[Pathology of experimental Chagas disease in dogs]

Chagas Disease: A Silent Threat for Dogs and Humans

Chagas disease (CD) is a vector-borne Neglected Zoonotic Disease (NZD) caused by a flagellate protozoan, Trypanosoma cruzi, that affects various mammalian species across America, including humans and domestic animals. However, due to an increase in population movements and new routes of transmission, T. cruzi infection is presently considered a worldwide health concern, no longer restricted to endemic countries. Dogs play a major role in the domestic cycle by acting very efficiently as reservoirs and allowing the perpetuation of parasite transmission in endemic areas. Despite the significant progress made in recent years, still there is no vaccine against human and animal disease, there are few drugs available for the treatment of human CD, and there is no standard protocol for the treatment of canine CD. In this review, we highlight human and canine Chagas Disease in its different dimensions and interconnections. Dogs, which are considered to be the most important peridomestic reservoir and sentinel for the transmission of T. cruzi infection in a community, develop CD that is clinically similar to human CD. Therefore, an integrative approach, based on the One Health concept, bringing together the advances in genomics, immunology, and epidemiology can lead to the effective development of vaccines, new treatments, and innovative control strategies to tackle CD.

Trypanosoma cruzi infection in dogs along the US-Mexico border: R0 changes with vector species composition

Infection with Trypanosoma cruzi, etiological agent of Chagas disease, is common in US government working dogs along the US-Mexico border. This 3145 km long border comprises four states: Texas (TX), New Mexico (NM), Arizona (AZ) and California (CA) with diverse ecosystems and several triatomine (a.k.a., kissing bug) species, primary vectors of T. cruzi in this region. The kissing bug (Heteroptera: Reduviidae) community ranging from CA to TX includes Triatoma protracta (Uhler), Triatoma recurva (Stål) and Triatoma rubida (Uhler) and becomes dominated by Triatoma gerstaeckeri Stål in TX. Here, we ask if T. cruzi infection dynamics in dogs varies along this border region, potentially reflecting changes in vector species and their vectorial capacity. Using reversible catalytic models of infection, where seropositivity can be lost, we estimated an R0 (Estimate ± S.E.) of 1.192 ± 0.084 for TX and NM. In contrast, seropositivity decayed to zero as dogs aged in AZ and CA. These results suggest that dogs are likely infected by T. cruzi during their training in western TX, with a force of infection large enough for keeping R0 above 1, i.e., the disease endemically established, in TX and NM. In AZ and CA, a lower force of infection, probably associated with different vector species communities and associated vectorial capacity and/or different lineages of T. cruzi, results in dogs decreasing their seropositivity with age.

Molecular detection of Trypanosoma cruzi in equids in a semiarid zone of Pernambuco - Brazil

Trypanosoma cruzi is the etiological agent of Chagas disease, a neglected and frequently occurring zoonosis in Central and South American countries. Wild mammals and domestic dogs are the main reservoirs of the parasite in the wild and domestic cycles, respectively. The vectors have a wide variety of food sources that can influence transmission cycles. The aim of this study was to determine the prevalence of T. cruzi infection in donkeys (Equus asininos) and mules (Equus mulus) living in rural areas of the Brazilian semi-arid region. Whole-blood samples from 72 equids (65 donkeys and 7 mules) were analyzed by nested polymerase chain reaction (nested PCR). A total of 51.39% of the samples (37/72) were positive. Phylogenetic analysis identified discrete typing units TcI and TcII, which suggested the possibility that donkeys and mules might be participating in domestic/peridomestic and wild transmission cycles. This was the first report of T. cruzi infection in donkeys and mules in Brazil, with high prevalence of positive animals. This places these animals as potential reservoirs for the parasite and the particular features of these hosts, the presence of vectors and the socioeconomic characteristics of the population under semiarid conditions create interactions that may favor transmission and overlapping T. cruzi infection cycles.

