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Chagas Heart Disease: Beyond a Single Complication, from Asymptomatic Disease to Heart Failure. J Clin Med 2022; 11:jcm11247262. [PMID: 36555880 PMCID: PMC9784121 DOI: 10.3390/jcm11247262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Chagas cardiomyopathy (CC), caused by the protozoan Trypanosoma cruzi, is an important cause of cardiovascular morbidity and mortality in developing countries. It is estimated that 6 to 7 million people worldwide are infected, and it is predicted that it will be responsible for 200,000 deaths by 2025. The World Health Organization (WHO) considers Chagas disease (CD) as a Neglected Tropical Disease (NTD), which must be acknowledged and detected in time, as it remains a clinical and diagnostic challenge in both endemic and non-endemic regions and at different levels of care. The literature on CC was analyzed by searching different databases (Medline, Cochrane Central, EMBASE, PubMed, Google Scholar, EBSCO) from 1968 until October 2022. Multicenter and bioinformatics trials, systematic and bibliographic reviews, international guidelines, and clinical cases were included. The reference lists of the included papers were checked. No linguistic restrictions or study designs were applied. This review is intended to address the current incidence and prevalence of CD and to identify the main pathogenic mechanisms, clinical presentation, and diagnosis of CC.
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Yauri V, Castro-Sesquen YE, Verastegui M, Angulo N, Recuenco F, Cabello I, Malaga E, Bern C, Gavidia CM, Gilman RH. Domestic Pig (Sus scrofa) as an Animal Model for Experimental Trypanosoma cruzi Infection. Am J Trop Med Hyg 2016; 94:1020-7. [PMID: 26928841 DOI: 10.4269/ajtmh.15-0233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 01/28/2016] [Indexed: 01/09/2023] Open
Abstract
Pigs were infected with a Bolivian strain of Trypanosoma cruzi (genotype I) and evaluated up to 150 days postinoculation (dpi) to determine the use of pigs as an animal model of Chagas disease. Parasitemia was observed in the infected pigs during the acute phase (15-40 dpi). Anti-T. cruzi immunoglobulin M was detected during 15-75 dpi; high levels of anti-T. cruzi immunoglobulin G were detected in all infected pigs from 75 to 150 dpi. Parasitic DNA was observed by western blot (58%, 28/48) and polymerase chain reaction (27%, 13/48) in urine samples, and in the brain (75%, 3/4), spleen (50%, 2/4), and duodenum (25%, 1/4), but no parasitic DNA was found in the heart, colon, and kidney. Parasites were not observed microscopically in tissues samples, but mild inflammation, vasculitis, and congestion was observed in heart, brain, kidney, and spleen. This pig model was useful for the standardization of the urine test because of the higher volume that can be obtained as compared with other small animal models. However, further experiments are required to observe pathological changes characteristic of Chagas disease in humans.
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Affiliation(s)
- Verónica Yauri
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Yagahira E Castro-Sesquen
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Manuela Verastegui
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Noelia Angulo
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Fernando Recuenco
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Ines Cabello
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Edith Malaga
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Caryn Bern
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Cesar M Gavidia
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Robert H Gilman
- Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru; Laboratorio de Investigación en Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Rachid MA, Teixeira AL, Barcelos LS, Machado CRS, Chiari E, Tanowitz HB, Camargos ERS, Teixeira MM. Role of endothelin receptors in the control of central nervous system parasitism in Trypanosoma cruzi infection in rats. J Neuroimmunol 2010; 220:64-8. [PMID: 20116865 DOI: 10.1016/j.jneuroim.2010.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Revised: 12/02/2009] [Accepted: 01/12/2010] [Indexed: 10/19/2022]
Abstract
Endothelin has been implicated in the pathogenesis of experimental and human Chagas disease. In the present study, we investigated whether the treatment with bosentan, an antagonist of both ET(A)/ET(B) endothelin receptors, modified parasite load and inflammation in the central nervous system (CNS) of Trypanosomacruzi-infected rats. The cerebellum was the most affected region in the CNS with marked parasitism and inflammation. Treatment with bosentan enhanced parasitemia and CNS parasitism, but control of infection was eventually attained. There was also an increase in the levels of the cytokines TNF-alpha, IL-10, IFN-gamma, CCL2/MCP-1, CCL3/MIP-1alpha and CCL5/RANTES in the brain of infected animals at days 9, 13 and 18 after infection. Overall, bosentan has some effects on the expression of certain cytokines and this may be related to the initial enhanced parasite load. Altogether, our data suggest that endothelin action via ET(A) and ET(B) receptors may play a role in the initial resistance of the CNS to T. cruzi infection in rats.
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Affiliation(s)
- Milene A Rachid
- Departamento de Patologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270901, Belo Horizonte, MG, Brazil.
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