Chagas disease and SARS-CoV-2 coinfection does not lead to worse in-hospital outcomes.

Chagas disease (CD) continues to be a major public health burden in Latina America. Information on the interplay between COVID-19 and CD is lacking. Our aim was to assess clinical characteristics and in-hospital outcomes of patients with CD and COVID-19, and to compare it to non-CD patients. Consecutive patients with confirmed COVID-19 were included from March to September 2020. Genetic matching for sex, age, hypertension, diabetes mellitus and hospital was performed in a 4:1 ratio. Of the 7018 patients who had confirmed COVID-19, 31 patients with CD and 124 matched controls were included (median age 72 (64-80) years-old, 44.5% were male). At baseline, heart failure (25.8% vs. 9.7%) and atrial fibrillation (29.0% vs. 5.6%) were more frequent in CD patients than in the controls (p < 0.05). C-reactive protein levels were lower in CD patients compared with the controls (55.5 [35.7, 85.0] vs. 94.3 [50.7, 167.5] mg/dL). In-hospital management, outcomes and complications were similar between the groups. In this large Brazilian COVID-19 Registry, CD patients had a higher prevalence of atrial fibrillation and chronic heart failure compared with non-CD controls, with no differences in-hospital outcomes. The lower C-reactive protein levels in CD patients require further investigation.

Prevalence of serologic markers of transfusion and sexually transmitted infections and their correlation with clinical features in a large cohort of Brazilian patients with sickle cell disease.

BACKGROUND: Patients with sickle cell disease (SCD) often require red blood cell (RBC) transfusion for clinical complications, so may be exposed to transfusion-transmitted infections (TTIs). The prevalence of markers for human immunodeficiency virus (HIV), hepatitis C virus (HCV) and B (HBV), human T-cell lymphotropic virus (HTLV-1/2), Chagas disease, and syphilis in an SCD cohort in Brazil were studied. STUDY DESIGN AND METHODS: Clinical history, interview data, blood samples, and medical chart review data were collected during cohort enrollment from November 2013 to May 2015. Serologic markers of infection were assessed. Standard measures of statistical association were calculated, and multivariable models were developed for the most prevalent infections to identify associated factors. RESULTS: Infection markers were evident in 5.2% (144/2779) of the enrolled cohort. Anti-HCV was detected in 69 (2.5%), syphilis antibodies in 34 (1.2%), anti-HTLV-1/2 in 17 (0.6%), HBV surface antigen in 13 (0.5%), Chagas disease antibodies in 13 (0.5%), and anti-HIV in 8 (0.3%) of participants. Factors associated with increased odds of being anti-HCV reactive were older age, illegal drug use, increasing number of RBCs, more than three pain crises in the previous year, and geographic location. Syphilis was associated with older age, females, and smoking history. CONCLUSION: HCV infection was more common in older patients who may have received RBCs before testing was performed on donations, suggesting possible historic transfusion transmission. The cohort showed decreasing rates of infections and a reduction in transfusion transmission markers in younger patients compared to historical literature except for syphilis, indicating contemporary reduced risk of TTI.

A decade of vector control activities: Progress and limitations of Chagas disease prevention in a region of Guatemala with persistent Triatoma dimidiata infestation.

