Detection of Trypanosoma cruzi DNA in blood by PCR is associated with Chagas cardiomyopathy and disease severity

BACKGROUND

The significance of detection of Trypanosoma cruzi DNA in blood of antibody-positive patients for risk of development of Chagas heart disease is not well established. The objective of this study was to compare detection of T. cruzi DNA with known clinical and laboratory markers of Chagas cardiomyopathy (CC) severity.

METHODS

This is a case-control study nested within a retrospective cohort developed in Brazil to understand the natural history of Chagas disease. The study enrolled 499 T. cruzi seropositive blood donors (SP-BD) and 488 frequency matched seronegative control donors (SN-BD) who had donated between 1996 and 2002, and 101 patients with clinically diagnosed CC. In 2008-2010 all enrolled subjects underwent a health questionnaire, medical examination, electrocardiograms and echocardiograms and polymerase chain reaction (PCR) analyses. A blinded panel of three cardiologists adjudicated the outcome of CC. Trypanosoma cruzi kinetoplast minicircle sequences were amplified by real-time PCR using an assay with a sensitivity of one parasite per 20 mL of blood. All testing was performed on coded samples.

RESULTS

Rates of PCR detection of T. cruzi DNA were significantly (P = 0.003) higher in CC patients and SP-BD diagnosed with CC (79/105 [75.2 %]) compared with SP-BD without CC (143/279 [51.3%]). The presence of parasitaemia was significantly associated with known markers of disease progression such as QRS and QT interval duration, lower left ventricular ejection fraction, higher left ventricular index mass, and elevated troponin and NTpro-BNP levels.

CONCLUSION

Trypanosoma cruzi PCR positivity is associated with presence and severity of cardiomyopathy, suggesting a direct role of parasite persistence in disease pathogenesis.

Extraction of DNA from human skeletal remains: practical applications in forensic sciences

We have developed an efficient protocol for the extraction of DNA from bone samples. The protocol precludes decalcification and associates an efficient extraction of the DNA with removal of inhibitors by binding of DNA to silica particles. Two forensic cases are described in detail to demonstrate the usefulness of the method.

Pharmacological and toxicological evaluation of Alpinia speciosa

Alpinia speciosa Schum or A. nutans is a plant of the Zingiberaceae family, known popularly as "colony" (colônia) and used as a diuretic and to control hypertension. We have determined the concentration of Na+ and K+ found in the alcoholic extract and in the tea concoction. They contained 51.0 mEq Na+, and 132 mEq K+ in the extract, and 0.0 mEq of Na+ and 26 mEq K+ in the tea. Phytochemical analysis of the leaves demonstrated the presence of catecquic tanins, phenols and alkaloids, and also some essential oils. When injected intra-peritoneally the hydroalcoholic extract, in a dose range of 100 to 1400 mg/kg, (or 2500-18000 mg/kg orally) produced in mice: writhing, psychomotor excitation, hypokinesis and pruritus. The LD50 by ip was 0.760 +/- 0.126 g/kg and 10.0 +/- 2.5 g/kg by oral administration for the hydroalcoholic extract. Subacute toxicity made by injecting daily for 30 days the LD10 in rats caused an increase in transaminases and lactate dehydrogenase, whereas other parameters such as blood glucose, urea and creatinine were normal. A histopathological analysis of liver, spleen, gut, lung and heart showed no alterations. The drug also produced a prolongation of the sleeping time. The hydroalcoholic extract induced in the rat and in the dog a dose-dependent fall in blood pressure in doses of 10 to 30 mg/kg. In isolated atria the extract induced a reduction of the frequency and in the inotropic responses. Neither the extract nor the tea had an effect on the diuresis of the rat.