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Gonçalves KR, Mazzeti AL, Nascimento AFDS, Castro-Lacerda In Memory JM, Nogueira-Paiva NC, Mathias FAS, Reis AB, Caldas S, Bahia MT. The entrance route: Oral, mucous, cutaneous, or systemic has a marked influence on the outcome of Trypanosoma cruzi experimental infection. Acta Trop 2022; 234:106581. [PMID: 35779591 DOI: 10.1016/j.actatropica.2022.106581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
In recent decades, the oral infection of Trypanosoma cruzi has gathered increased attention due to frequent outbreaks that can lead to more severe clinical signs than those usually found in the areas of vector transmission. This study addresses the main routes of infection using metacyclic trypomastigotes (MT) and blood trypomastigotes (BT). Herein, BALB/c mice were infected with the Colombian (TcI) strain via intraperitoneal (IP), oral, intragastric (IG), ocular (OC) and cutaneous (CT) routes with 106 culture-derived MT or BT. Parasitemia was intermittent and low in animals inoculated with MT, in contrast, high parasitemia levels were found in BT-mice. A tropism for the muscles was observed in oral or IG infection with BT. Differently, the parasite was widely distributed in the tissues of mice infected with MT. However, the intensity of the inflammation infiltrating the tissues was higher in oral or IG infection with BT. Animals inoculated with BT via the IG route had similar serum levels of IFN-γ and smaller IL-10 compared to those infected with MT via the IG route. TNF-α levels were higher in the serum from BT-animals, which could explain the higher intensity of heart inflammation in these animals. Our results suggest that the infective form and the route of infection differentially modulated the outcome of Trypanosoma cruzi mice infection.
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Affiliation(s)
- Karolina Ribeiro Gonçalves
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil.
| | - Ana Lia Mazzeti
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Av. Brasil, 4365 Rio de Janeiro, Brasil; Laboratório de Parasitologia Aplicada, Universidade Estadual de Minas Gerais - Unidade Passos, Av. Juca Stockler, 1130 Passos, Minas Gerais, Brasil
| | - Alvaro Fernando da Silva Nascimento
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil
| | - Jéssica Mara Castro-Lacerda In Memory
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil
| | - Nívia Carolina Nogueira-Paiva
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil
| | - Fernando Augusto Siqueira Mathias
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil; Laboratório de Informática de Biossistemas e Genômica, Instituto René Rachou, Fundação Oswaldo Cruz, Av. Augusto de Lima, 1715 Belo Horizonte, Minas Gerais, Brasil
| | - Alexandre Barbosa Reis
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil
| | - Sérgio Caldas
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil; Serviço de Biotecnologia e Saúde, Diretoria de Pesquisa e Desenvolvimento, Fundação Ezequiel Dias, Rua Conde Pereira Carneiro, 80 - Belo Horizonte, Minas Gerais, Brasil
| | - Maria Terezinha Bahia
- Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Campus Universitário, Morro do Cruzeiro - Ouro Preto, Minas Gerais, Brasil
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2
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Shikanai Yasuda MA. Emerging and reemerging forms of Trypanosoma cruzi transmission. Mem Inst Oswaldo Cruz 2022; 117:e210033. [PMID: 35584508 PMCID: PMC9113729 DOI: 10.1590/0074-02760210033] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/08/2021] [Indexed: 01/13/2023] Open
Abstract
This review aims to update and discuss the main challenges in controlling emergent and reemergent forms of Trypanosoma cruzi transmission through organ transplantation, blood products and vertical transmission in endemic and non-endemic areas as well as emergent forms of transmission in endemic countries through contaminated food, currently representing the major cause of acute illness in several countries. As a neglected tropical disease potentially controllable with a major impact on morbimortality and socioeconomic aspects, Chagas disease (CD) was approved at the WHO global plan to interrupt four transmission routes by 2030 (vector/blood transfusion/organ transplant/congenital). Implementation of universal or target screening for CD are highly recommended in blood banks of non-endemic regions; in organ transplants donors in endemic/non-endemic areas as well as in women at risk from endemic areas (reproductive age women/pregnant women-respective babies). Moreover, main challenges for surveillance are the application of molecular methods for identification of infected babies, donor transmitted infection and of live parasites in the food. In addition, the systematic recording of acute/non-acute cases and transmission sources is crucial to establish databases for control and surveillance purposes. Remarkably, antiparasitic treatment of infected reproductive age women and infected babies is essential for the elimination of congenital CD by 2030.
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Affiliation(s)
- Maria Aparecida Shikanai Yasuda
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Ptarasitárias, São Paulo, SP, Brasil,Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Laboratório de Imunologia, São Paulo, SP, Brasil,WHO Technical Group IVb on Prevention and Control of Transmission and Case Management of Trypanosoma cruzi Infections, WHO, Geneva, Switzerland,+ Corresponding author:
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3
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Bruneto EG, Fernandes-Silva MM, Toledo-Cornell C, Martins S, Ferreira JMB, Corrêa VR, da Costa JM, Pinto AYDN, de Souza DDSM, Pinto MCG, Neto JADF, Ramos AN, Maguire JH, Silvestre OM. Case-fatality From Orally-transmitted Acute Chagas Disease: A Systematic Review and Meta-analysis. Clin Infect Dis 2021; 72:1084-1092. [PMID: 32772104 DOI: 10.1093/cid/ciaa1148] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Indexed: 11/13/2022] Open
Abstract
Orally-transmitted acute Chagas disease (CD) is emerging as an important public health problem. The prognosis of acute infection following oral transmission is unknown. The aim of this study was to analyze and summarize data on orally-transmitted acute CD. We searched for publications from 1968 to 31 January 2018. We included studies and unpublished data from government sources that reported patients with acute orally-transmitted CD. We identified 41 papers and we added 932 unpublished cases. In all, our study covered 2470 cases and occurrence of 97 deaths. Our meta-analysis estimated that the case-fatality rate was 1.0% (95% CI 0.0-4.0%). Lethality rates have declined over time (P = .02). In conclusion, orally-transmitted acute CD has considerable lethality in the first year after infection. The lethality in symptomatic cases is similar to that from other routes of infection. The lethality rate of orally-acquired disease has declined over the years.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - James H Maguire
- Division of Infectious Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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4
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Pérez AR, de Meis J, Rodriguez-Galan MC, Savino W. The Thymus in Chagas Disease: Molecular Interactions Involved in Abnormal T-Cell Migration and Differentiation. Front Immunol 2020; 11:1838. [PMID: 32983098 PMCID: PMC7492291 DOI: 10.3389/fimmu.2020.01838] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/08/2020] [Indexed: 12/24/2022] Open
Abstract
Chagas disease, caused by the protozoan parasite T. cruzi, is a prevalent parasitic disease in Latin America. Presently, it is spreading around the world by human migration, thus representing a new global health issue. Chronically infected individuals reveal a dissimilar disease progression: while nearly 60% remain without apparent disease for life, 30% develop life-threatening pathologies, such as chronic chagasic cardiomyopathy (CCC) or megaviscerae. Inflammation driven by parasite persistence seems to be involved in the pathophysiology of the disease. However, there is also evidence of the occurrence of autoimmune events, mainly caused by molecular mimicry and bystander activation. In experimental models of disease, is well-established that T. cruzi infects the thymus and causes locally profound structural and functional alterations. The hallmark is a massive loss of CD4+CD8+ double positive (DP) thymocytes, mainly triggered by increased levels of glucocorticoids, although other mechanisms seem to act simultaneously. Thymic epithelial cells (TEC) exhibited an increase in extracellular matrix deposition, which are related to thymocyte migratory alterations. Moreover, medullary TEC showed a decreased expression of AIRE and altered expression of microRNAs, which might be linked to a disrupted negative selection of the T-cell repertoire. Also, almost all stages of thymocyte development are altered, including an abnormal output of CD4−CD8− double negative (DN) and DP immature and mature cells, many of them carrying prohibited TCR-Vβ segments. Evidence has shown that DN and DP cells with an activated phenotype can be tracked in the blood of humans with chronic Chagas disease and also in the secondary lymphoid organs and heart of infected mice, raising new questions about the relevance of these populations in the pathogenesis of Chagas disease and their possible link with thymic alterations and an immunoendocrine imbalance. Here, we discuss diverse molecular mechanisms underlying thymic abnormalities occurring during T. cruzi infection and their link with CCC, which may contribute to the design of innovative strategies to control Chagas disease pathology.