Technological advances in the serological diagnosis of Chagas disease in dogs and cats: a systematic review

Background

Chagas disease (CD) is caused by Trypanosoma cruzi, which is transmitted mainly through the feces/urine of infected triatomine bugs. The acute phase lasts 2–3 months and is characterized by high parasitemia and nonspecific symptoms, whereas the lifelong chronic phase features symptoms affecting the heart and/or digestive tract occurring in 30–40% of infected individuals. As in humans, cardiac abnormalities are observed in T. cruzi-infected dogs and cats. We reviewed the technological advances in the serological diagnosis of CD in dogs and cats.

Methods

A review of the published literature during the last 54 years (1968–2022) on the epidemiology, clinical features, diagnosis, treatment and prevention of CD in dogs and cats was conducted.

Results

Using predefined eligibility criteria for a search of the published literature, we retrieved and screened 436 publications. Of these, 84 original studies were considered for inclusion in this review. Dogs and cats are considered as sentinels, potentially indicating an active T. cruzi transmission and thus the risk for human infection. Although dogs and cats are reputed to be important for maintaining the T. cruzi domestic transmission cycle, there are no commercial tests to detect past or active infections in these animals. Most published research on CD in dogs and cats have used in-house serological tests prepared with native and/or full-length recombinant antigens, resulting in variable diagnostic performance. In recent years, chimeric antigens have been used to improve the diagnosis of chronic CD in humans with encouraging results. Some of them have high performance values (> 95%) and extremely low cross-reactivity rates for Leishmania spp., especially the antigens IBMP-8.1 to IBMP-8.4. The diagnostic performance of IBMP antigens was also investigated in dogs, showing high diagnostic performance with negligible cross-reactivity with anti-Leishmania infantum antibodies.

Conclusions

The development of a commercial immunodiagnostic tool to identify past or active T. cruzi infections in dogs and cats is urgently needed. The use of chimeric recombinant T. cruzi antigens may help to fill this gap and is discussed in this review.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-022-05476-4.

Basic Biology of Trypanosoma cruzi

The present review addresses basic aspects of the biology of the pathogenic protozoa Trypanosoma cruzi and some comparative information of Trypanosoma brucei. Like eukaryotic cells, their cellular organization is similar to that of mammalian hosts. However, these parasites present structural particularities. That is why the following topics are emphasized in this paper: developmental stages of the life cycle in the vertebrate and invertebrate hosts; the cytoskeleton of the protozoa, especially the sub-pellicular microtubules; the flagellum and its attachment to the protozoan body through specialized junctions; the kinetoplast-mitochondrion complex, including its structural organization and DNA replication; glycosome and its role in the metabolism of the cell; acidocalcisome, describing its morphology, biochemistry, and functional role; cytostome and the endocytic pathway; the organization of the endoplasmic reticulum and Golgi complex; the nucleus, describing its structural organization during interphase and division; and the process of interaction of the parasite with host cells. The unique characteristics of these structures also make them interesting chemotherapeutic targets. Therefore, further understanding of cell biology aspects contributes to the development of drugs for chemotherapy.

Dogs as a Model for Chemotherapy of Chagas Disease and Leishmaniasis

BACKGROUND

Dogs are natural reservoir of Chagas disease (CD) and leishmaniasis and have been used for studies of these infections as they develop different clinical forms of these diseases similar to humans.

OBJECTIVE

This article describes publications on the dog model relative to CD and leishmaniasis chemotherapy.

METHODS

The search of articles was based on PubMed, Scopus and MESH using the keywords: dog, Trypanosoma cruzi, treatment (T. cruzi chemotherapy analysis), Leishmania chagasi, Leishmania infantum, canine visceral leishmaniasis, treatment (Leishmania chemotherapy evaluation).

RESULTS

Benznidazole and nifurtimox were used as a reference in the treatment of CD and in combination with other compounds. Eleven out of the fifteen studies have authors from the same team, using similar protocols and post-treatment evaluations, which assured more reproducibility and credibility. Twenty leishmaniasis studies, especially on visceral leishmaniasis, presenting at least one parasitological analysis tested in distinct monochemotherapy and polychemotherapy approaches were accessed. Data demonstrated that polychemotherapy was more effective in improving the clinical signs and parasitism control.

