Reorganization of Extracellular Matrix in Placentas from Women with Asymptomatic Chagas Disease: Mechanism of Parasite Invasion or Local Placental Defense?
Chagas disease, produced by the protozoan Trypanosoma cruzi (T. cruzi), is one of the most frequent endemic diseases in Latin America. In spite the fact that in the past few years T. cruzi congenital transmission has become of epidemiological importance, studies about this mechanism of infection are scarce. In order to explore some morphological aspects of this infection in the placenta, we analyzed placentas from T. cruzi-infected mothers by immunohistochemical and histochemical methods. Infection in mothers, newborns, and placentas was confirmed by PCR and by immunofluorescence in the placenta. T. cruzi-infected placentas present destruction of the syncytiotrophoblast and villous stroma, selective disorganization of the basal lamina, and disorganization of collagen I in villous stroma. Our results suggest that the parasite induces reorganization of this tissue component and in this way may regulate both inflammatory and immune responses in the host. Changes in the ECM of placental tissues, together with the immunological status of mother and fetus, and parasite load may determine the probability of congenital transmission of T. cruzi. 1. Introduction American Trypanosomiasis, or Chagas disease, is a zoonosis caused by Trypanosoma cruzi (T. cruzi). Currently, 10 million people in the Americas, from Mexico in the north to Argentina and Chile in the south, are estimated to be infected [1]. For thousands of years, Chagas disease was known only in the Region of the Americas, mainly in Latin America, where it has been endemic [2]. In past decades, it has been increasingly detected in other non-endemic countries in the American (Canada and the United States), the Western Pacific (mainly Australia and Japan) and the European continents. The presence of Chagas disease outside Latin America is the result of population mobility, notably migration, but cases have been reported among travelers returning from Latin America and even in adopted children [3]. Subsequent transmission occurs through transfusion, vertical, and transplantation routes [3]. The vertical transmission of T. cruzi cannot be prevented, but early detection and treatment of congenital infection achieves cure rates close to 100 per cent [4]. Fetal and maternal tissues are separated by a fetal epithelium (the trophoblast), the greatest area of which is in the villous placenta, the site of nutrient and gas exchange [5]. The human placenta is classified as a hemochorial villous placenta in which the free chorionic villi are the functional units. These chorionic villi are formed by the trophoblast and
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