INTRODUCTION: Chagas disease, a neglected tropical disease that affects millions of Latin Americans, has been effectively controlled in Guatemala after multiple rounds of indoor residual insecticide spraying (IRS). However, a few foci remain with persistent Triatoma dimidiata infestation. One such area is the municipality of Comapa, Department of Jutiapa, in the southeastern region of Guatemala, where control interventions appear less effective. We carried out three cross sectional entomological and serological surveys in Comapa to evaluate a decade of vector control activities. Baseline serological (1999) and entomological (2001-2) surveys were followed by three rounds of insecticide applications (2003-2005) and intermittent focal spraying of infested houses, until approximately 2012. Household inspections to determine entomological indices and construction materials were conducted in 2001, 2007 and 2011. Seroprevalence surveys were conducted in school-age children in 1999, 2007 and 2015, and in women of child bearing age (15-44 years) only in 2015. After multiple rounds of indoor residual sprayings (IRS), the infestation index decreased significantly from 39% (2001-2) to 27% (2011). Household construction materials alone predicted <10% of infested houses. Chagas seroprevalence in Comapa declined in school-aged children by 10-fold, from 10% (1999) to 1% (2015). However, seroprevalence in women of child bearing age remains >10%. CONCLUSION: After a decade of vector control activities in Comapa, there is evidence of significantly reduced transmission. However, the continued risk for vector-borne and congenital transmission pose a threat to the 2022 Chagas disease elimination goal. Systematic integrated vector control and improved Chagas disease screening and treatment programs for congenital and vector-borne disease are needed to reach the elimination goal in regions with persistent vector infestation.

Can Triatoma virus inhibit infection of Trypanosoma cruzi (Chagas, 1909) in Triatoma infestans (Klug)? A cross infection and co-infection study.

Triatoma virus occurs infecting Triatominae in the wild (Argentina) and in insectaries (Brazil). Pathogenicity of Triatoma virus has been demonstrated in laboratory; accidental infections in insectaries produce high insect mortality. When more than one microorganism enters the same host, the biological interaction among them differs greatly depending on the nature and the infection order of the co-existing species of microorganisms. We studied the possible interactions between Triatoma virus (TrV) and Trypanosoma cruzi (the etiological agent of Chagas disease) in three different situations: (i) when Triatoma virus is inoculated into an insect host (Triatoma infestans) previously infected with T. cruzi, (ii) when T. cruzi is inoculated into T. infestans previously infected with TrV, and (iii) when TrV and T. cruzi are inoculated simultaneously into the same T. infestans individual. Trypanosoma cruzi infection was found in 57% of insects in the control group for T. cruzi, whereas 85% of insects with previous TrV infection were infected with T. cruzi. TrV infection was found in 78.7% of insects in the control group for TrV, whereas insects previously infected with T. cruzi showed 90% infection with TrV. A total of 67.9% of insects presented simultaneous infection with both types of microorganism. Our results suggest that TrV infection could increase adhesion of T. cruzi to the intestinal cells of triatomines, but presence of T. cruzi in intestinal cells would not increase the possibility of entry of TrV into cells. Although this study cannot explain the mechanism through which TrV facilitates the infection of triatomines with T. cruzi, we conclude that after TrV replication, changes at cellular level should occur that increase the adhesion of T. cruzi.

Astrocyte Apoptosis and HIV Replication Are Modulated in Host Cells Coinfected with Trypanosoma cruzi.

The protozoan Trypanosoma cruzi is the etiological agent of Chagas disease. In immunosuppressed individuals, as it occurs in the coinfection with human immunodeficiency virus (HIV), the central nervous system may be affected. In this regard, reactivation of Chagas disease is severe and often lethal, and it accounts for meningoencephalitis. Astrocytes play a crucial role in the environment maintenance of healthy neurons; however, they can host HIV and T. cruzi. In this report, human astrocytes were infected in vitro with both genetically modified-pathogens to express alternative fluorophore. As evidenced by fluorescence microscopy and flow cytometry, HIV and T. cruzi coexist in the same astrocyte, likely favoring reciprocal interactions. In this context, lower rates of cell death were observed in both T. cruzi monoinfected-astrocytes and HIV-T. cruzi coinfection in comparison with those infected only with HIV. The level of HIV replication is significantly diminished under T. cruzi coinfection, but without affecting the infectivity of the HIV progeny. This interference with viral replication appears to be related to the T. cruzi multiplication rate or its increased intracellular presence but does not require their intracellular cohabitation or infected cell-to-cell contact. Among several Th1/Th2/Th17 profile-related cytokines, only IL-6 was overexpressed in HIV-T. cruzi coinfection exhibiting its cytoprotective role. This study demonstrates that T. cruzi and HIV are able to coinfect astrocytes thus altering viral replication and apoptosis.

