Urine Screening for Early Detection of Subarachnoid Neurocysticercosis

尿液筛查以早期发现蛛网膜下腔神经囊尾蚴病

• 批准号: 10680362
• 负责人: Hector Hugo Garcia
• 金额: $ 56.22万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-15 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10680362
• 关键词: Adrenal Cortex Hormones; Adult; Antiepileptic Agents; Antigens; Antiparasitic Agents; Area; Award; Benign; Biological Assay; Brain; Brain imaging; Centers for Disease Control and Prevention (U.S.); Central Nervous System Infections; Chronic Disease; Clinical; Clinical Research; Communities; Contracts; Cross-Sectional Studies; Cyst; Data; Developing Countries; Development; Diagnosis; Diagnostic; Disease; Disease Management; Disease Progression; Early Diagnosis; Early Intervention; Educational Status; Eligibility Determination; Enrollment; Enzyme-Linked Immunosorbent Assay; Epilepsy; Excretory function; Fostering; Future; Grant; Health; Health system; Immunoassay; Immunodiagnostics; Incidence; Infection; Inflammation; Intervention; Invaded; Laboratories; Laboratory Research; Lateral; Magnetic Resonance Imaging; Malignant - descriptor; Measures; Membrane; Mentors; Migrant; Morbidity - disease rate; Neurocysticercosis; Outcome; Parasites; Parasitology; Participant; Patient-Focused Outcomes; Patients; Performance; Persons; Peru; Pilot Projects; Population; Prevalence; Process; Prognosis; Public Health; Risk Factors; Rotation; Safety; Sampling; Series; Specialist; Structure; Students; Subarachnoid Space; Symptoms; Taenia solium; Testing; United States; Urine; Vertebral column; cohort; community setting; detection assay; disorder risk; early screening; efficacy evaluation; experience; improved; improved outcome; infection burden; information gathering; mortality; mortality risk; nervous system disorder; novel; novel strategies; patient retention; point of care; preventable epilepsy; progression risk; prospective; prototype; randomized, clinical trials; screening; tool; training opportunity

Neurocysticercosis (NCC) is a common neurologic disease and a leading cause of preventable epilepsy across the developing world. It is caused by central nervous infection with Taenia solium (the pork tapeworm) larval cysts. While most cases of NCC have a relatively benign clinical course, the prognosis is grim for infections involving the subarachnoid space (SANCC). New approaches are needed to improve outcomes for patients with this devastating malignant form of infection. One promising approach involves early detection through population screening, which would allow early intervention while the burden of infection is low and while the patient retains relatively good health. We recently developed an assay that detects T. solium antigens excreted in the urine, and have now shown in pilot studies that this assay can be used to detect asymptomatic people with SANCC in the community setting.    In this 5-year project we will validate the new assay by applying it in a large cross-sectional study in northern Peru (30,000), using magnetic resonance imaging (MRI) of the brain as the gold standard to confirm diagnosis. Participants subsequently diagnosed with asymptomatic SANCC, and other forms on NCC, will be enrolled in an 18-month prospective observational cohort to determine risk of disease progression. Furthermore, we will develop a prototype point-of-care format of the assay and validate it with samples gathered from the community. The results of these studies will provide information and tools necessary to conduct a definitive randomized clinical trial evaluating the efficacy of screening and early intervention as an approach to improve clinical outcomes of patients with SANCC. We will also provide a series of didactic and hands-on laboratory and clinical research training opportunities for students from northern regions of Peru.

神经囊肿（NCC）是一种常见的神经系统疾病，是整个发展中国家可预防癫痫的主要原因。它是由中枢神经感染引起的，taenia固体（猪肉tap虫）幼虫囊肿。尽管大多数NCC病例都有相对良性的临床过程，但涉及蛛网膜下腔空间（SANCC）的感染的预后是严峻的。需要采用新的方法来改善这种毁灭性恶性感染形式的患者的结局。一种承诺方法涉及通过人口筛查的早期检测，这将允许早期干预，而感染的燃烧却很低，而患者的健康状况相对较好。我们最近开发了一种检测尿液中超过肠抗原抗原的测定法，现在在试点研究中表明，该测定法可用于检测社区环境中SANCC的不对称人。   在这个为期5年的项目中，我们将使用大脑的磁共振成像（MRI）在北部北部的一项大型横断面研究中应用新评估，以确认诊断诊断。随后被诊断出患有不对称SANCC的参与者，以及NCC上的其他形式，将招募18个月的前瞻性观察队列，以确定疾病进展的风险。此外，我们将开发一种原型的测定点格式，并通过从社区收集的样品进行验证。这些研究的结果将提供必要的信息和工具，以进行确定的随机临床试验，以评估筛查和早期干预的有效性，作为改善SANCC患者临床结果的方法。我们还将为秘鲁北部地区的学生提供一系列教学和动手实验室和临床研究培训机会。