CONCLUSION

The benefits of treatment in terms of reducing or eliminating lesions and/or cardiac dysfunctions were demonstrated at acute and/or chronic phases relative to parasite load and/or the T. cruzi strain resistance to treatment. BZ presented better therapeutic results than the two EBI compounds evaluated. Although treatment of the canine visceral leishmaniasis was not able to induce complete parasite clearance, it can improve clinical recovery. Thus, the dog is a good model for CD and leishmaniasis studies of chemotherapy and may be indicated for pre-clinical trials of new treatments.

Chagas disease in urban and peri‑urban environment in the Amazon: Sentinel hosts, vectors, and the environment

Chagas disease is an anthropozoonosis, caused by a flagellated protozoan, Trypanosoma cruzi, in which the enzootic cycle occurs between mammals and triatomines. Two dogs with a history of sudden death were necropsied at the Federal University of Pará (UFPA). One dog had a pale area in the myocardium, which on histopathological examination showed a T. cruzi amastigote nest; immunohistochemistry (IHC) analysis characterized it as acute Chagas disease (ACD). The second dog showed no macroscopic changes. Microscopically, a few cardiomyocytes were replaced by adipocytes, and IHC result was negative for T. cruzi. However, results of polymerase chain reaction (PCR) of the cardiac tissue of both dogs was positive for T. cruzi DNA. After that, an epidemiological study was conducted in the region. For this study, we selected four areas in Castanhal. One of the four areas (Area 1) is where one of the dogs lived. The other three areas were chosen because they were recently deforested for housing. Blood samples were collected from dogs, cats, wild small mammals (marsupials and rodents), and the digestive tract of triatomines. Nested PCR was performed on all the blood samples and the triatomine digestive tracts. In Area 1, T. cruzi DNA was detected in 50% (12/24) of the tested dogs, in the only tested cat (1/1), 50% (1/2) of the tested marsupials (Didelphis marsupials), and 100% of the captured triatomines (Rhodnius pictipes) (2/2). In Area 2, T. cruzi DNA was not detected in any of the 11 (0/11) dogs and two marsupials tested (0/2), and no triatomines were found in this area. In Area 3, T. cruzi DNA was detected in 42.25% (30/71) of the dogs, in 66,6% (2/3) of the cats, the only captured marsupial (D. marsupialis) (1/1), and all three triatomines (3/3) (R. pictipes) tested. In Area 4, the two dogs tested were negative (0/2), 25% (1/4) of the captured marsupials (D. marsupialis) was positive, and no triatomine was captured in this area. The data demonstrate the importance of detecting T. cruzi in dogs, cats, small rodents, and marsupials in the Amazon metropolitan areas, where ecotopes carry reservoirs and vectors capable of participating in the Chagas disease cycle. The proximity between humans and T. cruzi vectors in these places might contribute to increased disease transmission risk and maintenance of agents. It was noted that high-standard condominiums, previously thought to reduce the risk for this disease, presented a new epidemiological risk. The presence of T. cruzi DNA in a dog who, a year earlier had tested negative, when another dog in the same house died of ACD, shows that the transmission cycle is present and active, with a high possibility of disease transmission to animals and humans.

Physical training improves exercise tolerance, cardiac function and promotes changes in neurotrophins levels in chagasic mice

AIMS

To investigate the effects of moderate aerobic physical training on cardiac function and morphology as well as on the levels of glial cell-derived neurotrophic factor (GDNF), nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) of animals infected with the Y strain of Trypanosoma cruzi.

MAIN METHODS

Twenty-eight male C57BL/6 mice were distributed into 4 groups: sedentary control (SC), trained control (TC), sedentary infected (CHC) and trained infected (CHT). The infection was performed by intraperitoneal injection of trypomastigote forms and the animals were adapted to treadmill in the week before the beginning of the training protocol, initiated 45 days post infection. Maximal exercise test (TEM) was performed at the baseline as well as at the end of the 4th, 8th and 12th weeks of training. At the end of the 12th week, all animals were evaluated for cardiac morphology and function by echocardiography.