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Affiliation(s)
- Ana Rosa Pérez
- Instituto de Inmunología Clínica y Experimental de Rosario, CONICET-Universidad Nacional de Rosario, Rosario, Argentina.,Centro de Investigación y Producción de Reactivos Biológicos, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina
| | - Juliana de Meis
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,National Institute of Science and Technology on Neuroimmunomodulation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Rio de Janeiro Research Network on Neuroinflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Wilson Savino
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,National Institute of Science and Technology on Neuroimmunomodulation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Rio de Janeiro Research Network on Neuroinflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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5
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Velásquez-Ortiz N, Ramírez JD. Understanding the oral transmission of Trypanosoma cruzi as a veterinary and medical foodborne zoonosis. Res Vet Sci 2020; 132:448-461. [PMID: 32781335 DOI: 10.1016/j.rvsc.2020.07.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/21/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023]
Abstract
Chagas disease is a neglected tropical disease transmitted by the protozoan Trypanosoma cruzi that lately has been highlighted because several outbreaks attributed to oral transmission of the parasite have occurred. These outbreaks are characterized by high mortality rates and massive infections that cannot be related to other types of transmission such as the vectorial route. Oral transmission of Chagas disease has been reported in Brazil, Colombia, Venezuela, Bolivia, Ecuador, Argentina and French Guiana, most of them are massive oral outbreaks caused by the ingestion of beverages and food contaminated with triatomine feces or parasites' reservoirs secretions and considered since 2012 as a foodborne disease. In this review, we present the current status and all available data regarding oral transmission of Chagas disease, highlighting its relevance as a veterinary and medical foodborne zoonosis.
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Affiliation(s)
- Natalia Velásquez-Ortiz
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia
| | - Juan David Ramírez
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Departamento de Biología, Facultad de Ciencias Naturales, Universidad del Rosario, Bogotá, Colombia.
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6
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Meira CS, Santos EDS, Santo RFDE, Vasconcelos JF, Orge ID, Nonaka CKV, Barreto BC, Caria ACI, Silva DN, Barbosa-Filho JM, Macambira SG, Moreira DRM, Soares MBP. Betulinic Acid Derivative BA5, Attenuates Inflammation and Fibrosis in Experimental Chronic Chagas Disease Cardiomyopathy by Inducing IL-10 and M2 Polarization. Front Immunol 2019; 10:1257. [PMID: 31244833 PMCID: PMC6579897 DOI: 10.3389/fimmu.2019.01257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 05/17/2019] [Indexed: 12/29/2022] Open
Abstract
Chronic Chagas disease cardiomyopathy (CCC) is a major cause of heart disease in Latin America and treatment for this condition is unsatisfactory. Here we investigated the effects of BA5, an amide semi-synthetic derivative betulinic acid, in a model of CCC. Mice chronically infected with T. cruzi were treated orally with BA5 (10 or 1 mg/Kg), three times per week, for 2 months. BA5 treatment decreased inflammation and fibrosis in heart sections but did not improve exercise capacity or ameliorate cardiac electric disturbances in infected mice. Serum concentrations of TNF-α, IFN-γ, and IL-1β, as well as cardiac gene expression of pro-inflammatory mediators, were reduced after BA5 treatment. In contrast, a significant increase in the anti-inflammatory cytokine IL-10 concentration was observed in BA5-treated mice in both tested doses compared to vehicle-treated mice. Moreover, polarization to anti-inflammatory/M2 macrophage phenotype was evidenced by a decrease in the expression of NOS2 and proinflammatory cytokines and the increase in M2 markers, such as Arg1 and CHI3 in mice treated with BA5. In conclusion, BA5 had a potent anti-inflammatory activity on a model of parasite-driven heart disease related to IL-10 production and a switch from M1 to M2 subset of macrophages.
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Affiliation(s)
| | | | - Renan Fernandes do Espírito Santo
- FIOCRUZ, Gonçalo Moniz Institute, Salvador, Brazil.,Science and Health Institute, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Juliana Fraga Vasconcelos
- FIOCRUZ, Gonçalo Moniz Institute, Salvador, Brazil.,Center for Biotechnology and Cell Therapy, Hospital São Rafael, Salvador, Brazil
| | - Iasmim Diniz Orge
- FIOCRUZ, Gonçalo Moniz Institute, Salvador, Brazil.,Center for Biotechnology and Cell Therapy, Hospital São Rafael, Salvador, Brazil
| | - Carolina Kymie Vasques Nonaka
- FIOCRUZ, Gonçalo Moniz Institute, Salvador, Brazil.,Center for Biotechnology and Cell Therapy, Hospital São Rafael, Salvador, Brazil
| | - Breno Cardim Barreto
- FIOCRUZ, Gonçalo Moniz Institute, Salvador, Brazil.,Center for Biotechnology and Cell Therapy, Hospital São Rafael, Salvador, Brazil
| | | | - Daniela Nascimento Silva
- FIOCRUZ, Gonçalo Moniz Institute, Salvador, Brazil.,Center for Biotechnology and Cell Therapy, Hospital São Rafael, Salvador, Brazil
| | - José Maria Barbosa-Filho
- Laboratory of Pharmaceutical Technology, Federal University of Paraíba (UFPB), João Pessoa, Brazil
| | - Simone Garcia Macambira
- Science and Health Institute, Federal University of Bahia (UFBA), Salvador, Brazil.,Center for Biotechnology and Cell Therapy, Hospital São Rafael, Salvador, Brazil
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7
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Ortiz JV, Pereira BVM, Couceiro KDN, Silva MRHDSE, Doria SS, Silva PRLD, Lira EDFD, Guerra MDGVB, Guerra JADO, Ferreira JMBB. Cardiac Evaluation in the Acute Phase of Chagas' Disease with Post-Treatment Evolution in Patients Attended in the State of Amazonas, Brazil. Arq Bras Cardiol 2019; 112:240-246. [PMID: 30916205 PMCID: PMC6424035 DOI: 10.5935/abc.20190007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 09/05/2018] [Indexed: 11/25/2022] Open
Abstract
Background In the past two decades, a new epidemiological profile of Chagas' disease
(CD) has been registered in the Brazilian Amazon where oral transmission has
been indicated as responsible for the increase of acute cases. In the
Amazonas state, five outbreaks of acute CD have been registered since 2004.
The cardiac manifestations in these cases may be characterized by diffuse
myocarditis, with alteration in the electrocardiogram (ECG) and
transthoracic echocardiogram (TTE). Objective To perform a cardiac evaluation in autochthonous patients in the acute phase
and at least one year after submitted to treatment for acute CD and evaluate
the demographic variables associated with the presence of cardiac
alterations. Methods We evaluated patients diagnosed with acute CD through direct parasitological
or serological (IgM) methods from 2007 to 2015. These patients were treated
with benznidazole and underwent ECG and TTE before and after treatment. We
assumed a confidence interval of 95% (CI 95%, p < 0.05) for all variables
analyzed. Results We observed 63 cases of an acute CD in which oral transmission corresponded
to 75%. Cardiac alterations were found in 33% of the cases, with a greater
frequency of ventricular repolarization alteration (13%), followed by
pericardial effusion (10%) and right bundle branch block and left anterior
fascicular block (2%). The follow-up occurred in 48 patients with ECG and 25
with TTE for a mean period of 15.5 ± 4.1 months after treatment. Of
these, 8% presented normalization of the cardiac alterations in ECG, 62.5%
remained with the normal exams. All of the patients presented normal results
in TTE in the post-treatment period. As for the demographic variables,
isolated cases presented more cardiac alterations than outbreaks (p = 0.044)
as well as cases from Central Amazonas mesoregion (p = 0.020). Conclusions Although cardiac alterations have not been frequent in most of the studied
population, a continuous evaluation of the clinical-epidemiological dynamics
of the disease in the region is necessary in order to establish preventive
measures.