CHAGASIC MENINGOENCEPHALITIS IN AN HIV INFECTED PATIENT WITH MODERATE IMMUNOSUPPRESSION: PROLONGED SURVIVAL AND CHALLENGES IN THE HAART ERA / Meningoencefalite chagásica em paciente infectada pelo HIV com imunodepressão moderada: desafios na era HAART e sobrevida prolongada

The reactivation of Chagas disease in HIV infected patients presents high mortality and morbidity. We present the case of a female patient with confirmed Chagasic meningoencephalitis as AIDS-defining illness. Interestingly, her TCD4+ lymphocyte cell count was 318 cells/mm3. After two months of induction therapy, one year of maintenance with benznidazol, and early introduction of highly active antiretroviral therapy (HAART), the patient had good clinical, parasitological and radiological evolution. We used a qualitative polymerase chain reaction for the monitoring of T. cruzi parasitemia during and after the treatment. We emphasize the potential value of molecular techniques along with clinical and radiological parameters in the follow-up of patients with Chagas disease and HIV infection. Early introduction of HAART, prolonged induction and maintenance of antiparasitic therapy, and its discontinuation are feasible, in the current management of reactivation of Chagas disease.

A reativação da doença de Chagas em pacientes com a infecção pelo HIV apresenta uma alta morbidade e mortalidade. Neste relato, apresentamos caso confirmado de meningoencefalite chagásica, como doença definidora de aids, em paciente com 318 linfócitos T-CD4+/mm3. Após 2 meses de tratamento seguido de um ano de profilaxia secundária com benzonidazol e início precoce de terapia antirretroviral (HAART), a paciente apresentou boa evolução clínica, parasitológica e radiológica. Utilizamos a reação em cadeia da polimerase qualitativa do T. cruzi, para monitorização da parasitemia por T. cruzi durante e após o tratamento. Ressaltamos o valor potencial das técnicas moleculares associadas aos parâmetros clínicos e radiológicos nos pacientes com doença de Chagas e infecção pelo HIV. A introdução precoce da terapia antirretroviral, a terapia antiparasitária prolongada, manutenção e descontinuação da mesma, são desafios atuais, embora possíveis, no manejo da reativação da doença de Chagas na era das terapias antirretrovirais de alta eficácia.

CHAGASIC MENINGOENCEPHALITIS IN AN HIV INFECTED PATIENT WITH MODERATE IMMUNOSUPPRESSION: PROLONGED SURVIVAL AND CHALLENGES IN THE HAART ERA.

The reactivation of Chagas disease in HIV infected patients presents high mortality and morbidity. We present the case of a female patient with confirmed Chagasic meningoencephalitis as AIDS-defining illness. Interestingly, her TCD4+ lymphocyte cell count was 318 cells/mm3. After two months of induction therapy, one year of maintenance with benznidazol, and early introduction of highly active antiretroviral therapy (HAART), the patient had good clinical, parasitological and radiological evolution. We used a qualitative polymerase chain reaction for the monitoring of T. cruzi parasitemia during and after the treatment. We emphasize the potential value of molecular techniques along with clinical and radiological parameters in the follow-up of patients with Chagas disease and HIV infection. Early introduction of HAART, prolonged induction and maintenance of antiparasitic therapy, and its discontinuation are feasible, in the current management of reactivation of Chagas disease.

Chagas disease reactivation in HIV-coinfected patients: histopathological aspects.