KEY FINDINGS

CHC group showed a larger area of right ventricle (RVA), increased end-systolic volume and reduction in ejection fraction (EF), stroke volume (SV), cardiac output (CO) and fractional area change (FAC). The training reduced the RVA and improved the FAC of chagasic animals. GDNF level was higher in TC and CHC groups compared to SC in heart and BDNF levels were higher in CHC compared to SC in heart and serum.

SIGNIFICANCE

Physical training ameliorated the cardiac function of infected animals and promoted adjusts in BDNF and GDNF levels. These findings evidenced these neurotrophins as possible biomarkers of cardiac function responsive to exercise stimulus.

The TcI and TcII Trypanosoma cruzi experimental infections induce distinct immune responses and cardiac fibrosis in dogs

Trypanosoma cruzi infection may be caused by different strains with distinct discrete typing units (DTUs) that can result in variable clinical forms of chronic Chagas disease. The present study evaluates the immune response and cardiac lesions in dogs experimentally infected with different T. cruzi strains with distinct DTUs, namely, the Colombian (Col) and Y strains of TcI and TcII DTU, respectively. During infection with the Col strain, increased levels of alanine aminotransferase, erythrocytes, haematocrit and haemoglobin were observed. In addition, CD8⁺ T-lymphocytes isolated from the peripheral blood produced higher levels of interleukin (IL)-4. The latter suggests that during the acute phase, infection with the Col strain may remain unnoticed by circulating mononuclear cells. In the chronic phase, a significant increase in the number of inflammatory cells was detected in the right atrium. Conversely, infection with the Y strain led to leucopoenia, thrombopoenia, inversion of the ratio of CD4⁺/CD8⁺ T-lymphocytes and alterations in monocyte number. The Y strain stimulated the production of interferon-γ by CD4⁺ and CD8⁺ T-lymphocytes and IL-4 by CD8⁺ T-cells. In the chronic phase, significant heart inflammation and fibrosis were observed, demonstrating that strains of different DTUs interact differently with the host.

Myenteric plexus is differentially affected by infection with distinct Trypanosoma cruzi strains in Beagle dogs

Chagasic megaoesophagus and megacolon are characterised by motor abnormalities related to enteric nervous system lesions and their development seems to be related to geographic distribution of distinct Trypanosoma cruzi subpopulations. Beagle dogs were infected with Y or Berenice-78 (Be-78) T. cruzi strains and necropsied during the acute or chronic phase of experimental disease for post mortem histopathological evaluation of the oesophagus and colon. Both strains infected the oesophagus and colon and caused an inflammatory response during the acute phase. In the chronic phase, inflammatory process was observed exclusively in the Be-78 infected animals, possibly due to a parasitism persistent only in this group. Myenteric denervation occurred during the acute phase of infection for both strains, but persisted chronically only in Be-78 infected animals. Glial cell involvement occurred earlier in animals infected with the Y strain, while animals infected with the Be-78 strain showed reduced glial fibrillary acidic protein immunoreactive area of enteric glial cells in the chronic phase. These results suggest that although both strains cause lesions in the digestive tract, the Y strain is associated with early control of the lesion, while the Be-78 strain results in progressive gut lesions in this model.

Caracterização clínica e laboratorial de cães naturalmente infectados com Trypanosoma cruzi no semiárido nordestino

