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Cardiovascular function in elderly patients with chronic chagasic cardiopathy
Rocha, Manoel Otávio Costa;Correia, Paulo César;Barros, Márcio Vinícius L.;Torres, Rosália Moraes;Ribeiro, Ant?nio Luiz P.;Teixeira, Mauro Martins;
Revista da Sociedade Brasileira de Medicina Tropical , 2003, DOI: 10.1590/S0037-86822003000500001
Abstract: the objective of this work was to verify the degree and type of heart damage of elderly chagasic patients seen at an outpatient referral center and to compare them with the changes found in young chagasic patients with a similar degree of heart damage. elderly and young patients without advanced cardiopathy presented good functional behavior. elderly patients with advanced cardiopathy had more ventricular premature beats (vpb) in 24 h and less functional capacity in the exercise test than young patients of the same subgroup. there was a higher occurrence of effort-induced vpb and a lower prevalence of severe forms in elderly men, suggesting that chagas' disease may have a worse evolution in males. the association of cardiac damage characteristic of aging with the secondary damage due to chagas' disease could explain the greater functional damage found in elderly chagasic patients. thus, it appears that the physiopathological components of chagas' disease do have an influence on the clinical course of cardiopathy in the elderly population.
Cardiovascular function in elderly patients with chronic chagasic cardiopathy
Rocha Manoel Otávio Costa,Correia Paulo César,Barros Márcio Vinícius L.,Torres Rosália Moraes
Revista da Sociedade Brasileira de Medicina Tropical , 2003,
Abstract: The objective of this work was to verify the degree and type of heart damage of elderly chagasic patients seen at an outpatient referral center and to compare them with the changes found in young chagasic patients with a similar degree of heart damage. Elderly and young patients without advanced cardiopathy presented good functional behavior. Elderly patients with advanced cardiopathy had more ventricular premature beats (VPB) in 24 h and less functional capacity in the exercise test than young patients of the same subgroup. There was a higher occurrence of effort-induced VPB and a lower prevalence of severe forms in elderly men, suggesting that Chagas' disease may have a worse evolution in males. The association of cardiac damage characteristic of aging with the secondary damage due to Chagas' disease could explain the greater functional damage found in elderly chagasic patients. Thus, it appears that the physiopathological components of Chagas' disease do have an influence on the clinical course of cardiopathy in the elderly population.
CHRONIC CHAGASIC CARDIOPATHY: THE PRODUCT OF A TURBULENT HOST-PARASITE RELATIONSHIP
Revista do Instituto de Medicina Tropical de S?o Paulo , 1997, DOI: 10.1590/S0036-46651997000100012
Abstract: the pathogenesis of chronic chagasic cardiopathy is still a debated matter. in this review, the main theories raised about it since the first description of the disease in 1909 by carlos chagas, are considered. the scarcity of t.cruzi parasites into the myocardium and the apparent lack of correlation between their presence and the occurrence of myocardial inflammatory infiltrate, have originated many theories indicating that chronic chagas' cardiopathy is an autoimmune disease. recently however, papers using immunohistochemical technique or pcr have demonstrated a strong association between moderate or severe myocarditis and presence of t.cruzi ags, indicating a direct participation of the parasite in the genesis of chronic chagasic myocarditis. different patterns of cytokine production seem to have important role in the outcome of the disease. participation of the microcirculatory alterations and fibrosis as well as the relationship with the parasite are also emphasized. finally, the author suggests that the indeterminate form of the disease occurs when the host immunological response against the parasite is more efficient while the chronic cardiopathy occurs in patients with hyperergic and inefficient immune response
CHRONIC CHAGASIC CARDIOPATHY: THE PRODUCT OF A TURBULENT HOST-PARASITE RELATIONSHIP  [cached]
HIGUCHI Maria de Lourdes
Revista do Instituto de Medicina Tropical de S?o Paulo , 1997,
Abstract: The pathogenesis of chronic chagasic cardiopathy is still a debated matter. In this review, the main theories raised about it since the first description of the disease in 1909 by Carlos Chagas, are considered. The scarcity of T.cruzi parasites into the myocardium and the apparent lack of correlation between their presence and the occurrence of myocardial inflammatory infiltrate, have originated many theories indicating that chronic Chagas' cardiopathy is an autoimmune disease. Recently however, papers using immunohistochemical technique or PCR have demonstrated a strong association between moderate or severe myocarditis and presence of T.cruzi Ags, indicating a direct participation of the parasite in the genesis of chronic chagasic myocarditis. Different patterns of cytokine production seem to have important role in the outcome of the disease. Participation of the microcirculatory alterations and fibrosis as well as the relationship with the parasite are also emphasized. Finally, the author suggests that the indeterminate form of the disease occurs when the host immunological response against the parasite is more efficient while the chronic cardiopathy occurs in patients with hyperergic and inefficient immune response