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Affiliation(s)
- Jessica Vanina Ortiz
- Universidade do Estado do Amazonas, Manaus, AM - Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM - Brazil
| | | | - Katia do Nascimento Couceiro
- Universidade do Estado do Amazonas, Manaus, AM - Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM - Brazil
| | | | - Susan Smith Doria
- Universidade do Estado do Amazonas, Manaus, AM - Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM - Brazil
| | | | | | | | - Jorge Augusto de Oliveira Guerra
- Universidade do Estado do Amazonas, Manaus, AM - Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM - Brazil
| | - João Marcos Bemfica Barbosa Ferreira
- Universidade do Estado do Amazonas, Manaus, AM - Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM - Brazil.,Hospital Universitário Francisca Mendes, Manaus, AM - Brazil
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8
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Barreto de Albuquerque J, Silva Dos Santos D, Stein JV, de Meis J. Oral Versus Intragastric Inoculation: Similar Pathways of Trypanosoma cruzi Experimental Infection? From Target Tissues, Parasite Evasion, and Immune Response. Front Immunol 2018; 9:1734. [PMID: 30100907 PMCID: PMC6072848 DOI: 10.3389/fimmu.2018.01734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 07/13/2018] [Indexed: 12/27/2022] Open
Abstract
Currently, oral infection is the most frequent transmission mechanism of Chagas disease in Brazil and others Latin American countries. This transmission pathway presents increased mortality rate in the first 2 weeks, which is higher than the calculated mortality after the biting of infected insect vectors. Thus, the oral route of Trypanosoma cruzi infection, and the consequences in the host must be taken into account when thinking on the mechanisms underlying the natural history of the disease. Distinct routes of parasite entry may differentially affect immune circuits, stimulating regional immune responses that impact on the overall profile of the host protective immunity. Experimental studies related to oral infection usually comprise inoculation in the mouth (oral infection, OI) or gavage (gastrointestinal infection, GI), being often considered as similar routes of infection. Hence, establishing a relationship between the inoculation site (OI or GI) with disease progression and the mounting of T. cruzi-specific regional immune responses is an important issue to be considered. Here, we provide a discussion on studies performed in OI and GI in experimental models of acute infections, including T. cruzi infection.
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Affiliation(s)
| | - Danielle Silva Dos Santos
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Jens V Stein
- Theodor Kocher Institute, University of Bern, Bern, Switzerland
| | - Juliana de Meis
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,National Institute of Science and Technology on Neuroimmunomodulation (INCT-NIM), Rio de Janeiro, Brazil
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9
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Pérez AR, Morrot A, Carvalho VF, de Meis J, Savino W. Role of Hormonal Circuitry Upon T Cell Development in Chagas Disease: Possible Implications on T Cell Dysfunctions. Front Endocrinol (Lausanne) 2018; 9:334. [PMID: 29963015 PMCID: PMC6010535 DOI: 10.3389/fendo.2018.00334] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 05/31/2018] [Indexed: 12/22/2022] Open
Abstract
T cell response plays an essential role in the host resistance to infection by the protozoan parasite Trypanosoma cruzi, the causative agent of Chagas disease. This infection is often associated with multiple manifestations of T cell dysfunction, both during the acute and the chronic phases of disease. Additionally, the normal development of T cells is affected. As seen in animal models of Chagas disease, there is a strong thymic atrophy due to massive death of CD4+CD8+ double-positive cells by apoptosis and an abnormal escape of immature and potentially autoreactive thymocytes from the organ. Furthermore, an increase in the release of corticosterone triggered by T. cruzi-driven systemic inflammation is strongly associated with the alterations seen in the thymus of infected animals. Moreover, changes in the levels of other hormones, including growth hormone, prolactin, and testosterone are also able to contribute to the disruption of thymic homeostasis secondary to T. cruzi infection. In this review, we discuss the role of hormonal circuits involved in the normal T cell development and trafficking, as well as their role on the thymic alterations likely related to the peripheral T cell disturbances largely reported in both chagasic patients and animal models of Chagas disease.
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Affiliation(s)
- Ana Rosa Pérez
- Institute of Clinical and Experimental Immunology (IDICER-CONICET UNR), Rosario, Argentina
- *Correspondence: Ana Rosa Pérez, ,
| | - Alexandre Morrot
- Faculty of Medicine, Tuberculosis Research Center, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Vinicius Frias Carvalho
- Laboratory of Inflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Juliana de Meis
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- National Institute of Science and Technology on Neuroimmunomodulation (INCT-NIM), Rio de Janeiro, Brazil
| | - Wilson Savino
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- National Institute of Science and Technology on Neuroimmunomodulation (INCT-NIM), Rio de Janeiro, Brazil
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10
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de Góes Costa E, Dos Santos SO, Sojo-Milano M, Amador ECC, Tatto E, Souza DSM, de A Costa F, Póvoa RMS. Acute Chagas Disease in the Brazilian Amazon: Epidemiological and clinical features. Int J Cardiol 2017; 235:176-178. [PMID: 28268086 DOI: 10.1016/j.ijcard.2017.02.101] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 01/05/2017] [Accepted: 02/20/2017] [Indexed: 11/19/2022]
Affiliation(s)
| | | | | | | | - Erica Tatto
- Secretary of Health, Rio Grande do Sul, Brazil
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11
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Outcome of oral infection in mice inoculated with Trypanosoma cruzi IV of the Western Brazilian Amazon. Acta Trop 2017; 166:212-217. [PMID: 27876646 DOI: 10.1016/j.actatropica.2016.11.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 11/01/2016] [Accepted: 11/16/2016] [Indexed: 12/17/2022]
Abstract
A new epidemiological view of American trypanosomiasis or Chagas disease has been formulated in recent decades. Oral transmission of the etiological agent of Chagas disease, Trypanosoma cruzi, has been the most common form of transmission. The T. cruzi discrete typing units TcI and TcIV have been involved in tens outbreaks of acute cases of Chagas disease in the Brazilian Amazon region. We investigated the intensity of infection in mice that were orally inoculated (OR group) with four strains of TcIV that were isolated from two outbreaks of acute Chagas disease that was orally acquired in the state of Amazonas, Brazil. We compared the OR group with mice that were intraperitoneally inoculated (IP group). Blood samples were analyzed by fresh blood examination, hemoculture, and conventional and qualitative real-time polymerase chain reaction (PCR). Samples of different tissues were analyzed by quantitative real-time PCR. The OR group exhibited a higher maximum peak of parasitemia, greater rates of positivity, and higher parasite loads in different tissues during acute infection compared with the IP group, indicating a greater intensity of orally acquired infection. Mice that were orally inoculated with TcIV strains that were obtained from two outbreaks of orally acquired Chagas disease in Amazonas, Brazil, exhibited a more intense course of infection compared with intraperitoneally inoculated mice, reflected by higher levels of parasitemia and parasite loads.
