 | NEUROIMMUNOMODULATION: MOLECULAR ASPECTS, INTEGRATIVE SYSTEMS, AND CLINICAL ADVANCES
Copyright © 1998 by the New York Academy of Sciences
description
Annals of the New York Academy of Sciences 840:809-821 (1998)
© 1998 New York Academy of Sciences
Neuroendocrine Dysfunction in African Trypanosomiasis: The Role of Cytokinesa
MARTIN REINCKEb,c,
WIEBKE ARLTc,
CHRISTINA HEPPNERc,
FRANK PETZKEc,
GEORGE P. CHROUSOSd AND
BRUNO ALLOLIOc
cSection of Endocrinology, Medical Department, University of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany
dDevelopmental Endocrinology Branch, Building 10, Room 10 N 244, NICHD, National Institutes of Health, 9000 Rockville Pike, Bethesda, Maryland 20892 USA
aM.R. was supported by the Deutsche Forschungsgemeinschaft (Re 752/1-1 and 2-1).
bAddress for correspondence: PD Dr. med. M. Reincke, Medizinische Universitätsklinik Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany. Telephone: 49/931/2013507; Fax: 49/931/2012283.
Sleeping sickness (SS; African trypanosomiasis) is an anthropozoonosis transmitted by the tsetse fly. Infection with Trypanosoma brucei in humans is associated with adynamia, lethargy, anorexia, and more specifically amenorrhea/infertility in women and loss of libido/impotence in men. Recent evidence suggests that experimental infection in animals with Trypanosoma brucei species causes polyglandular endocrine failure by local inflammation of the pituitary, thyroid, adrenal, and gonadal glands. In a cross-sectional study we investigated the prevalence and significance of neuroendocrine abnormalities in 137 Ugandan patients with SS. In the untreated stage of the disease, there was a high prevalence of adrenal insufficiency (27%), hypothyroidism (50%) and hypogonadism (85%). Pituitary function tests suggested an unusual combined central (hypothalamic/pituitary) and peripheral defect in hormone secretion. Specific therapy resulted in a rapid recovery of adrenal/thyroid function, whereas hypogonadism persisted for years in a substantial portion of patients. We did not detect pituitary, thyroid, adrenal, and gonadal autoantibodies in patients with endocrine dysfunction, ruling out an autoimmune origin of the endocrine abnormalities. However, the presence of hypopituitarism correlated with high cytokine concentrations (TNF-alpha, IL-6) which-together with direct parasitic infiltration of the endocrine glands-are involved in the pathogenesis of SS-associated endocrine dysfunction.
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