Monocytes are classified according to their CD14 and CD16 expression into classical (reparative), intermediate (inflammatory), and non-classical. This study assessed the frequency of monocyte and the relationship between monocyte subset percentages and the levels of blood cytokines in Colombian chagasic patients with different clinical forms. This study included chagasic patients in different clinical stages: indeterminate (IND) n = 14, chronic chagasic cardiomyopathy (CCC) n = 14, and heart transplant chagasic (HTCC) n = 9; controls with non-chagasic cardiopathy (NCC) n = 15, and healthy individuals (HI) n = 15. Peripheral blood mononuclear cells (PBMCs) were isolated, labeled for CD14, CD16, and HLA-DR, and analyzed by flow cytometry. Cytokines were measured with a bead-based immunoassay. Percentages of total CD14+ CD16+ and CD14+ HLA-DR+ monocytes were higher in patients with heart involvement (CCC, HTCC, and NCC) than controls. Percentages of intermediate monocytes increased in symptomatic chagasic patients (CCC and HTCC) compared to asymptomatic chagasic patients (IND) and controls (HI). Asymptomatic chagasic patients (IND) had higher percentages of classical monocytes, an increased production of CCL17 chemokine compared to chagasic symptomatic patients (CCC), and their levels of CCL17 was positively correlated with the percentage of classical monocyte subset. In CCC, the percentages of intermediate and classical monocytes were positively correlated with IL-6 levels, which were higher in this group compared to HI, and negatively with IL-12p40 concentration, respectively. Remarkably, there also was an important increased of classical monocytes frequency in three chronic chagasic patients who underwent cardiac transplant, of which one received anti-parasitic treatment. Our findings suggest that cardiac chagasic patients have an increased percentage of inflammatory monocytes and produce more IL-6, a biomarker of heart failure and left ventricular dysfunction, whereas asymptomatic chagasic individuals present a higher percentage of reparative monocytes and CCL17.
Monocytes are classified according to CD14 and CD16 expression into classical, intermediate and non classical. Variations in monocytes subsets are involved in the pathogenesis of protozoan and helminthic infections. This study assessed the relationship of monocyte subsets percentages and the level of cytokines in blood from Colombian chagasic patients. Donors included asymptomatic or indeterminate (IND), symptomatic or chronic cardiac chagasic (CCC) and heart transplant (HTCC) patients; also, non-chagasic cardiopathy patients (NCC) and healthy individuals (HI) as controls. Peripheral blood mononuclear cells (PBMCs) were isolated. Fc receptors were blocked using anti-CD16/CD32 and human AB serum. Cells were labeled with antibodies for CD14, CD16 and HLA-DR, and acquired in a flow cytometer. Cytokines were measured in plasma with a Human M1/M2 Macrophage kit. Comparisons were done with Kruskal-Wallis followed by Dunn’s post hoc test and correlations were evaluated by Spearman’s coefficient. Percentages of CD14+ CD16+ and CD14+ HLA-DR+ monocytes were higher in patients with heart involvement (CCC, HTCCC, and NCC). Percentage of intermediate monocytes (inflammatory) increased in CCC patients and was positively correlated with IL-6 concentration and negatively correlated with IL-12p40 levels. IND donors had higher percentages of classical monocytes and an increased production of CCL17, and they positively correlate. The results suggest that variations in the monocyte subsets and cytokines levels might be associated with protection (classical monocytes and CCL17) or the development (intermediate monocytes and IL-6) of chagasic myocardiopathy
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