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12
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Coura J, Junqueira A. Ecological diversity of Trypanosoma cruzi transmission in the Amazon basin. The main scenaries in the Brazilian Amazon. Acta Trop 2015; 151:51-7. [PMID: 26254002 DOI: 10.1016/j.actatropica.2015.04.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 04/27/2015] [Accepted: 04/30/2015] [Indexed: 10/23/2022]
Abstract
The ecological diversity of Trypanosoma cruzi transmission in the Brazilian Amazon region is directly interlinked with the parasite's extensive reservoir, composed of 33 species of wild mammals within the following orders: Marsupialia, Chiroptera, Rodentia, Xenarthra, Carnivora and Primates; and of 16 species of wild triatomines, of which ten may be infected with T. cruzi. Four scenarios for the diversity of T. cruzi transmission in the Brazilian Amazon region are evident: (i) T. cruzi transmission between vectors and wild mammals, which is characterized as a wild enzooty encompassing the entire Amazon basin; (ii) accidental T. cruzi transmission from vectors and wild mammals to humans, when they invade the wild ecotope or when these vectors and wild mammals invade human homes; (iii) occupational Chagas disease among piassava (Leopoldinia piassaba) palm fiber gatherers, transmitted by the vector Rhodnius brethesi, for which these palm trees are the specific ecotope; (IV) oral T. cruzi transmission to humans through food contamination, particularly in juices from plants such as assai, which today is considered to be endemic in the Brazilian Amazon region, with more than 1500 cases notified.
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de Noya BA, González ON. An ecological overview on the factors that drives to Trypanosoma cruzi oral transmission. Acta Trop 2015; 151:94-102. [PMID: 26066984 DOI: 10.1016/j.actatropica.2015.06.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 05/19/2015] [Accepted: 06/02/2015] [Indexed: 01/14/2023]
Abstract
American trypanosomiasis is one of the few native parasites of this continent. As a zoonosis, Trypanosoma cruzi infects about 180 species out of 25 families of mammals. Its regular transmission is through triatomines, which can easily transmit parasites either by the skin route (contamination of mammals skin with their feces) or by oral route (ingestion of food contaminated with complete triatomines or their feces) and additionally through haematogenous via (congenital and transfusional) and by tissues (transplants). The oral route, which seems to be the ancestral form of transmission to wild and domestic mammals, has recently become more important after the success achieved in the control of domicile vectors using residual pesticides. From its initial diagnosis in 1967, tens of oral outbreaks have been diagnosed mostly in the Brazilian Amazon and subsequently in other four countries in South America. Environmental imbalance caused by man through the invasion and deforestation of woodlands, results in reduction of biodiversity of mammals as food source for triatomines, affecting the "dilution effect" of T. cruzi in the nature increasing the risk of human infection. On the other hand, triatomines invade houses looking for new blood sources. One of the consequences of domiciliated triatomines is the food contamination spread, especially in home-made juices, which has been the source of infection of most oral outbreaks. Other biotic and abiotic factors help to explain the recent increase of oral transmission outbreaks of Chagas disease, distributed in nine eco-regions of America.
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Messenger LA, Miles MA, Bern C. Between a bug and a hard place: Trypanosoma cruzi genetic diversity and the clinical outcomes of Chagas disease. Expert Rev Anti Infect Ther 2015; 13:995-1029. [PMID: 26162928 PMCID: PMC4784490 DOI: 10.1586/14787210.2015.1056158] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Over the last 30 years, concomitant with successful transnational disease control programs across Latin America, Chagas disease has expanded from a neglected, endemic parasitic infection of the rural poor to an urbanized chronic disease, and now a potentially emergent global health problem. Trypanosoma cruzi infection has a highly variable clinical course, ranging from complete absence of symptoms to severe and often fatal cardiovascular and/or gastrointestinal manifestations. To date, few correlates of clinical disease progression have been identified. Elucidating a putative role for T. cruzi strain diversity in Chagas disease pathogenesis is complicated by the scarcity of parasites in clinical specimens and the limitations of our contemporary genotyping techniques. This article systematically reviews the historical literature, given our current understanding of parasite genetic diversity, to evaluate the evidence for any association between T. cruzi genotype and chronic clinical outcome, risk of congenital transmission or reactivation and orally transmitted outbreaks.
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Affiliation(s)
- Louisa A Messenger
- Department of Pathogen Molecular Biology, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Michael A Miles
- Department of Pathogen Molecular Biology, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Caryn Bern
- Global Health Sciences, Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, USA
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Barreto-de-Albuquerque J, Silva-dos-Santos D, Pérez AR, Berbert LR, de Santana-van-Vliet E, Farias-de-Oliveira DA, Moreira OC, Roggero E, de Carvalho-Pinto CE, Jurberg J, Cotta-de-Almeida V, Bottasso O, Savino W, de Meis J. Trypanosoma cruzi Infection through the Oral Route Promotes a Severe Infection in Mice: New Disease Form from an Old Infection? PLoS Negl Trop Dis 2015; 9:e0003849. [PMID: 26090667 PMCID: PMC4474863 DOI: 10.1371/journal.pntd.0003849] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 05/26/2015] [Indexed: 11/16/2022] Open
Abstract
Oral transmission of Chagas disease has been documented in Latin American countries. Nevertheless, significant studies on the pathophysiology of this form of infection are largely lacking. The few studies investigating oral route infection disregard that inoculation in the oral cavity (Oral infection, OI) or by gavage (Gastrointestinal infection, GI) represent different infection routes, yet both show clear-cut parasitemia and heart parasitism during the acute infection. Herein, BALB/c mice were subjected to acute OI or GI infection using 5x104 culture-derived Trypanosoma cruzi trypomastigotes. OI mice displayed higher parasitemia and mortality rates than their GI counterparts. Heart histopathology showed larger areas of infiltration in the GI mice, whereas liver lesions were more severe in the OI animals, accompanied by higher Alanine Transaminase and Aspartate Transaminase serum contents. A differential cytokine pattern was also observed because OI mice presented higher pro-inflammatory cytokine (IFN-γ, TNF) serum levels than GI animals. Real-time PCR confirmed a higher TNF, IFN-γ, as well as IL-10 expression in the cardiac tissue from the OI group compared with GI. Conversely, TGF-β and IL-17 serum levels were greater in the GI animals. Immunolabeling revealed macrophages as the main tissue source of TNF in infected mice. The high mortality rate observed in the OI mice paralleled the TNF serum rise, with its inhibition by an anti-TNF treatment. Moreover, differences in susceptibility between GIversusOI mice were more clearly related to the host response than to the effect of gastric pH on parasites, since infection in magnesium hydroxide-treated mice showed similar results. Overall, the present study provides conclusive evidence that the initial site of parasite entrance critically affects host immune response and disease outcome. In light of the occurrence of oral Chagas disease outbreaks, our results raise important implications in terms of the current view of the natural disease course and host-parasite relationship. Chagas disease caused by the protozoan Trypanosoma cruzi is endemic in Latin America and a neglected tropical disease, which affects 6–7 million people worldwide. Currently, oral transmission is the most frequent pathway of infection in Brazil but also occurs in other endemic countries. This important infection route is underestimated and understudied. Here, we demonstrate that the site of parasite entrance, in the oral cavity (OI), as observed in natural infection, or directly to the gastrointestinal tract (GI), differentially affects the host-immune response and mortality. OI promotes a severe acute disease, elevated parasitemia and TNF mediated mortality. OI showed intense hepatitis and mild heart damage. Interestingly, GI mice presented mild disease, along with less circulating TNF and higher TGF-β and IL-17 serum contents. GI animals showed mild liver damage and intense heart inflammation. Our study is a pioneer work that analyzes the features of two distinct routes of oral infection. In addition, it provides new clues for Chagas pathology and stimulates background for the elucidation of disease features in orally exposed populations.