INTRODUCTION: Chagas disease reactivation has been described in severely immunocompromised patients by various etiologies, including in HIV-coinfected patients. OBJECTIVE: This study aimed to perform histopathological and immunohistochemical evaluation of the brain, myocardium, esophagus and large bowel of autopsied patients with CHD and/or acquired immunodeficiency syndrome in comparison with control patients. MATERIAL AND METHODS: Autopsy reports were reviewed from 1998 to 2012 and eight adult subjects were selected and divided into four groups: RE, CH, AI and CO. Sections of brain, myocardium, esophagus and large bowel were collected from each subject and processed for histological and immunohistochemical analysis. The histological sections stained with HE, Giemsa and picrosirius were used to quantify the density of inflammatory cells, the density of mast cells, and the percentage of collagen, respectively. Immunohistochemical analysis of IL17 and CD31 was performed. RESULTS: The density of mast cells in the myocardium was significantly higher in the CH group than in the other groups. The density of mast cells in the esophagus and in the large bowel was significantly higher when compared to the other groups. The percentage of collagen in the esophagus, myocardium and large bowel was significantly lower in the RE group than in the CO group. The CH group had a higher percentage of collagen in the myocardium and in the large bowel in relation to the other groups. The density of cells immunostained with anti-IL17 was significantly higher in the large bowel and in the myocardium in the CH group than in the CO group. There was higher density of vessels immunostained with anti-CD31 in the myocardium and esophagus of the AI group than in the other groups. There were no significant correlations between the density of mast cells and percentage of collagen in the RE, CO, CH and AI groups. CONCLUSION: Brain lesions observed in patients with CDR, as well as the higher density of cells immunostained with anti-IL17 at these sites, suggest that this cytokine was increasing local inflammation with subsequent tissue damage due to inflammation. Furthermore, the higher density of mast cells in the esophagus and large bowel of these subjects suggests that these cells might play a major role in esophageal and intestinal inflammation.

Vector surveillance to determine species composition and occurrence of trypanosoma cruzi at three military installations in San Antonio, Texas.

Chagas disease, also known as American trypanosomiasis, is caused by the hemoflagellate protozoan Trypanosoma cruzi which is transmitted by blood-sucking triatomine bugs (Hemiptera: Reduviidae; Triatominae). The disease is endemic to south Texas, but exists almost exclusively as a zoonosis. Chagas disease has proven to be a serious public health threat to military working dogs. In 2007, seroprevalence of Chagas disease in military working dogs in San Antonio, Texas, reached 8%. A faunal survey was conducted at 3 San Antonio area military installations (Camp Bullis, Fort Sam Houston, and Lackland Air Force Base). A total of 140 triatomines representing 4 species (Triatoma gerstaeckeri, T. sanguisuga, T. lectularia, and T. indictiva) were collected. Trypanosoma cruzi infected bugs were only collected at Lackland Air Force Base, where the overall infection rate was 16%. The wood excavation technique developed during this study collected all life stages. Only 2 life stages (adult and 5th instar) were positive for T. cruzi.

Actualización de la presencia y distribución de triatominos en el departamento del Atlántico-Colombia: 2003-2010 / Current state of the presence and distribution of triatomine in the department of Atlántico-Colombia: 2003-2010

El departamento del Atlántico es considerado no endémico para la enfermedad de chagas; sin embargo, existen factores de riesgo asociados a la presencia de especies vectoras. Según el último registro de distribución de especies de triatominos en Colombia, para este departamento solo se reporta la presencia de la especie Triatoma maculata. El presente artículo tiene como objetivo actualizar la presencia y distribución de especies de triatominos en áreas urbanas, periurbanas y rurales del departamento del Atlántico-Colombia. Se realizó un estudio retrospectivo que consistió en analizar los datos de registros de triatominos para el departamento del Atlántico entre los años 2003 al 2010. Durante el periodo estudiado se registraron las especies Panstrongylus geniculatus en los municipios de Piojó, Tubará, Puerto Colombia, Barranquilla, Soledad y Luruaco, Eratyrus cuspidatus en los municipios de Piojó y Tubará y T. maculata en el municipio de Puerto Colombia; ampliando de esta forma la distribución para el departamento del Atlántico y la región del caribe colombiana.