Characterising the KMP-11 and HSP-70 recombinant antigens' humoral immune response profile in chagasic patients
Ivonne D Flechas, Adriana Cuellar, Zulma M Cucunubá, Fernando Rosas, Víctor Velasco, Mario Steindel, María Thomas, Manuel López, John González, Concepción Puerta
BMC Infectious Diseases , 2009, DOI: 10.1186/1471-2334-9-186
Abstract: Seventeen Brazilian acute chagasic patients, 50 Colombian chronic chagasic patients (21 indeterminate and 29 cardiopathic patients) and 30 healthy individuals were included. Total IgG and its subtypes directed against the above-mentioned recombinant antigens were determined by ELISA tests.The T. cruzi KMP-11 and T. rangeli HSP-70 recombinant proteins were able to distinguish both acute from chronic chagasic patients and infected people from healthy individuals. Specific antibodies to T. cruzi crude antigen in acute patients came from IgG3 and IgG4 subclasses whereas IgG1 and IgG3 were the prevalent isotypes in indeterminate and chronic chagasic patients. By contrast, the specific prominent antibodies in all disease stages against T. cruzi KMP-11 and T. rangeli HSP-70 recombinant antigens were the IgG1 subclass.T. cruzi KMP-11 and the T. rangeli HSP-70 recombinant proteins may be explored together in the immunodiagnosis of Chagas' disease.Polarising the IgG1 subclass of the IgG response to T. cruzi KMP-11 and T. rangeli HSP-70 recombinant proteins could have important biological effects, taking into account that this is a complement fixing antibody.Antibodies against several parasitic antigens are copious during blood-borne parasite infections such as malaria and Chagas' disease. These humoral immune responses have been used for diagnosis, following up individuals throughout the course of a natural infection, vaccination protocols and evaluating drug therapy efficacy. However, little is known about these antibodies' specific role or profile according to disease phases. Concerning humoral responses, it has been described that antibodies against repeat and/or evolutionary conserved sequences are highly predominant in parasitic infections such as that caused by Trypanosoma cruzi, the aetiological agent of Chagas' disease [1-3]. B lymphocytes and antigen specific antibodies seem to be crucial for controlling acute infection during the course of T. cruzi infection and cou
Trypanosoma cruzi isolates from Mexican and Guatemalan acute and chronic chagasic cardiopathy patients belong to Trypanosoma cruzi I
Ruíz-Sánchez, Rosario;León, María Paula de;Matta, Vivian;Reyes, Pedro A;López, R;Jay, David;Monteón, Victor M;
Memórias do Instituto Oswaldo Cruz , 2005, DOI: 10.1590/S0074-02762005000300012
Abstract: trypanosoma cruzi is classified into two major groups named t. cruzi i and t. cruzi ii. in the present work we analyzed 16 stocks isolated from human cases and four isolated from triatomines from diverse geographical origins (mexico and guatemala). from human cases four were acute cases, six indeterminates, and six from chronic chagasic cardiophatic patients with diagnosis of dilated cardiomyopathy established based on the left-ventricular end systolic dimension and cardiothoracic ratio on chest x-radiography and impaired contracting ventricle and different degree conduction/rhythm aberrations. dna samples were analyzed based on mini-exon (me) polymorphism, using a pool of three oligonucleotide for the amplification of specific intergenic region of t. cruzi me gene. all the mexican and guatemalan isolates regardless their host or vector origin generated a 350 bp amplification product. in conclusion t. cruzi i is dominant in mexico and guatemala even in acute and chronic chagasic cardiopathy patients. to our knowledge, this is the first study describing predominance of t. cruzi i in human infection for north and central america.
Do Archaea and bacteria co-infection have a role in the pathogenesis of chronic chagasic cardiopathy?
Higuchi, Maria de Lourdes;Kawakami, Joyce;Ikegami, Renata;Clementino, Maysa Beatriz Mandetta;Kawamoto, Flavio M;Reis, Marcia M;Bocchi, Edimar;
Memórias do Instituto Oswaldo Cruz , 2009, DOI: 10.1590/S0074-02762009000900026
Abstract: chronic cardiopathy (cc) in chagas disease is a fibrotic myocarditis with c5b-9 complement deposition. mycoplasma and chlamydia may interfere with the complement response. proteolytic enzymes and archaeal genes that have been described in trypanosoma cruzi may increase its virulence. here we tested the hypothesis that different ratios of mycoplasma, chlamydia and archaeal organisms, which are frequent symbionts, may be associated with chagasic clinical forms. materials and methods: eight indeterminate form (if) and 20 cc chagasic endomyocardial biopsies were submitted to in situ hybridization, electron and immunoelectron microscopy and pcr techniques for detection of mycoplasma pneumoniae (mp), chlamydia pneumoniae(cp), c5b-9 and archaeal-like bodies. results: mp and cp-dna were always present at lower levels in cc than in if (p < 0.001) and were correlated with each other only in cc. electron microscopy revealed mycoplasma, chlamydia and two types of archaeal-like bodies. one had electron dense lipid content (edl) and was mainly present in if. the other had electron lucent content (elc) and was mainly present in cc. in this group, elc correlated negatively with the other microbes and edl and positively with c5b-9. the cc group was positive for archaea and t. cruzi dna. in conclusion, different amounts of mycoplasma, chlamydia and archaeal organisms may be implicated in complement activation and may have a role in chagas disease outcome.