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Affiliation(s)
| | - Danielle Silva-dos-Santos
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Ana Rosa Pérez
- Immunology Institute, Faculty of Medical Science, National University of Rosario, Rosario, Argentina
| | - Luiz Ricardo Berbert
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | - Otacilio C. Moreira
- Laboratory on Molecular Biology and Endemic Diseases, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Eduardo Roggero
- Immunology Institute, Faculty of Medical Science, National University of Rosario, Rosario, Argentina
| | | | - José Jurberg
- National and International Laboratory on Triatomine Taxonomy, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Vinícius Cotta-de-Almeida
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Oscar Bottasso
- Immunology Institute, Faculty of Medical Science, National University of Rosario, Rosario, Argentina
| | - Wilson Savino
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Juliana de Meis
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- * E-mail:
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Coura JR, Viñas PA, Brum-Soares LM, Sousa ASD, Xavier SS. Morbidity of Chagas heart disease in the microregion of Rio Negro, Amazonian Brazil: a case-control study. Mem Inst Oswaldo Cruz 2015; 108:1009-13. [PMID: 24402153 PMCID: PMC4005545 DOI: 10.1590/0074-0276130425] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 11/29/2013] [Indexed: 12/27/2023] Open
Abstract
A case-control study on the morbidity of Chagas heart disease was carried out in the
municipality of Barcelos in the microregion of the Rio Negro, state of Amazonas. One
hundred and six individuals, who were serologically positive for Trypanosoma
cruzi infection, as confirmed by at least two techniques with different
principles, were matched according to age and sex with an equal number of
seronegative individuals. The cases and controls were evaluated using an
epidemiological questionnaire and clinical, electrocardiograph and echocardiograph
examinations. In the seroepidemiological evaluation, 62% of the interviewees
recognised triatomines and most of them confirmed that they had seen these insects in
the piassava plantations of the riverside communities of the Negro River tributaries.
Of the seropositive patients, 25.8% affirmed that they had been stung by the
triatomines and 11.7% denied having been stung. The principal clinical manifestations
of the seropositive individuals were palpitations, chest pain and dyspnoea upon
effort. Cardiac auscultation revealed extrasystoles, bradycardia and systolic
murmurs. The electrocardiographic alterations were ventricular extrasystoles, left
and right bundle branch block, atrioventricular block and primary T wave alterations.
The echocardiogram was altered in 22.6% of the seropositive individuals and in 8.5%
of the seronegative individuals.
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Affiliation(s)
| | - Pedro Albajar Viñas
- Department of Neglected Tropical Disease, World Health Organization, Switzerland, Geneva
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Blanchet D, Brenière SF, Schijman AG, Bisio M, Simon S, Véron V, Mayence C, Demar-Pierre M, Djossou F, Aznar C. First report of a family outbreak of Chagas disease in French Guiana and posttreatment follow-up. INFECTION GENETICS AND EVOLUTION 2014; 28:245-50. [DOI: 10.1016/j.meegid.2014.10.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/05/2014] [Accepted: 10/07/2014] [Indexed: 11/28/2022]
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de Meis J, Barreto de Albuquerque J, Silva Dos Santos D, Farias-de-Oliveira DA, Berbert LR, Cotta-de-Almeida V, Savino W. Trypanosoma cruzi Entrance through Systemic or Mucosal Infection Sites Differentially Modulates Regional Immune Response Following Acute Infection in Mice. Front Immunol 2013; 4:216. [PMID: 23898334 PMCID: PMC3724200 DOI: 10.3389/fimmu.2013.00216] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 07/13/2013] [Indexed: 12/11/2022] Open
Abstract
Acute Chagas disease is characterized by a systemic infection that leads to the strong activation of the adaptive immune response. Outbreaks of oral contamination by the infective protozoan Trypanosoma cruzi are frequent in Brazil and other Latin American countries, and an increased severity of clinical manifestations and mortality is observed in infected patients. These findings have elicited questions about the specific responses triggered after T. cruzi entry via mucosal sites, possibly modulating local immune mechanisms, and further impacting regional and systemic immunity. Here, we provide evidence for the existence of differential lymphoid organ responses in experimental models of acute T. cruzi infection.
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Affiliation(s)
- Juliana de Meis
- Laboratory of Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation , Rio de Janeiro , Brazil
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Pinto AYDN, Valente VDC, Coura JR, Valente SADS, Junqueira ACV, Santos LC, Ferreira AG, de Macedo RC. Clinical follow-up of responses to treatment with benznidazol in Amazon: a cohort study of acute Chagas disease. PLoS One 2013; 8:e64450. [PMID: 23724050 PMCID: PMC3664625 DOI: 10.1371/journal.pone.0064450] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 04/16/2013] [Indexed: 11/19/2022] Open
Abstract
A total of 179 individuals with acute Chagas disease mainly transmitted by oral source, from Pará and Amapá State, Amazonian, Brazil were included during the period from 1988 to 2005. Blood samples were used to survey peripheral blood for T. cruzi hemoparasites by quantitative buffy coat (QBC), indirect xenodiagnosis, blood culture and serology to detection of total IgM and anti-T. cruzi IgG antibodies by indirect immunofluorescence assay (IFA) and indirect hemagglutination assay (HA). All assays were performed pre-treatment (0 days) and repeated 35 (±7) and 68 (±6) days after the initiation of treatment with benznidazol and every 6 months while remained seropositive. The endpoint of collection was performed in 2005. Total medium period of follow-up per person was 5.6 years. Also, a blood sample was collected from 72 randomly chosen treated patients to perform polimerase chain reaction (PCR) method. Proportions of subjects with negative or positive serology according to the number of years after treatment were compared. In the endpoint of follow-up we found 47 patients (26.7%) serologically negative, therefore considered cured and 5 (2.7%) exhibited mild cardiac Chagas disease. Other 132 patients had persistent positive serologic tests. The PCR carried out in 72 individuals was positive in 9.8%. Added, there was evidence of therapeutic failure immediately following treatment, as demonstrated by xenodiagnosis and blood culture methods in 2.3% and 3.5% of cases, respectively. There was a strong evidence of antibody clearing in the fourth year after treatment and continuous decrease of antibody titers. Authors suggest that control programs should apply operational researches with new drug interventions four years after the acute phase for those treated patients with persistently positive serology.
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Affiliation(s)
- Ana Yecê das Neves Pinto
- Clinical epidemiologic Department of Evandro Chagas Institute-SOAMU-IEC-Secretaria de Vigilância em Saúde/Brazil Ministery Health-SVS/MS, Belém, Pará, Brazil.
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Aridgides D, Salvador R, PereiraPerrin M. Trypanosoma cruzi highjacks TrkC to enter cardiomyocytes and cardiac fibroblasts while exploiting TrkA for cardioprotection against oxidative stress. Cell Microbiol 2013; 15:1357-66. [PMID: 23414299 DOI: 10.1111/cmi.12119] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 01/26/2013] [Accepted: 01/31/2013] [Indexed: 12/13/2022]
Abstract
Chronic Chagas cardiomyopathy (CCC), caused by the obligate intracellular protozoan parasite Trypanosoma cruzi, is a major cause of morbidity and mortality in Latin America. CCC begins when T. cruzi enters cardiac cells for intracellular multiplication and differentiation, a process that starts with recognition of host-cell entry receptors. However, the nature of these surface molecules and corresponding parasite counter-receptor(s) is poorly understood. Here we show that antibodies against neurotrophin (NT) receptor TrkC, but not against family members TrkA and TrkB, prevent T. cruzi from invading primary cultures of cardiomyocytes and cardiac fibroblasts. Invasion is also selectively blocked by the TrkC ligand NT-3, and by antagonists of Trk autophosphorylation and downstream signalling. Therefore, these results indicate that T. cruzi gets inside cardiomyocytes and cardiac fibroblasts by activating TrkC preferentially over TrkA. Accordingly, short hairpin RNA interference of TrkC (shTrkC), but not TrkA, selectively prevents T. cruzi from entering cardiac cells. Additionally, T. cruzi parasite-derived neurotrophic factor (PDNF)/trans-sialidase, a TrkC-binding protein, but not family member gp85, blocks entry dose-dependently, underscoring the specificity of PDNF as TrkC counter-receptor in cardiac cell invasion. In contrast to invasion, competitive and shRNA inhibition studies demonstrate that T. cruzi-PDNF recognition of TrkA, but not TrkC on primary cardiomyocytes and the cardiomyocyte cell line H9c2 protects the cells against oxidative stress. Thus, this study shows that T. cruzi via PDNF favours neurotrophin receptor TrkC for cardiac cell entry and TrkA for cardiomyocyte protection against oxidative stress, and suggests a new therapeutic opportunity in PDNF and/or fragments thereof for CCC therapy as entry inhibitors and/or cardioprotection agonists.