Objetivou-se, com este estudo, evidenciar os sinais clínicos e laboratoriais desta enfermidade para auxiliar na caracterização da doença de forma natural na área semi-árida da região nordeste. Foram avaliados 10 cães positivos para Trypanosoma cruzi, identificados mediante análises sorológicas de reação de imunofluorescência indireta (RIFI) e enzyme linked immunosorbent assay (ELISA); análise molecular pela Reação em Cadeia Polimerase (PCR), microscopia direta e hemocultura. Os cães chagásicos foram submetidos à avaliação física, verificação da pressão arterial, exames eletrocardiográficos, radiográficos, hematológicos (eritrograma e leucograma) e bioquímicos (ureia, creatinina, ALT, AST, PT, albumina, globulina, CK, CK-MB e cTnI). O exame físico e os valores das pressões arteriais dos cães apresentaram dentro dos parâmetros de normalidade, enquanto que na eletrocardiografia observou-se FC normal com ritmo sinusal, com exceção de um cão, que apresentou taquicardia sinusal (168 bat/min). No ECG de oito cães houve aumento da duração de P (47±6,5ms) sugestivo de aumento atrial, não confirmado radiograficamente. Foi observado supradesnivelamento do segmento ST em um cão. Nos resultados hematológicos constatou-se trombocitopenia (187,4x10³ ±137,2x10³) e anemia (5,0x10(6) ±1,39x10(6)/uL). Os valores médios da hemoglobina (11±2,7g/dL) e do hematócrito (34±10,5%) estavam abaixo dos limites de normalidade. A série branca apresentou-se dentro dos limites de normalidade, com exceção da eosinofilia observada em três cães. Individualmente, registrou-se em dois cães, leucocitose, linfocitose e neutrofilia. Na avaliação bioquímica, registrou-se hiperproteinemia (7,2±0,9g/dL), hipoalbuminemia (2,2±0,4g/dL), hiperglobulinemia (5,1±1,0g/dL) e aumento da CK (196±171U/L). Não houve alteração nas enzimas ALT e AST. A isoenzima CK-MB e o cTnI alteraram somente em três cães. Os cães infectados naturalmente no semiárido nordestino apresentam características relacionáveis à forma crônica indeterminada, ou seja, cães assintomáticos. A identificação dos cães infectados naturalmente sem características patognomônicas da doença de Chagas ressalta a importância desta enfermidade no processo diagnóstico com as demais que manifestam perfis inespecíficos associados ou não às doenças cardiovasculares.

Comparison of two immunochromatographic assays and the indirect immunofluorescence antibody test for diagnosis of Trypanosoma cruzi infection in dogs in south central Louisiana

Two rapid tests evaluated in dogs considered to be of high risk of infection with the Chagas parasite Trypanosoma cruzi using two immunochromatographic assays: Trypanosoma Detect for canine, InBios, Seattle, WA and CHAGAS STAT-PAK assay, Chembio Diagnostic Systems, Medford, NY, in south central Louisiana. For this purpose a serological survey was carried out in a total of 122 dogs and a serum bank was created. These 122 animals were first tested by IFAT that was used as the standard test. From the serum bank 50 samples were tested using the two rapid Chagas assays and results compared to the standard test IFAT. The serological survey using IFAT showed a prevalence of T. cruzi infection in 22.1% of the tested dogs. In the immunochromatographic assays, 13 and 11 animals were positive on rapid assay: Trypanosoma Detect for canine, InBios and CHAGAS STAT-PAK, Chembio Diagnostic Systems, respectively compared to 11 positive by IFAT. These two immunochromatographic tests have shown high susceptibility and specificity compared to our standard method IFAT. The rapid, easy and accurate screening assays used in conjunction with confirmatory tests, would be an excellent tool for veterinarians to diagnose T. cruzi infection. Early detection of T. cruzi infection may prevent complications through an effective treatment. Greater awareness by veterinarians of the risk, clinical findings, history along with diagnostic methods will contribute greatly to an understanding of the true prevalence of Chagas disease in dogs in Louisiana.

Trypanosoma cruzi: immunoglobulin isotype profiles during the acute phase of canine experimental infection with metacyclic or blood trypomastigotes

A detailed investigation has been carried out about the serological profiles of groups of dogs experimentally infected with metacyclic (MT) or blood (BT) trypomastigotes of Berenice-78 Trypanosoma cruzi strain. Peripheral blood was collected from infected dogs and uninfected controls, weekly during 35 days following the acute phase of infection, and immunoglobulin profiles were determined by ELISA. Dogs infected with BT exhibited unaltered levels of IgG2, increases in IgM, IgE, IgA, IgG and IgG1. In contrast, dogs infected with MT presented unaltered levels of IgE and IgG1 and an increase in IgM, IgA, IgG and IgG2 levels. Compared with the MT group, animals infected with BT showed significant increases in IgM on days 7, 14 and 28, in IgA on days 7, 14 and 21, in IgE on days 7 and 14, in IgG on days 14 and 28, and in IgG1 on days 7, 14 and 21. Parasitemia levels of the infected animals were measured over the same time period. No correlations were found between the immunoglobulin profiles and the parasitemia levels. The results demonstrated that the inoculum source (BT or MT) influence the immunoglobulin isotype profile that may drive distinct outcome of acute canine Chagas disease.