Characterising the KMP-11 and HSP-70 recombinant antigens' humoral immune response profile in chagasic patients  [cached]
Flechas Ivonne,Cuellar Adriana,Cucunubá Zulma,Rosas Fernando
BMC Infectious Diseases , 2009,
Abstract: Background Antigen specificity and IgG subclass could be significant in the natural history of Chagas' disease. The relationship between the different stages of human Chagas' disease and the profiles of total IgG and its subclasses were thus analysed here; they were directed against a crude T. cruzi extract and three recombinant antigens: the T. cruzi kinetoplastid membrane protein-11 (rKMP-11), an internal fragment of the T. cruzi HSP-70 protein192-433, and the entire Trypanosoma rangeli HSP-70 protein. Methods Seventeen Brazilian acute chagasic patients, 50 Colombian chronic chagasic patients (21 indeterminate and 29 cardiopathic patients) and 30 healthy individuals were included. Total IgG and its subtypes directed against the above-mentioned recombinant antigens were determined by ELISA tests. Results The T. cruzi KMP-11 and T. rangeli HSP-70 recombinant proteins were able to distinguish both acute from chronic chagasic patients and infected people from healthy individuals. Specific antibodies to T. cruzi crude antigen in acute patients came from IgG3 and IgG4 subclasses whereas IgG1 and IgG3 were the prevalent isotypes in indeterminate and chronic chagasic patients. By contrast, the specific prominent antibodies in all disease stages against T. cruzi KMP-11 and T. rangeli HSP-70 recombinant antigens were the IgG1 subclass. Conclusion T. cruzi KMP-11 and the T. rangeli HSP-70 recombinant proteins may be explored together in the immunodiagnosis of Chagas' disease. Polarising the IgG1 subclass of the IgG response to T. cruzi KMP-11 and T. rangeli HSP-70 recombinant proteins could have important biological effects, taking into account that this is a complement fixing antibody.
Sera of Chagasic patients react with antigens from the tomato parasite Phytomonas serpens
Gra?a-de Souza,Viviane K; Monteiro-Góes,Viviane; Manque,Patrício; Souza,Tatiana A.C.B; Corrêa,Paulo R.C.; Buck,Gregory A; ávila,Andréa R; Yamauchi,Lucy M; Pinge-Filho,Phileno; Goldenberg,Samuel; Krieger,Marco A; Yamada-Ogatta,Sueli F;
Biological Research , 2010, DOI: 10.4067/S0716-97602010000200011
Abstract: the genus phytomonas comprises trypanosomatids that can parasitize a broad range of plant species. these fagellates can cause diseases in some plant families with a wide geographic distribution, which can result in great economic losses. we have demonstrated previously that phytomonas serpens 15t, a tomato trypanosomatid, shares antigens with trypanosoma cruzi, the agent of human chagas disease. herein, two-dimensional gel electrophoresis (2-de) and mass spectrometry (ms) were used to identify proteins of p. serpens 15t that are recognized by sera from patients with chagas disease. after 2d-electrophoresis of whole-cell lysates, 31 peptides were selected and analyzed by tandem mass spectrometry. twenty-eight polypeptides were identifed, resulting in 22 different putative proteins. the identifed proteins were classifed into 8 groups according to biological process, most of which were clustered into a cellular metabolic process category. these results generated a collection of proteins that can provide a starting point to obtain insights into antigenic cross reactivity among trypanosomatids and to explore p. serpens antigens as candidates for vaccine and immunologic diagnosis studies.
Sera of Chagasic patients react with antigens from the tomato parasite Phytomonas serpens
Viviane K Gra?a-de Souza,Viviane Monteiro-Góes,Patrício Manque,Tatiana A.C.B Souza
Biological Research , 2010,
Abstract: The genus Phytomonas comprises trypanosomatids that can parasitize a broad range of plant species. These fagellates can cause diseases in some plant families with a wide geographic distribution, which can result in great economic losses. We have demonstrated previously that Phytomonas serpens 15T, a tomato trypanosomatid, shares antigens with Trypanosoma cruzi, the agent of human Chagas disease. Herein, two-dimensional gel electrophoresis (2-DE) and mass spectrometry (MS) were used to identify proteins of P. serpens 15T that are recognized by sera from patients with Chagas disease. After 2D-electrophoresis of whole-cell lysates, 31 peptides were selected and analyzed by tandem mass spectrometry. Twenty-eight polypeptides were identifed, resulting in 22 different putative proteins. The identifed proteins were classifed into 8 groups according to biological process, most of which were clustered into a cellular metabolic process category. These results generated a collection of proteins that can provide a starting point to obtain insights into antigenic cross reactivity among trypanosomatids and to explore P. serpens antigens as candidates for vaccine and immunologic diagnosis studies.
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