The department of Atlántico in Colombia is considered non-endemic for Chagas disease, however there are risk factors associated with the presence of vector species. According to the last record of distribution of triatomine species in Colombia, this department only reported the presence of Triatoma maculata. The objective of this article a is to update the presence and distribution of triatomine species in urban and rural areas in Atlántico-Colombia. A retrospective study was performed based on Atlántico´s records of triatomines between the years 2003 to 2010. During the period studied the following species were recorded: Panstrongylus geniculatus in the municipalities of Piojó, Tubará, Puerto Colombia, Barranquilla, Soledad and Luruaco; Eratyrus cuspidatus in the municipalities of Piojó and Tubará and T. maculata in Puerto Colombia. These results broaden the distribution of triatomines in Atlántico department and Colombian Caribbean region.

Presencia de Meccus longipennis y Triatoma recurva en el estado de Durango, México / Presence of Meccus longipennis and Triatoma recurva in the state of Durango, Mexico

Se reporta por primera vez la recolecta de ejemplares de Meccus longipennis (Usinger) y de Triatoma recurva (Stål) en el estado de Durango. La búsqueda de triatominos se realizó durante 12 meses (septiembre 2010-agosto 2011) en cuatro comunidades de dos municipios (Pueblo Nuevo y Mezquital) del estado de Durango. Se recolectaron 71 ejemplares de M. longipennis y seis de T. recurva provenientes mayoritariamente del interior de las viviendas humanas (recámaras). La presencia de M. longipennis en el área abre la posibilidad de un riesgo potencial de transmisión de Trypanosoma cruzi Chagas a las poblaciones humanas del área estudiada.

The collection of Meccus longipennis (Usinger) and of Triatoma recurva (Stål) in the state of Durango is reported for the first time. Both species were collected during twelve months (from September 2010 to August 2011) in four localities of two municipalities (Pueblo Nuevo y Mezquital) in the state of Durango. Seventy one specimens of M. longipennis and six of T. recurva were collected mostly from indoors of human dwellings (bedrooms). Presence of M. longipennis means a potential risk of transmission of Trypanosoma cruzi Chagas to human populations in the study area.

Adaptabilidad de cepas argentinas de Trypanosoma cruzi en Dipetalogaster maxima (Uhler, 1894) / Adaptability of Argentine strains of Trypanosoma cruzi in Dipetalogaster maxima

Dipetalogaster maxima habita el sur de la península de Baja California, México. La adaptabilidad de las cepas argentinas de Trypanosoma cruzi a vectores propios de otras latitudes podría tener importancia epidemiológica y para su uso en xenodiagnóstico. El objetivo principal del presente estudio fue investigar si existía buena adaptación de cepas de T. cruzi (circulantes en Santiago del Estero, Argentina) en D. maxima, comparativamente con Triatoma infestans. Se utilizaron ninfas I de D. maxima y ninfas III de T. infestans, criadas en laboratorio. Se realizaron diez xenodiagnósticos sobre pacientes chagásicos crónicos no tratados, con serología positiva para cada especie, en paralelo. El peso promedio de sangre ingerida por cada ejemplar fue 61.4 mg para T. infestans y 63.8 mg para D. maxima. A los 30 días, la materia fecal de los insectos fue examinada al microscopio óptico. Se encontró que el 30% de los ejemplares de T. infestans y el 20% de los de D. maxima estaban infectados. Todos los pacientes que mostraron positividad en el xenodiagnóstico con D. maxima también fueron positivos con T. infestans. Comparados los resultados de infectividad, existió significación estadística válida para afirmar que las cepas de T. cruzi argentinas estudiadas se adaptaban a D. maxima. Consideramos importante este primer registro de infectividad de D. maxima con T. cruzi de pacientes chagásicos crónicos de la Argentina debido a la adaptabilidad significativa demostrada, ya que posibilitaría su utilización para xenodiagnóstico. Además, y a pesar del hábitat y la distribución actual de D.maxima, podría tener repercusiones epidemiológicas futuras, como consecuencia de los procesos de globalización y cambios climáticos que se observan en el planeta.