Mechanisms of myocardial damage in Trypanosoma cruzi infection

A study of pathological lesions caused by Trypanosoma cruzi in human and experimental hosts indicated that the main mechanisms of myocardial damage in Chagas' disease are the following. (1) During acute infection inflammatory lesions are related to parasite-induced destruction of myocardial cells, with probable participation of immune-complex reactions. When parasitism decreases, inflammation subsides and may disappear completely. (2) After recovery from acute infection the hosts remain infected but asymptomatic for a prolonged period of time. Focal fibrotic areas may be present in the myocardium, conducting tissue and autonomic nervous system, representing sequelae from the acute phase. Such sequelae may have or may acquire functional significance in some special circumstances. (3) Some patients with latent T. cruzi infection may progress to show a diffuse, active and fibrosing myocarditis without an apparent change in parasitological and immunological status from the asymptomatic phase. The microscopic changes in the heart are compatible with the presence of a delayed-type hypersensitivity process. An abolition of the suppressive factors of delayed hypersensitivity which are present during latent infection may be involved.

The dog as model for chemotherapy of the Chagas' disease

In the present study, we investigated the role of dogs as experimental models for acute and chronic phases of Chagas' disease, before and after therapeutic treatments. Dogs were infected with Trypanosoma cruzi strains of different susceptibilities to benznidazole (Bz) and treated with the same therapeutic scheme as used for human chagasic. The treatment with Bz was able to prevent death and induced parasitological cure in 62.5% (acute phase) and 38.7% (chronic recent phase) of the tested animals. These results were similar to those reported in clinical trials for treated human patients (cured and uncured) in both phases of the disease. We also showed that parasitologic and serologic tests for monitoring the cure were similar to those obtained for human trials. In addition, Polymerase chain reaction showed the highest sensitivity when compared with hemoculture as an indicator of parasite clearance. In conclusion, the proposed experimental model should be relevant for chemotherapy studies for the control of Chagas' disease.

Follow-up of experimental chronic Chagas' disease in dogs: use of polymerase chain reaction (PCR) compared with parasitological and serological methods

In this study, the polymerase chain reaction (PCR) was compared with parasitological and serological methods to detect the infection in dogs, 5-12 years after experimental infection with Trypanosoma cruzi. The ability of parasitological methods to identify a positive animal was 22 and 11% by hemoculture and xenodiagnosis/xenoculture, respectively. On the other hand, the serological tests, including conventional serology and anti-live trypomastigote antibodies (ALTA) were positive in all infected dogs. Despite its low sensitivity, if considering only one reaction, the PCR analysis showed 100% of positivity, demonstrating the presence of parasite kDNA in all infected dogs. To identify a positive dog required at least two blood samples and up to nine repeated reactions using the same sample. Serial blood sample collection, ranging from 1 to 9, revealed that the percentage of dogs with positive PCR ranged from 67 to 100%. These findings suggested that, although the PCR is useful to detect the parasite in infected hosts, it should not be used isolated for the diagnosis of Chagas' disease and warn for the necessity of serial blood collection and re-tests. Moreover, these data validate once more the dog as a model for Chagas' disease since they demonstrate the permanence of infection by PCR, parasitological and serological methods, reaching relevant requisites for an ideal model to study this disease.

Evaluation of dogs as sentinels of the transmission of Trypanosoma cruzi in a rural area of north-western Argentina

