Chronic Chagas cardiomyopathy: a review of the main pathogenic mechanisms and the efficacy of aetiological treatment following the BENznidazole Evaluation for Interrupting Trypanosomiasis (BENEFIT) trial
Mem. Inst. Oswaldo Cruz
;
112(3): 224-235, Mar. 2017. tab, graf
Article
in English
| LILACS
| ID: biblio-841775
ABSTRACT
Chagas cardiomyopathy is the most frequent and most severe manifestation of chronic Chagas disease, and is one of the leading causes of morbidity and death in Latin America. Although the pathogenesis of Chagas cardiomyopathy is incompletely understood, it may involve several mechanisms, including parasite-dependent myocardial damage, immune-mediated myocardial injury (induced by the parasite itself and by self-antigens), and microvascular and neurogenic disturbances. In the past three decades, a consensus has emerged that parasite persistence is crucial to the development and progression of Chagas cardiomyopathy. In this context, antiparasitic treatment in the chronic phase of Chagas disease could prevent complications related to the disease. However, according to the results of the BENEFIT trial, benznidazole seems to have no benefit for arresting disease progression in patients with chronic Chagas cardiomyopathy. In this review, we give an update on the main pathogenic mechanisms of Chagas disease, and re-examine and discuss the results of the BENEFIT trial, together with its limitations and implications.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Trypanocidal Agents
/
Trypanosoma cruzi
/
Chagas Cardiomyopathy
/
Nitroimidazoles
Limits:
Animals
/
Female
/
Humans
/
Male
Language:
English
Journal:
Mem. Inst. Oswaldo Cruz
Journal subject:
Tropical Medicine
/
Parasitology
Year:
2017
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Hospital do Coração Anis Rassi/BR
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