Expressão de RNAm para TLR 2, TLR 4 e citocinas em infecção experimental por cepas de Trypanosoma cruzi de diferentes origens / mRNA expression to TLR2, TLR4 and cytokines in experimental infection with Trypanosoma cruzi strain of different origins

Receptores Toll-like (TLRs), em células apresentadoras de antígenos, têm importante papel no reconhecimento microbiano e no desenvolvimento da resposta imune adaptativa. Na infecção por T. cruzi, a imunidade celular, medida pela atividade de citocinas pró-inflamatórias, como IL-12 e IFN-γ, do perfil Th1, associadas ao TNF-α, reduz a carga parasitária na fase crônica. Simultaneamente, a IL-4 e a IL-10, do perfil Th2, são responsáveis por amortecer os fortes efeitos da ação pró-inflamatória. Características do parasita, como variação antigênica e diversidade genética das linhagens de T. cruzi, também têm influência na resposta imune do hospedeiro. Assim, este estudo teve como objetivos, em infecção experimental com cepas de diferentes origens de T. cruzi: fazer a caracterização molecular das cepas; determinar os momentos evolutivos da infecção (curva de parasitemia e sobrevida) e verificar a expressão gênica relativa de TLR 2, TLR 4, IL-12p40, IFN-γ,TNF-α, IL-10 e IL-4 em cada momento da infecção. Para isso, foram utilizadas duas cepas de T. cruzi isoladas de pacientes chagásicos crônicos, ZMC e JLP, e a cepa Y de T. cruzi. Camundongos machos Balb/C foram infectados com 104 tripomastigotas/animal e distribuídos em: G1, infectados com a cepa Y; G2, infectados com a cepa ZMC; e G3, infectados com a cepa JLP de T. cruzi. Os momentos para a determinação da expressão gênica das variáveis estudadas foram definidos segundo curva de parasitemia e de sobrevida previamente realizadas: M1: 24 h p.i.; M2: início da fase aguda; M3: fase aguda; M4:momento da queda importante e de manutenção da parasitemia e M5: momento final, determinado pela curva de sobrevida.

Toll-like receptors (TLRs), in antigen-presenting cells, play an important role in microbial recognition and adaptive immune response development. In T. cruzi infection, cellular immunity, mediated by the activity of proinflammatory cytokines such as IL-12 and IFN-γ, of the Th1 profile, associated with TNF-α, reduces parasite load in the chronic phase. Simultaneously, IL-4 and IL-10, of the Th2 profile, are responsible for controlling the strong proinflammatory effects of Th1 profile. Parasite characteristics, such as antigen variation and genetic diversity of T. cruzi strains, also influence host immune response. Hence, by using experimental infection with T. cruzi strains of different origins, this study aimed at: performing the molecular characterization of the strains; determining the evolutive moments of the infection (parasitemia and survival curve) and analyzing the relative gene expression of TLR 2, TLR 4, IL-12p40, IFN-γ,TNF-α, IL-10 and IL-4 at each moment of infection. To that end, two T. cruzi strains, ZMC and JLP, isolated from chronic chagasic patients, and the Y strain of T. cruzi were used. Male Balb/C mice were infected with 104 trypomastigotes/animal and distributed into: G1, infected with the Y strain; G2, infected with the ZMC strain; and G3, infected with the JLP of T. cruzi. The moments for determination of gene expression of the studied variables were defined according to the curve of parasitemia and survival that was previously performed: M1: 24 h p.i.; M2: beginning of the acute phase; M3: acute phase; M4: moment of important decrease and maintenance of parasitemia and M5: final moment, determined by the survival curve.

Definition of a diagnostic routine in individuals with inconclusive serology for chagas disease

Despite the existence of highly sensitive tests, inconclusive serological results are frequent in chronic chagasic infection. This study aimed to define a diagnostic conduct for 30 individuals with inconclusive serology (G3) for chagasic infection assisted at the Outpatient Unit for Infectious and Parasitic Diseases of the Botucatu School of Medicine. Twenty-one individuals with negative serology (G1) and 33 with positive serology (G2) were also studied. Serological methods ELISA, HAI, IFI and immunoblotting TESA-cruzi were used for G1, G2 and G3, and parasitological methods xenodiagnosis, hemoculture and PCR-LIT were used for G2 and G3 individuals. ELISA, HAI and IFI were performed in 5 different blood samples in G2 and G3. TESA-cruzi was carried out only once in G1, G2 and G3 and, since it is the most sensitive, it was utilized as standard. In G3, positivity for ELISA reached 86 percent in the fifth blood sample; the ELISA+HAI+IFI combination showed a maximum of 44.8 percent in the second sample; and TESA-cruzi, 76 percent in one single sample. Xenodiagnosis positivity was 9.4 percent; hemoculture showed 15.2 percent; and PCR-LIT exhibited 22 percent positivity in G2. Nevertheless, in G3, positivity percentage was 3.4 percent for xenodiagnosis, 6.7 percent for PCR-LIT, and no positive result was found for hemoculture. In G3, PCR-LIT resolved one case which was still inconclusive according to serology tests. In order to define inconclusive diagnoses, the results suggest the combined use of ELISA+HAI+IFI in 2 blood samples, decreasing the occurrence of false positive/negative results. If results remain inconclusive, the performance of TESA-cruzi and PCR-LIT, if necessary, is recommended.