Dogs, the main domestic reservoirs of Trypanosoma cruzi in the Argentine chaco, may be useful as sentinels of vector-mediated transmission of Trypanosoma cruzi in control programmes if canine infections acquired by all other routes could be excluded. In the present study, in the province of Santiago del Estero, Argentina, the dog populations in the neighbouring villages of Amamá, Trinidad, Mercedes, Villa Matilde and Pampa Pozo were studied immediately before spraying of residual insecticides (in 1992 in Amamá, Trinidad and Mercedes and 1993-1994 in the other villages) and twice during a subsequent programme of triatomine surveillance (in 1994 and 1996). Overall seropositivity for Trypanosoma cruzi infection (i.e. the proportion of dogs found positive by at least two different serological tests in any one survey) steadily declined from 65% (54/83) in 1992 to 39% (70/182) in 1994 and 15% (36/237) in 1996. No seroconversion was detected between the 1994 and 1996 surveys in any dog aged > 2 years. However, among the dogs aged < 2 years (which were born after virtual elimination of Triatoma infestans from the villages), seropositivity fell from 15% (12/81) in 1994 to 5% (6/131) in 1996. Thirteen demographic, behavioural and entomological variables were analysed by logistic multiple-regression analysis for their association with seropositivity in dogs born locally during the surveillance programme. The total number of Triatoma guasayana collected in the bedroom areas of the owner's house, having a mother which was seropositive for Trypanosoma cruzi, and the number of seropositive dogs with which it cohabited were all found to be significant predictors of seropositivity in any dog. The results are the first indication that Triatoma guasayana is the vector responsible for the new cases of Trypanosoma cruzi infection seen in dogs in domestic or peridomestic sites during the surveillance programme.

[Chronic fibrotic cardiac stage of experimental trypanosomiasis cruzi in dogs]

Os autores documentam a cardiopatia difusa fibrosante, com todos os sintomas clínicos e dados de autópsia pertinentes à insuficiência cardíaca congestiva, em um dos 21 cães infectados com a cepa Colombiana (cinco morreram na fase aguda e quatro continuam vivos) e cinco, dos 13 infectados com a cepa Berenice-78 (oito morreram na fase aguda), num período de oito anos de observação. Em vista destes resultados, os autores sugerem que o cão possa vir a ser um modelo experimental, adequado para o estudo da história natural da doença de Chagas, preenchendo os requisitos estabelecidos pelo Comitê Assessor de Doença de Chagas do Programa Especial de Pesquisa e Treinamento em Doenças Tropicais da Organização Mundial de Saúde.

Pathophysiology of parasitic infections

Parasites can have a wide range of pathophysiological effects on the host. This review describes those associated with some parasites of major importance in man and animals. Haemoprotozoan diseases such as trypanosomiasis and malaria are primarily associated with anaemia. Such anaemias have a complex aetiology involving various mechanisms responsible for red cell destruction as well as possible defects in red cell production. In addition to these haematological effects these diseases are associated with marked disturbances in heart function and the nervous, immune and urinary systems. The other major groups of parasitic diseases are those associated with the gastrointestinal tract. The most advanced studies have been conducted on the pathophysiology of gastrointestinal nematode parasites of sheep and have revealed significant effects on feed intake, gastrointestinal function, and protein and energy metabolism. Similar studies have yet to be conducted in other hosts and parasitic diseases. There is also a need to examine in greater detail the factors which can modulate pathophysiological responses by the host to parasitic infections.

Effects of betamethasone on the course of experimental infection with Trypanosoma cruzi

In this experiment, the effect of betamethasone administered in the early post- acute infection of mice by Trypanosoma cruzi was studied. This drug was administered during 30 days after the 42nd day of infection in a dose of 0.15 mg/day. The betamethasone treatment did not cause fresh outbreaks of parasitemia and the histopathological findings in the chronic phase were not different from those in the control group. The higher cumulative mortality after treatment in the experimental group was due to superimposed bacterial infections. Outbred albino mice infected with low numbers ofY strain Trypanosoma cruzi trypomastigotes were not suitable models for Chagas' disease, since after 7 months of observation only mild histological lesions developed in all the animais. Prolonged betamethasone treatment of mice infected with low numbers o/Trypanosoma cruzi of the Y strain, during the post-acute phase did not aggravate the course of infection.

