Urine screening for early detection of subarachnoid neurocysticercosis

尿液筛查早期发现蛛网膜下腔神经囊尾蚴病

• 批准号: 10454533
• 负责人: Hector Hugo Garcia
• 金额: $ 3.16万
• 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/10454533
• 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; Clinical Trials; Communities; Contracts; Cross-Sectional Studies; Cyst; Data; Developing Countries; Development; Diagnosis; Diagnostic; Disease; Disease Management; Disease Progression; Early Diagnosis; Early Intervention; Early treatment; Educational Status; Encephalitis; Enrollment; Enzyme-Linked Immunosorbent Assay; Epilepsy; Fostering; Future; Gold; Grant; Health; Health system; Immunoassay; Immunodiagnostics; Incidence; Infection; 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; Peru; Phase; Pilot Projects; Population; Prevalence; Process; Prognosis; Public Health; Randomized Clinical Trials; Research; Risk; Risk Factors; Rotation; Safety; Sampling; Seeds; Series; Serious Adverse Event; Specialist; Structure; Students; Subarachnoid Space; Symptoms; Taenia solium; Testing; United States; Urine; Vertebral column; base; cohort; community setting; disorder risk; early screening; efficacy evaluation; experience; improved; improved outcome; infection burden; mortality; mortality risk; nervous system disorder; novel; novel strategies; point of care; preventable epilepsy; programs; prospective; prototype; screening; tool; training opportunity

PROJECT SUMMARY 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 will be enrolled in either an 18-month prospective observational cohort to determine risk of disease progression, or a small clinical trial evaluating safety of early intervention for asymptomatic SANCC. 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.

项目概要 神经囊尾蚴病 (NCC) 是一种常见的神经系统疾病，也是全球可预防癫痫的主要原因 发展中国家。它是由猪带绦虫（猪肉绦虫）幼虫的中枢神经感染引起的 囊肿。虽然大多数 NCC 病例的临床病程相对良性，但感染的预后却很严峻 涉及蛛网膜下腔（SANCC）。需要新方法来改善患者的治疗结果 患有这种毁灭性的恶性感染。一种有前途的方法涉及通过以下方式进行早期检测： 人群筛查，这将允许在感染负担较低且 患者保持相对良好的健康状况。我们最近开发了一种检测 T. solium 分泌物抗原的检测方法 尿液中存在，现已在试点研究中表明，这种检测可用于检测无症状的人 在社区环境中与 SANCC 合作。 在这个为期 5 年的项目中，我们将通过在北部地区的一项大型横断面研究中应用新的检测方法来验证它。 秘鲁（30,000），使用大脑磁共振成像（MRI）作为确诊的金标准。 随后诊断为无症状 SANCC 的参与者将被纳入为期 18 个月的 确定疾病进展风险的前瞻性观察队列，或评估的小型临床试验 无症状 SANCC 早期干预的安全性。此外，我们将开发一个原型护理点 测定的格式并用从社区收集的样本进行验证。这些研究的结果将 提供进行评估疗效的明确随机临床试验所需的信息和工具 筛查和早期干预作为改善 SANCC 患者临床结果的方法。我们 还将为以下人员提供一系列教学和实践实验室及临床研究培训机会 来自秘鲁北部地区的学生。