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Affiliation(s)
- Daniel Aridgides
- Graduate Program in Immunology, Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA, USA
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Andrade SG, Campos RF, Steindel M, Guerreiro ML, Magalhães JB, Almeida MCD, Reis JN, Santos VC, Valadares HMS, Reis MGD, Macedo AM. Biological, biochemical and molecular features of Trypanosoma cruzi strains isolated from patients infected through oral transmission during a 2005 outbreak in the state of Santa Catarina, Brazil: its correspondence with the new T. cruzi Taxonomy Consensus (2009). Mem Inst Oswaldo Cruz 2012; 106:948-56. [PMID: 22241116 DOI: 10.1590/s0074-02762011000800009] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Accepted: 09/22/2011] [Indexed: 11/22/2022] Open
Abstract
We examined strains of Trypanosoma cruzi isolated from patients with acute Chagas disease that had been acquired by oral transmission in the state of Santa Catarina, Brazil (2005) and two isolates that had been obtained from a marsupial (Didelphis aurita) and a vector (Triatoma tibiamaculata). These strains were characterised through their biological behaviour and isoenzymic profiles and genotyped according to the new Taxonomy Consensus (2009) based on the discrete typing unities, that is, T. cruzi genotypes I-VI. All strains exhibited the biological behaviour of biodeme type II. In six isolates, late peaks of parasitaemia, beyond the 20th day, suggested a double infection with biodemes II + III. Isoenzymes revealed Z2 or mixed Z1 and Z2 profiles. Genotyping was performed using three polymorphic genes (cytochrome oxidase II, spliced leader intergenic region and 24Sα rRNA) and the restriction fragment length polymorphism of the kDNA minicircles. Based on these markers, all but four isolates were characterised as T. cruzi II genotypes. Four mixed populations were identified: SC90, SC93 and SC97 (T. cruzi I + T. cruzi II) and SC95 (T. cruzi I + T. cruzi VI). Comparison of the results obtained by different methods was essential for the correct identification of the mixed populations and major lineages involved indicating that characterisation by different methods can provide new insights into the relationship between phenotypic and genotypic aspects of parasite behaviour.
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Affiliation(s)
- Sonia Gumes Andrade
- Laboratório de Chagas Experimental, Autoimunidade e Imunologia Celular, Centro de Pesquisas Gonçalo Moniz, Fiocruz, Salvador, BA, Brasil.
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Monteiro WM, Magalhães LKC, de Sá ARN, Gomes ML, Toledo MJDO, Borges L, Pires I, de Oliveira Guerra JA, Silveira H, Barbosa MDGV. Trypanosoma cruzi IV causing outbreaks of acute Chagas disease and infections by different haplotypes in the Western Brazilian Amazonia. PLoS One 2012; 7:e41284. [PMID: 22848457 PMCID: PMC3405119 DOI: 10.1371/journal.pone.0041284] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 06/19/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chagas disease is an emergent tropical disease in the Brazilian Amazon Region, with an increasing number of cases in recent decades. In this region, the sylvatic cycle of Trypanosoma cruzi transmission, which constitutes a reservoir of parasites that might be associated with specific molecular, epidemiological and clinical traits, has been little explored. The objective of this work is to genetically characterize stocks of T. cruzi from human cases, triatomines and reservoir mammals in the State of Amazonas, in the Western Brazilian Amazon. METHODOLOGY/PRINCIPAL FINDINGS We analyzed 96 T. cruzi samples from four municipalities in distant locations of the State of Amazonas. Molecular characterization of isolated parasites from cultures in LIT medium or directly from vectors or whole human blood was performed by PCR of the non-transcribed spacer of the mini-exon and of the 24 S alfa ribosomal RNA gene, RFLP and sequencing of the mitochondrial cytochrome c oxidase subunit II (COII) gene, and by sequencing of the glucose-phosphate isomerase gene. The T. cruzi parasites from two outbreaks of acute disease were all typed as TcIV. One of the outbreaks was triggered by several haplotypes of the same DTU. TcIV also occurred in isolated cases and in Rhodnius robustus. Incongruence between mitochondrial and nuclear phylogenies is likely to be indicative of historical genetic exchange events resulting in mitochondrial introgression between TcIII and TcIV DTUs from Western Brazilian Amazon. TcI predominated among triatomines and was the unique DTU infecting marsupials. CONCLUSION/SIGNIFICANCE DTU TcIV, rarely associated with human Chagas disease in other areas of the Amazon basin, is the major strain responsible for the human infections in the Western Brazilian Amazon, occurring in outbreaks as single or mixed infections by different haplotypes.
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Affiliation(s)
- Wuelton Marcelo Monteiro
- Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- University of the State of Amazonas, Manaus, Amazonas, Brazil
- Federal University of Amazonas, Manaus, Amazonas, Brazil
| | - Laylah Kelre Costa Magalhães
- Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- University of the State of Amazonas, Manaus, Amazonas, Brazil
| | | | | | | | - Lara Borges
- Instituto de Higiene e Medicina Tropical, Center for Malaria Studies, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Isa Pires
- Instituto de Higiene e Medicina Tropical, Center for Malaria Studies, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Jorge Augusto de Oliveira Guerra
- Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- University of the State of Amazonas, Manaus, Amazonas, Brazil
| | - Henrique Silveira
- Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- Instituto de Higiene e Medicina Tropical, Center for Malaria Studies, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Maria das Graças Vale Barbosa
- Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- University of the State of Amazonas, Manaus, Amazonas, Brazil
- Nilton Lins University Center, Manaus, Amazonas, Brazil
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Coura JR, Junqueira ACV. Risks of endemicity, morbidity and perspectives regarding the control of Chagas disease in the Amazon Region. Mem Inst Oswaldo Cruz 2012; 107:145-54. [DOI: 10.1590/s0074-02762012000200001] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 02/01/2011] [Indexed: 11/21/2022] Open
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Abstract
Chagas disease is now an active disease in the urban centers of countries of nonendemicity and endemicity because of congenital and blood and/or organ transplantation transmissions and the reactivation of the chronic disease in smaller scale than vectorial transmission, reported as controlled in countries of endemicity. Oral transmission of Chagas disease has emerged in unpredictable situations in the Amazon region and, more rarely, in areas of nonendemicity where the domiciliary triatomine cycle was under control because of exposition of the food to infected triatomine and contaminated secretions of reservoir hosts. Oral transmission of Chagas disease is considered when >1 acute case of febrile disease without other causes is linked to a suspected food and should be confirmed by the presence of the parasite after direct microscopic examination of the blood or other biological fluid sample from the patient.
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Carvalho EOCD, Rosa JAD, Carvalho AAD, Chaves HCO, Souza EAD, Ostermayer AL, Camargo LMAD. Study on Chagas disease occurrence in the municipality of Monte Negro, State of Rondônia, Brazilian Amazon. Rev Soc Bras Med Trop 2011; 44:703-7. [DOI: 10.1590/s0037-86822011000600010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2011] [Accepted: 06/01/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Studies on Chagas disease deal with the perspective of its occurrence in the Amazon region, which is directly correlated to the population growth and the spread of the bug biotope. The state of Rondônia has an immense source of vectors (Triatomine) and reservoirs of Trypanosoma cruzi. Environmental changes brought forth by the deforestation in the region may cause vector behavior changes and bring these vectors to a closer contact with humans, increasing the probability of vector infection. METHODS: This study was carried out to check the occurrence of Chagas disease in the municipality of Monte Negro, Rondônia, Brazil, based on a random sampling of the farms and people wherein blood collection from the population and capturing triatomines were done. The blood samples were submitted to serologic tests to detect antibodies of the IgG class against T. cruzi. The triatomines that were collected had their digestive tract checked for the presence of trypanosomatidae with morphology resembling that of the T. cruzi. RESULTS: The population examined was mostly from other states. From the 322 bugs examined on the microscope, 50% showed parasites with morphology compatible with T. cruzi. From the serology of 344 random samples of human blood, 1.2% was found positive, 6% showed inconclusive results, and 92.8% were negative. CONCLUSIONS: Monte Negro shows low prevalence of human infection by T. cruzi and none active vector transmission; however, preventive and surveying measures, which are not performed until now, shall be taken due to the abundance of vectors infected by trypanosomatidae.
