Antibodies to the core region of endotoxin (endotoxin core
antibodies, EndoCAb), which cross-react with endotoxin from
a range of Gram-negative bacteria, are maintained in relative homeostasis
in
health, but undergo marked changes in a
number of different diseases associated directly or indirectly with
endotoxaemic or septicaemic states. The levels of
EndoCAb IgG in the blood and cerebrospinal fluid (CSF) of 35 late-stage
sleeping sickness patients and 9 control
individuals were measured by ELISA. EndoCAb levels were significantly
elevated in the patient blood (mean EndoCAb
value 290 MU/ml cf. control 182 MU/ml, P<0·001),
and CSF (mean EndoCAb value 254 MU/ml cf. control
150 MU/ml, P<0·001). EndoCAb IgG levels correlated
with
endotoxin levels in patient blood (r=0·78,
P<0·001), but
not in the CSF and were not reduced 6 weeks following chemotherapy, unlike
the endotoxin levels. It is concluded that
late-stage sleeping sickness is associated with chronic exposure to endotoxins
from Gram-negative bacteria.