Adaptabilidad de cepas argentinas de Trypanosoma cruzi en Dipetalogaster maxima (Uhler, 1894) / Adaptability of Argentine strains of Trypanosoma cruzi in Dipetalogaster maxima

Dipetalogaster maxima habita el sur de la península de Baja California, México. La adaptabilidad de las cepas argentinas de Trypanosoma cruzi a vectores propios de otras latitudes podría tener importancia epidemiológica y para su uso en xenodiagnóstico. El objetivo principal del presente estudio fue investigar si existía buena adaptación de cepas de T. cruzi (circulantes en Santiago del Estero, Argentina) en D. maxima, comparativamente con Triatoma infestans. Se utilizaron ninfas I de D. maxima y ninfas III de T. infestans, criadas en laboratorio. Se realizaron diez xenodiagnósticos sobre pacientes chagásicos crónicos no tratados, con serología positiva para cada especie, en paralelo. El peso promedio de sangre ingerida por cada ejemplar fue 61.4 mg para T. infestans y 63.8 mg para D. maxima. A los 30 días, la materia fecal de los insectos fue examinada al microscopio óptico. Se encontró que el 30% de los ejemplares de T. infestans y el 20% de los de D. maxima estaban infectados. Todos los pacientes que mostraron positividad en el xenodiagnóstico con D. maxima también fueron positivos con T. infestans. Comparados los resultados de infectividad, existió significación estadística válida para afirmar que las cepas de T. cruzi argentinas estudiadas se adaptaban a D. maxima. Consideramos importante este primer registro de infectividad de D. maxima con T. cruzi de pacientes chagásicos crónicos de la Argentina debido a la adaptabilidad significativa demostrada, ya que posibilitaría su utilización para xenodiagnóstico. Además, y a pesar del hábitat y la distribución actual de D.maxima, podría tener repercusiones epidemiológicas futuras, como consecuencia de los procesos de globalización y cambios climáticos que se observan en el planeta.(AU)

Estudio transversal de la Enfermedad de Chagas en un área endémica de la Provincia de Corrientes, Argentina / Transversal study on Chagas´ disease in an endemic area of Corrientes Province, Argentina

El objetivo de esta investigación fue evaluar la presencia de triatominos en ecotopos domésticos y extradomésticos, conocer el índice de infección natural de Triatoma infestans y estimar la prevalencia humana de anticuerpos contra el Trypanosoma cruzi. Los muestreos se llevaron a cabo en primavera del 2008 y verano - otoño del 2009 en viviendas seleccionadas al azar de áreas rurales del Departamento San Luis del Palmar, Provincia de Corrientes, Argentina. El diagnóstico de la infección chagásica se realizó a voluntarios mediante las pruebas de hemaglutinación indirecta, inmunofluorescencia indirecta y ensayo inmunoenzimático. Se investigaron 27 domicilios, de los cuales el 29,6% (8/27) estaban infestados por T. infestans. Se colectaron 50 ejemplares de todas las edades y el 7,0% resultaron infectados por T. cruzi. Se exploraron 24 peridomicilios y un 20,8% (5/24) resultaron positivos, capturándose 157 individuos de T. sordida, ninguno de los cuales resultó infectado. La prevalencia global de los 163 voluntarios fue 11,7% (19/163) y en el grupo 0 -10 años fue 4,8%. La realidad de San Luis del Palmar no responde a exitosas condiciones de control y si bien la infestación doméstica por T. infestans fue moderada, la transmisión del T. cruzi sigue activa, por lo que se concluye que este departamento no reúne las condiciones de baja endemicidad.