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Bastos CJC, Aras R, Mota G, Reis F, Dias JP, de Jesus RS, Freire MS, de Araújo EG, Prazeres J, Grassi MFR. Clinical outcomes of thirteen patients with acute chagas disease acquired through oral transmission from two urban outbreaks in northeastern Brazil. PLoS Negl Trop Dis 2010; 4:e711. [PMID: 20559542 PMCID: PMC2886048 DOI: 10.1371/journal.pntd.0000711] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Accepted: 04/22/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Outbreaks of orally transmitted Trypanosoma cruzi continue to be reported in Brazil and are associated with a high mortality rate, mainly due to myocarditis. METHODS This study is a detailed report on the disease progression of acute Chagas disease in 13 patients who were infected during two micro-outbreaks in two northeastern Brazilian towns. Clinical outcomes as well as EKG and ECHO results are described, both before and after benznidazole treatment. RESULTS Fever and dyspnea were the most frequent symptoms observed. Other clinical findings included myalgia, periorbital edema, headache and systolic murmur. Two patients died of cardiac failure before receiving benznidazole treatment. EKG and ECHO findings frequently showed a disturbance in ventricular repolarization and pericardial effusion. Ventricular dysfunction (ejection fraction <55%) was present in 27.3% of patients. After treatment, EKG readings normalized in 91.7% of patients. Ventricular repolarization abnormalities persisted in 50% of the patients, while sinus bradycardia was observed in 18%. The systolic ejection fraction normalized in two out of three patients with initially depressed ventricular function, while pericardial effusion disappeared. CONCLUSIONS Myocarditis is frequently found and potentially severe in patients with acute Chagas disease. Benznidazole treatment may improve clinical symptoms, as well as EKG and ECHO findings.
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Affiliation(s)
- Claudilson J. C. Bastos
- Medicine and Human Health PhD Program, Bahian School of Medicine and Public Health, Bahia, Brazil
| | - Roque Aras
- Edgard Santos University Hospital, Federal University of Bahia, Bahia, Brazil
| | - Gildo Mota
- Edgard Santos University Hospital, Federal University of Bahia, Bahia, Brazil
| | - Francisco Reis
- Edgard Santos University Hospital, Federal University of Bahia, Bahia, Brazil
| | - Juarez Pereira Dias
- Epidemiological Surveillance Department of the Bahia Health Secretary, Bahia, Brazil
| | | | | | - Eline G. de Araújo
- Epidemiological Surveillance Department of the Bahia Health Secretary, Bahia, Brazil
| | - Juliana Prazeres
- Edgard Santos University Hospital, Federal University of Bahia, Bahia, Brazil
| | - Maria Fernanda Rios Grassi
- Medicine and Human Health PhD Program, Bahian School of Medicine and Public Health, Bahia, Brazil
- Oswaldo Cruz Foundation-FIOCRUZ, Bahia, Brazil
- * E-mail:
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Valente SADS, da Costa Valente V, das Neves Pinto AY, de Jesus Barbosa César M, dos Santos MP, Miranda COS, Cuervo P, Fernandes O. Analysis of an acute Chagas disease outbreak in the Brazilian Amazon: human cases, triatomines, reservoir mammals and parasites. Trans R Soc Trop Med Hyg 2009; 103:291-7. [DOI: 10.1016/j.trstmh.2008.10.047] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 10/30/2008] [Accepted: 10/31/2008] [Indexed: 10/21/2022] Open
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Blum JA, Zellweger MJ, Burri C, Hatz C. Cardiac involvement in African and American trypanosomiasis. THE LANCET. INFECTIOUS DISEASES 2008; 8:631-41. [PMID: 18922485 DOI: 10.1016/s1473-3099(08)70230-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
American trypanosomiasis (Chagas disease) and human African trypanosomiasis (HAT; sleeping sickness) are both caused by single-celled flagellates that are transmitted by arthropods. Cardiac problems are the main cause of morbidity in chronic Chagas disease, but neurological problems dominate in HAT. Physicians need to be aware of Chagas disease and HAT in patients living in or returning from endemic regions, even if they left those regions long ago. Chagas heart disease has to be taken into account in the differential diagnosis of cardiomyopathy, primarily in patients with pathological electrocardiographic (ECG) findings, such as right bundle branch block or left anterior hemiblock, with segmental wall motion abnormalities or aneurysms on echocardiography, and in young patients with stroke in the absence of arterial hypertension. In HAT patients, cardiac involvement as seen by ECG alterations, such as repolarisation changes and low voltage, is frequent. HAT cardiopathy in general is benign and does not cause relevant congestive heart failure and subsides with treatment. We review the differences between the American and African trypanosomiasis with the main focus on the heart.
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Manoel-Caetano FDS, Silva AE. Implications of genetic variability of Trypanosoma cruzi for the pathogenesis of Chagas disease. CAD SAUDE PUBLICA 2007; 23:2263-74. [PMID: 17891288 DOI: 10.1590/s0102-311x2007001000002] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2007] [Accepted: 07/13/2007] [Indexed: 11/22/2022] Open
Abstract
Trypanosoma cruzi, the etiological agent of Chagas disease, presents a high degree of intraspecific genetic variability, with possible implications for the clinical forms of the disease, like the development of cardiopathy, megaesophagus, and megacolon, alone or in combination. This tissue tropism involved in the pathogenesis of Chagas disease has still not been totally elucidated. Thus, the current review approaches key aspects of T. cruzi genetic diversity, the clinical forms of Chagas disease, and the infection of the host cell by the parasite and the immune response. Other aspects discussed here include the release of immunosuppressive factors by the parasite, acting in the host's immune response pathways; host cell apoptosis inhibition; the pathogenesis of chagasic megaesophagus, which can be related to host-parasite interaction; and finally the association between megaesophagus and increased risk for the development of squamous-cell esophageal carcinoma. However, despite great advances in the understanding of this disease, it is still not possible to establish the true relationship between the parasite's genetic variability and the clinical form of Chagas disease.
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Cardoso AVN, Lescano SAZ, Amato Neto V, Gakiya E, Santos SV. Survival of Trypanosoma cruzi in sugar cane used to prepare juice. Rev Inst Med Trop Sao Paulo 2006; 48:287-9. [PMID: 17086319 DOI: 10.1590/s0036-46652006000500009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Accepted: 08/16/2006] [Indexed: 11/22/2022] Open
Abstract
Chagas disease can be transmitted to man by many different means, including contact with infected triatomine feces, blood transfusion, laboratory accidents, organ transplants, and congenital or oral routes. The latter mode has received considerable attention recently. In this assay, we evaluate the survival of Trypanosoma cruzi contaminating sugar cane used to prepare juice, as well as the viability and capacity for infection by the parasite after recovery. Thirty triatomines were contaminated with T. cruzi Y strain and 45 days later pieces of sugar cane were contaminated with the intestinal contents of the insects. The pieces were ground at different intervals after contamination (time = 0, 1, 4, 6, 12 and 24 hours) and the juice extracted and analyzed. Different methods were used to show T. cruzi in the juice: direct analysis, hematocrit tube centrifugation and QBC, and experimental inoculation in 47 female BALB/c mice (five control mice and seven mice for each interval examined (five inoculated orally and two intraperitoneally). Positive results were found using the direct analysis and QBC methods for juice prepared up to 12 hours after initial contamination. However, by the centrifugation technique, positivity was found only up to four hours after contamination of the sugar cane. Inoculated animals showed parasitemia during a 14 day observation period, demonstrating the high survival rate of T. cruzi in sugar cane.
