, and four healthy controls witho ut evidence of HAT. In patients with second stage HAT (n = 30), NFL levels were abnormally elevated in 10 cases and GFAP levels in five. The astroglio sis observed in HAT and experimental models of HAT is confirmed in our stud y by the presence of increased GFAP levels in the CSF. The abnormal NFL CSF levels reflect structural damage of nerve cells in 33 % of the second-stag e patients studied. To our knowledge, this is the first time neuronal damag e in HAT patients is demonstrated by using biochemical markers of brain dam age in the CSF.