Specific circulating immune complexes in acute Chagas' disease

Immune complexes in chronic Chagas disease patients are formed by exovesicles from Trypanosoma cruzi carrying the conserved MASP N-terminal region

The exovesicles (EVs) are involved in pathologic host-parasite immune associations and have been recently used as biomarkers for diagnosis of infectious diseases. The release of EVs by Trypanosoma cruzi, the causative agent of Chagas disease, has recently been described, with different protein cargoes including the MASP multigene family of proteins MASPs are specific to this parasite and characterized by a conserved C-terminal (C-term) region and an N-terminal codifying for a signal peptide (SP). In this investigation, we identified immature MASP proteins containing the MASP SP in EVs secreted by the infective forms of the parasite. Those EVs are responsible for the formation of immune complexes (ICs) containing anti-MASP SP IgGs in patients with different (cardiac, digestive and asymptomatic) chronic Chagas disease manifestations. Moreover, purified EVs as well as the MASP SP inhibit the action of the complement system and also show a significant association with the humoral response in patients with digestive pathologies. These findings reveal a new route for the secretion of MASP proteins in T. cruzi, which uses EVs as vehicles for immature and misfolded proteins, forming circulating immune complexes. Such complexes could be used in the prognosis of digestive pathologies of clinical forms of Chagas disease.

Participation of immune complexes in adenovirus infection

To determine the participation of immune complexes during adenovirus infection, we evaluated serum and necropsy specimens of patients with confirmed adenovirus infection of the lower respiratory tract. In lung and kidney from seven dead patients, immunofluorescence revealed the presence of hexon, immunoglobulins and complement. These patients had clinical manifestations of kidney dysfunction. In dead patients (3/3 in whom serum was available) neither anti-adenovirus antibodies nor adenovirus-specific immune complexes could be found in the final stage of the infection. However, two of these patients had anti-adenovirus antibodies and immune complexes in samples obtained early in the infection. Most patients (16/19) who survived the infection had circulating anti-adenovirus antibodies. Half also had immune complexes specific for adenovirus in some moment of the illness. This suggests that immune complexes arise during respiratory infection by adenovirus, probably contributing to its clinical picture.

Evaluación del método de ELISA para detección de antígenos y complejos inmunes circulantes de Trypanosoma cruzi a través de un estudio de campo en una zona endémica de Argentina

En una zona endémica de la República Argentina se llevó a cabo un ensayo de campo de la prueba inmunoenzimática ELISA para la detección de antígenos (cAg) y complejos inmunes circulantes (CIC) en sueros de pacientes chagásicos crónicos. Del total de 215 muestras de sangre analizadas, 51 fueron positivas para ELISA-CIC y 45 lo fueron para ELISA-cAg. De los 74 (34,32% de la población) sujetos considerados infectados con dos reacciones serológicas positivas, 49 (66,21%) presentaron CIC en suero, en tanto que en 43 (58,11%) de ellos se encontró cAg por ELISA. Solo en 2 casos serológicamente no reactivos, se detectaron inespecíficamente CIC y cAg. Dentro del grupo considerado no infectado, se observó reactividad inespecífica de bajo título por una de las pruebas serológicas en 16 (11,35%) de 141 individuos. Estos sueros arrojaron resultados consistentemente negativos por ELISA-CIC y cAg demostrando la utilidad de estos métodos de diagnóstico antigénico en casos de serología conflictiva. La determinación de fracciones antigénicas circulantes por ELISA en individuos chagásicos crónicos permite evidenciar la infección por T. cruzi de manera más directa que midiendo la respuesta inmune humoral en el huésped, presentando además mayor sensibilidad que el diagnóstico parasitológico clásico

Purification and characterization of an 80-kilodalton Trypanosoma cruzi urinary antigen

A Trypanosoma cruzi antigen eliminated in the urine of experimentally infected dogs was detected by enzyme-linked immunosorbent assay between 9 and 28 days after infection. The parasite urinary antigen (UAg) was purified by affinity chromatography with polyclonal antibodies to T. cruzi. The eluate of the antibody column was subjected to high-performance liquid chromatography and showed a single peak of A280. This antigen was the only parasite component found in the urine of infected dogs during the course of acute T. cruzi infection. Antigen characterization was performed by two-dimensional gel electrophoresis, lectin affinity chromatography, proteolytic digestion, and Western blotting (immunoblotting). The isolated UAg exhibited a relative molecular size of 80 kilodaltons (kDa), an isoelectric point of 6.2 to 6.8, binding to concanavalin A, and sensitivity to trypsin. The parasite antigen was electroeluted from polyacrylamide gels and subjected to acid hydrolysis and amino acid analysis by reverse-phase high-performance liquid chromatography. The 80-kDa glycoprotein was recognized by serum antibodies from a wide variety of T. cruzi-infected hosts. The UAg proved to be a highly antigenic component present in different strains of T. cruzi. This 80-kDa polypeptide resembles one of the parasite antigens previously found in the urine of patients with acute Chagas' disease.