Estudo parasitológico e anátomo-patológico da fase aguda da doença de Chagas em cães inoculados com duas diferentes cepas do Trypanosoma cruzi

Cães jovens foram infectados com as cepas Y e CL do T. cruzi usando-se como inóculos 107 formas sangüíneas inoculadaspor via intraperitoneal e 2 x 10³ tripomastigotas metacíclicos obtidos do inseto vetor e inoculadospor via conjuntival. As cepas Ye CL induziram nos cães curvas deparasitemia totalmente distintas, confirmando dados parasitológicos obtidos em camundongos e coelhos. Com a cepa CL a parasitemia, com ambos os inóculos, foi gradualmente ascencional ao passo que com Y a parasitemia foi extremamente baixa, irregular e, com freqüência, subpatente. Com ambas as cepas o parasitismo e as lesões predominaram no miocárdio. Entretanto, com a cepa Y a miocardite foi sempre intensa desde as fases mais precoces da infecção, ao passo que com a cepa CL o processo inflamatório tomou-se acentuado somente a partir do 20.° dia. Freqüentemente a intensidade da miocardite observada em alguns animais não guardava relação com a parasitemia; em alguns cães com parasitemia subpatente, nos quais a infecção só foi diagnosticada pelo xenodiagnóstico, a intensidade da miocardite foi comparável àquela observada nos animais com parasitemia patente. Idêntica correlação também não foi assinalada em relação ao parasitismo tissular. Esses achados sugerem a participação de mecanismo imunológicos na gênese das lesões, ainda na fase aguda da infecção.

Chagas' heart disease: experimental models

An experimental model embodies an evaluation procedure that helps the investigator to choose between possible alternatives. In this paper, consideration is given to a variety of aspects related to the host-parasite relationship in Trypanosoma cruzi infection and disease. Although several animal species have been used, there is still a lack of consistent experimental studies. A few examples of investigations mainly in dogs, monkeys, and rabbits are briefly described, showing the diversity of methodological approaches and, therefore, the difficulty experienced in comparing results and interpretations. Emphasis was given to the need for a suitable model presenting all possible stage of the infection as seen in man, as well as the functional and organic disorders commonly seen in this disease. The alterations of the autonomic nervous system involving the heart and other organs in Chagas' disease was stressed.

Damage and healing in the conducting tissue of the heart (an experimental study in dogs infected with Trypanosoma cruzi)

The consequences of acute inflammatory damage and chronic repair in the conducting system of the canine heart were observed after experimental Trypanosoma cruzi infection of young dogs. Acute infection lasted for 18-25 days and caused hyaline and lytic necrosis of the atrio-ventricular conducting fibres, the sinus node and the neurons in the cardiac para-sympathetic ganglia. Dogs that survived acute disease were examined after periods from 8 months to 3 years. Three main types of healing were found in the conducting system: fibrosis (diffuse and/or focal), sclero-atrophy and fatty infiltration. No signs of active chronic inflammation were present, although small focal residual accumulations of mononuclear cells were present in some animals. No evident electrocardiographic alterations were elicited by the presence of such cicatricial lesions. The animal model appears worthwhile for the study of the healing process in conducting tissue of the heart and for the better understanding of the asymptomatic phase of T. cruzi infection in man.

Course of infection and histopathological lesions in mice infected with seventeen Trypanosoma cruzi strains isolated from chronic patients

Mice were infected with blood forms of 17 Trypanosoma cruzi strains recently isolated from chronic patients, which were dassified as of low, medium or high virulence on grounds of the prepatent period, parasitemia and mortality at the acute phase. A total of 212 mice were studied after 3, 6, 9 and 12 months of infection. In the chronic phase, intracellular parasites were detected in 11.0%,27.9%and 54.0,% of mice inoculated, respectively, with the low, medium and high virulent strains (r= 0.98, p < 0.005). Heart fibrosis was also related to virulence, affecting 5.7%, 11.6%and30.8% (r = 0.98, p < 0.001) of the mice inoculated with the above strains; a similar relationship was observed between intensity and frequency of the heart inflammatory reaction and the severity of infection at its early stage. Necrotizing arteritis was detected in 12.2% of the inoculated animals and this lesion was related to the infection duration rather than to strain characteristics. Inflammatory lesions and tissue parasitism were stable within the period of observation, whereas fibrosis was Progressive. The findings suggest that mice may reproduce heart lesions resembling human pathology and that organ damage apparently depends on the parasite virulence.