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Affiliation(s)
- Adriana V N Cardoso
- Instituto de Medicina Tropical de São Paulo, Laboratório de Investigação Médica, Hospital das Clinicas, FMUSP, São Paulo, SP, Brazil
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Xavier SS, Sousa AS, Viñas PA, Junqueira ACV, Bóia MN, Coura JR. Cardiopatia chagásica crônica no Rio Negro, Estado do Amazonas. Relato de três novos casos autóctones, comprovados por exames sorológicos, clínicos, radiográficos do tórax, eletro e ecocardiográficos. Rev Soc Bras Med Trop 2006; 39:211-6. [PMID: 16699652 DOI: 10.1590/s0037-86822006000200015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
São relatados três novos casos de miocardiopatia chagásica crônica em pacientes autóctones do Rio Negro, Estado do Amazonas, confirmados por sorologia (imunofluorescência, ELISA e Western-blot para infecção pelo Trypanosoma cruzi) e por exames clínicos, radiográficos, eletro e ecocardiográficos. Os pacientes nasceram e sempre viveram na região do Rio Negro, tendo sido picados numerosas vezes por triatomíneos silvestres em piaçabais da área. O quadro clínico foi de insuficiência cardíaca congestiva e distúrbio da condução intraventricular nos três casos (BRD com HBAE em dois casos e BRE de terceiro grau em um caso), extra-sístoles ventriculares polimórficas em dois casos e alteração primária da repolarização ventricular em um deles. A avaliação ecocardiográfica revelou importante aumento dos diâmetros cavitários do VE, com fração da ejeção < 36% e padrão segmentar de acometimento miocárdico, incluindo aneurisma apical e acinesia ínfero-posterior nos três pacientes. Estes são os primeiros casos descritos de cardiopatia chagásica crônica autóctone do Amazonas com padrão ecocardiográfico sugestivo da doença.
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Affiliation(s)
- Sérgio Salles Xavier
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ
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Dávila DF, Donis JH, Torres A, Ferrer JA. A modified and unifying neurogenic hypothesis can explain the natural history of chronic Chagas heart disease. Int J Cardiol 2004; 96:191-5. [PMID: 15262032 DOI: 10.1016/j.ijcard.2003.06.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2003] [Revised: 06/02/2003] [Accepted: 06/09/2003] [Indexed: 11/18/2022]
Abstract
The pathogenesis of chronic Chagas disease still is an unresolved and controversial issue. Parasite persistence and autoimmune responses cannot explain the spectrum of chronic Chagas disease. However, a modified neurogenic hypothesis, concerning the timing and mechanisms responsible for the cardiac parasympathetic damage and for the activation of the sympathetic nervous system and of other neurohormonal systems, unifies cardiac remodelling and neurohormonal activation to explain most of the events of the natural history of Chagas disease.
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Affiliation(s)
- Diego F Dávila
- Instituto de Investigaciones Cardiovasculares, Departamento de Fisiopatología, Universidad de Los Andes, Apartado Postal 590, 5101 Mérida, Venezuela.
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Viñas Albajar P, Laredo SV, Terrazas MB, Coura JR. Miocardiopatia dilatada em pacientes com infecção chagásica crônica: relato de dois casos fatais autóctones do Rio Negro, Estado do Amazonas. Rev Soc Bras Med Trop 2003. [DOI: 10.1590/s0037-86822003000300013] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Dois casos fatais de miocardiopatia chagásica crônica dilatada são relatados pela primeira vez em pacientes autóctones do rio Negro, Estado do Amazonas. Ambos os casos, um homem de 45 anos de idade e uma mulher de 44, nasceram e viveram toda a vida na região do Rio Negro, no norte do estado do Amazonas, tendo sido picados numerosas vezes por triatomineos silvestres em piaçabais da área. Os pacientes que tiveram as reações sorológicas positivas para anticorpos anti-Trypanosoma cruzi (imunofluorescência, ELISA e Wertern blot) desenvolveram nos últimos 5-7 anos um quadro de insuficiência cardíaca progressivo, com aumento global da área cardíaca, bloqueios atrioventricular e de ramo esquerdo e extrassístoles ventriculares, faleceram de insuficiência cardíaca irreversível. Um dos casos em que foi feita a biópsia cardíaca cirúrgica pós-mortem, mostrou na histopatologia, miocardite crônica com infiltrado mononuclear difuso, com áreas de adensamento celular, fibrose, dissociação, fragmentação e hialinização de fibras cardíacas, sugestivo de miocardite chagásica crônica e o PCR in situ foi positivo para Trypanosoma cruzi.
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Coura JR, Junqueira ACV, Boia MN, Fernandes O, Bonfante C, Campos JE, Santos L, Devera R. Chagas disease in the Brazilian Amazon: IV. a new cross-sectional study. Rev Inst Med Trop Sao Paulo 2002; 44:159-65. [PMID: 12163910 DOI: 10.1590/s0036-46652002000300009] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A new conglomerate family sample of 194 dwellings with 996 resident persons were studied in the town of Barcelos, State of Amazonas, in order to re-evaluate the risk of Chagas disease. During the survey the persons were interviewed and in this occasion we showed to them a collection of Panstrongylus, Rhodnius and Triatoma, asking if they recognized and eventually have been bitten by this kind of bugs. At this time we collected 500 ul of blood in microtainer tubes from 886 interviewed persons who gave permission after informed consent. A screening test for T. cruzi antibodies based on agglutination of colored polymer particles, sensitized with three different synthetic peptides of T. cruzi (ID-PaGIA Chagas Test), showed 13.2% of sera positivity, but only 6.8% were confirmed by indirect immunofluorescence, and ELISA with purified T. cruzi antigens. Two hundred and six interviewed persons (20.7%) recognized the triatomines, as "piaçavas' lice" and 62 (30%) confirmed that have been bitten by the bugs, 25.8% of them had a positive serology for T. cruzi infection. Electrocardiographic alterations were shown in 9.3% of the seropositives and in 11.9% of the seronegative cases. This was considered not statistically significant.
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Camandaroba ELP, Pinheiro Lima CM, Andrade SG. Oral transmission of Chagas disease: importance of Trypanosoma cruzi biodeme in the intragastric experimental infection. Rev Inst Med Trop Sao Paulo 2002; 44:97-103. [PMID: 12048547 DOI: 10.1590/s0036-46652002000200008] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Oral transmission of Trypanosoma cruzi has been suspected when epidemic episodes of acute infection were observed in areas devoid of domiciled insect vectors. Considering that the distribution of T. cruzi biodemes differs in sylvatic and domestic cycles, results of studies on biodemes can be of interest regarding oral transmission. The infectivity of T. cruzi strains of different biodemes was tested in mice subjected to infection by the digestive route (gavage). Swiss mice were infected either with the Peruvian strain (Biodeme Type I, Z2b) or the Colombian strain (Biodeme Type III, Z1, or T. cruzi I); for control, intraperitoneal inoculation was performed in a group of mice. The Colombian strain revealed a similar high infectivity and pathogenicity when either route of infection was used. However, the Peruvian strain showed contrasting levels of infectivity and pathogenicity, being high by intraperitoneal inoculation and low when the gastric route was used. The higher infectivity of the Colombian strain (Biodeme Type III) by gastric inoculation is in keeping with its role in the epidemic episodes of acute Chagas disease registered in the literature, since strains belonging to Biodeme III are most often found in sylvatic hosts.
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Affiliation(s)
- Edson Luiz P Camandaroba
- Laboratório de doença de Chagas Experimental, Centro de Pesquisas Gonçalo Moniz, Fiocruz, Salvador, Bahia, 40295-001, Brasil
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