Why trypanosomes cause sleeping sickness.

@article{Lundkvist2004WhyTC,
  title={Why trypanosomes cause sleeping sickness.},
  author={Gabriella B. S. Lundkvist and Krister Kristensson and Marina Bentivoglio},
  journal={Physiology},
  year={2004},
  volume={19},
  pages={
          198-206
        }
}
African trypanosomiasis or sleeping sickness is hallmarked by sleep and wakefulness disturbances. In contrast to other infections, there is no hypersomnia, but the sleep pattern is fragmented. This overview discusses that the causative agents, the parasites Trypanosoma brucei, target circumventricular organs in the brain, causing inflammatory responses in hypothalamic structures that may lead to dysfunctions in the circadian-timing and sleep-regulatory systems. 
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Research on sleeping sickness parasite biology and the impact it has on host health is summarized and the possible evolutionary advantages of sleep and circadian deregulation for the parasite are considered.
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Although a great deal of progress has been made in recent years, the advent and application of sophisticated analysis techniques, to decipher the complexities of HAT pathogenesis, herald an exciting and rewarding period for advances in trypanosome research.
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Experimental results that support crossing of the blood–brain barrier and of theBlood–CSF barrier are listed and the implications that either pathway would have on infection progress and on the survival strategy of the parasite are discussed.
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The symptomatology of travellers is markedly different from the usual textbook descriptions of African HAT patients and a promising new drug combination is currently evaluated in a phase 3 b study and further new drugs are under evaluation.
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Current knowledge of tissue tropism in Trypanosoma infections in mammals is discussed, potential mechanisms of tissue entry are described, relevant findings from other parasitology fields are discussed, and new questions raised by recent discoveries are reflected.
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