The aim of this investigation was to evaluate triatomine presence in domestic and extradomestic ecotopes, to determine the Triatoma infestans natural infection index and to estimate human seroprevalence to Trypanosoma cruzi. Samplings were performed in spring 2008 and summer- autumm 2009 in randomly selected households in rural areas of Department San Luis del Palmar, Corrientes Province, Argentina. Diagnosis of Chagas infection was performed combining Indirect Hemagglutination Test; Indirect Immunofluorescence Test and Indirect Immunoenzimatic assay on voluntary residents.Twenty seven human dwellings were analyzed and 29.6% (8/27) were infested by T. infestans. A total of 50 T. infestans of all age classes were collected and T. cruzi infection was confirmed in 7.0%. Only 20.8% (5/24) of the twenty four extradomestic ecotopes were positive and 157 T. sordida were captured, none of them were infected. Serological study of 163 human volunteers showed that 11.7% (19/163) were seroreactive, the prevalence observed in the 0 - 10 age group was 4.8%. At San Luis del Palmar the control actions are not successful, and although the T. infestans domestic infestation is mild, there is an active T. cruzi transmission of Chagas. These results show that the endemicity at this department is not low.

Chagas' disease and HIV co-infection in patients without effective antiretroviral therapy: prevalence, clinical presentation and natural history.

The objectives of this study were to establish the prevalence of Chagas' disease among HIV seropositive patients and to define the clinical profile of co-infected cases. Cross-sectional study: the prevalence of co-infected subjects was 1.3% and there was no significant difference between co-infected and non co-infected patients relative to race, birthplace, home address and CD4 T cells. The co-infected group comprised predominantly women and mean age and median viral load were higher. Longitudinal study: included 20 patients (12 women) and described the clinical presentation and natural history of concomitant infections. The mean follow-up time was 35.8 months, mean age was 43+/-8.7 years and 60% of patients were white. During the follow-up, a total of 113 serological tests for Chagas' disease were performed: 89 (78.8%) were reactive/positive, 21 (18.6%) were doubtful and three (2.6%) were non-reactive/negative. Positive results for xenodiagnosis were high (81%). At the baseline evaluation, thirteen patients had the indeterminate form of Chagas' disease and seven cardiopathy. One patient developed from indeterminate to digestive form, three had a reactivation of Chagas' disease in the central nervous system, all had parasitological confirmation and received specific treatment. There were 11 deaths. Thus, HIV-infected patients should be tested for Chagas' disease when epidemiologically relevant.

Efectos de la ingestión de una dieta con alto contenido en grasas en ratas Wistar crónicamente infectadas con Trypanosoma cruzi / The effects of ingesting a high-fat diet on Wistar rats chronically infected with Trypanosoma cruzi

Se investigan los efectos de la ingestión de una dieta con alto contenido en grasas en ratas albinas (R. norvegicus) crónicamente infectadas con Trypanosoma cruzi “Planalto”, mediante pruebas de diagnóstico sero-parasitológicas, cuantificación del Índice de Masa Corporal (IMC), detección de la Proteína C Reactiva (PCR), evaluación de los niveles de lípidos plasmáticos (colesterol total, lipoproteínas de alta densidad - HDL y triglicéridos) y presencia de depósitos lipídicos en la arteria aorta. Durante el curso de la infección chagásica, se detectaron parasitemias patentes entre los 10 y 35 días pi, con un máximo promedio de 36,68±2 trips./mm³ de sangre a los 25 días. A los 90 días pi, se evidenció ausencia de parasitemias y presencia de anticuerpos IgG anti- T. cruzi. Las ratas chagásicas (A) y las sanas (C) sometidas a la dieta rica en grasas, mostraron: diferencias significativas (p<0,05) en el IMC, en comparación con los grupos de ratas sometidas a la dieta normal (B: infectadas y D: sanas); discreta reacción de la PCR en los sueros de las ratas infectadas B; aumento significativo en los niveles de colesterol total, colesterol - HDL y triglicéridos en los grupos A y C en comparación con los grupos controles B y D (p<0,05). El estudio histológico de las arterias de ratas del grupo A, reveló importantes depósitos lipídicos ubicados en la capa muscular próximos a las capas íntima y adventicia. Estos resultados sugieren que el incremento en los niveles de lípidos plasmáticos estimulado por el proceso infeccioso, son los principales mecanismos por el cual T. cruzi podría estar influyendo en la iniciación o progresión de placas ateromatosas

