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Trypanosomiasis

GSK’s research into trypanosomiasis infections at our facility in Spain started in 2008 and is done in collaboration with several alliance partners including Drugs for Neglected Diseases Initiative (DNDi).

Human African trypanosomiasis – sleeping sickness

Human African trypanosomiasis, more commonly known as sleeping sickness, can develop over months or years. The first stage causes bouts of fever, headaches, joint pains and itching. These symptoms often go undiagnosed so that that any opportunity to cure the disease when it is easier to treat is often missed. In its advanced stages, the disease attacks the central nervous system and it becomes very difficult to treat. Without treatment, infections can be fatal.

The disease is estimated to threaten 60 million people in 36 countries of sub-Saharan Africa. The World Health Organization estimated the number of new cases in 1998 at up to 500,000. Thanks to active diagnosis, treatment and control, the number of new cases is now thought to be between 50,000 and 70,000 per year.

Because these diseases primarily affect the poorest people in the poorest, most remote areas of the world, accurate estimates of disease prevalence are quite difficult to make, and the actual number of cases is thought to be far greater than those actually reported.

Chagas disease

Chagas disease, American trypanosomiasis, is a different form of infection caused by a trypanosome endemic in Latin America.

It can cause fever, malaise and problems with the lymph nodes, liver and spleen in the early stages of infection. Later on, patients may have no symptoms, but about 10% to 30% of those go on to develop chronic Chagas disease, which affects the heart or gastrointestinal tract and is fatal.

Chagas Disease threatens approximately 100 million people in 21 Central and South American countries. Estimated to infect somewhere between 8 to 14 million people, Chagas disease is endemic in Latin America disease and kills more people in the region than any other parasitic disease, including malaria. Because of globalization and the movement of unknowingly infected people, the disease is spreading to many developed, non-endemic countries such as Australia, Spain, and the United States. It is a leading cause of infectious cardiomyopathy worldwide..

Causes

Trypanosomiasis is caused by Trypanosoma parasites. Human African trypanosomiasis is spread to humans when they are bitten by infected tsetse flies. These flies get infected by biting humans who have the disease or other infected large mammals, including cattle.

Chagas disease is usually transmitted to humans through bites of infected triatomine insects, which are known widely as “kissing bugs” or “assassin bugs”. However, humans can also get infected through blood transfusions, organ transplants, breast milk and even eating contaminated food.

Trypanosomiasis can be controlled by breaking the cycle of infection, both by early diagnosis and treatment of people who are infected and by controlling the insects that spread the disease. Although treatment is available for both stages of human African trypanosomiasis, there are problems with toxicity and administration. There are no treatments available for the indeterminate and chronic stages of Chagas disease.

Our collaborative research

DNDi has identified specific patient needs for any improved treatments for either human African trypanosomiasis or Chagas disease. Treatments for later stages of either disease must be safe, effective and practical so that treatment can be improved and simplified, and should ideally work on all stages of the disease. For Human African trypanosomiasis, simple options for the first stages of the disease are also important, so that more people in more areas can have access to treatment. DNDi also recognises a need for an affordable, efficient, paediatric-strength treatment for Chagas disease.

Our collaborative research on trypanosomiasis focuses on identifying and developing compounds from existing GSK programmes that may act against the disease. We have already had some success with this approach. For example, the anti-trypanosome activity of falcipain inhibitors, originally identified during our malaria research, has been confirmed by other facilities..