The effects of ingesting a high fat diet on albino rats (R. norvegicus) chronically infected with Trypanosome cruzi “Planalto” were researched using serological and parasitological diagnostic tests, body mass index (BMI) quantification, detection of C-Protein Reactive (CPR), evaluation of the plasmatic lipid levels (total cholesterol, high density lipoproteins HDL and triglycerides) and the presence of lipidic deposits in the aorta artery. During the course of the chagasic infection, patent parasitemias were detected between the ages of 10 and 35 days post-infection (pi) with a maximum average of 36.68 ± 2 tryps/mm³ of blood at 25 days. At 90 days pi, the absence of parasitemias and the presence of IgG anti T. cruzi antibodies were in evidence. The chagasic rats in chronic phase (A) and the healthy controls (C) submitted to a high fat diet showed: 1. Significant variations (p0.05) in the BMI, in comparison with the rat groups receiving a normal diet (B: infected and D: healthy rats); 2. A discrete CRP reaction in the serum of infected rats B; 3. A significant increase was shown in the total cholesterol levels, HDL cholesterol and triglycerides for groups A and C in comparison with control groups B and D (p0.05). The histological study of rat arteries in group A revealed important lipid deposits located in the muscular layer near the intimal and adventitial layer. These results suggest that the increase in plasmatic lipid levels stimulated by the infectious process are the main mechanisms through which T. cruzi could be influencing the initiation or the progression of atheromatous plaque

Trypanosoma cruzi (Chagas' disease agent) reduces HIV-1 replication in human placenta.

BACKGROUND: Several factors determine the risk of HIV mother-to-child transmission (MTCT), such as coinfections in placentas from HIV-1 positive mothers with other pathogens. Chagas' disease is one of the most endemic zoonoses in Latin America, caused by the protozoan Trypanosoma cruzi. The purpose of the study was to determine whether T. cruzi modifies HIV infection of the placenta at the tissue or cellular level. RESULTS: Simple and double infections were carried out on a placental histoculture system (chorionic villi isolated from term placentas from HIV and Chagas negative mothers) and on the choriocarcinoma BeWo cell line. Trypomastigotes of T. cruzi (VD lethal strain), either purified from mouse blood or from Vero cell cultures, 24 h-supernatants of blood and cellular trypomastigotes, and the VSV-G pseudotyped HIV-1 reporter virus were used for the coinfections. Viral transduction was evaluated by quantification of luciferase activity. Coinfection with whole trypomastigotes, either from mouse blood or from cell cultures, decreased viral pseudotype luciferase activity in placental histocultures. Similar results were obtained from BeWo cells. Supernatants of stimulated histocultures were used for the simultaneous determination of 29 cytokines and chemokines with the Luminex technology. In histocultures infected with trypomastigotes, as well as in coinfected tissues, IL-6, IL-8, IP-10 and MCP-1 production was significantly lower than in controls or HIV-1 transducted tissue. A similar decrease was observed in histocultures treated with 24 h-supernatants of blood trypomastigotes, but not in coinfected tissues. CONCLUSION: Our results demonstrated that the presence of an intracellular pathogen, such as T. cruzi, is able to impair HIV-1 transduction in an in vitro system of human placental histoculture. Direct effects of the parasite on cellular structures as well as on cellular/viral proteins essential for HIV-1 replication might influence viral transduction in this model. Nonetheless, additional mechanisms including modulation of cytokines/chemokines at placental level could not be excluded in the inhibition observed. Further experiments need to be conducted in order to elucidate the mechanism(s) involved in this phenomenon. Therefore, coinfection with T. cruzi may have a deleterious effect on HIV-1 transduction and thus could play an important role in viral outcome at the placental level.

Dynamics of the antibody-T. cruzi competition during Chagas infection: prognostic relevance of intracellular replication.

A recently proposed model for the competitive parasite-antibody interactions in Chagas disease is extended by separately describing the parasitic intracellular and extracellular phases. The model solutions faithfully reproduce available population data and yield predictions for parasite-induced cardiac cell damage.