Correlation of transforming growth factor-β1 and tumour necrosis factor levels with left ventricular function in Chagas disease

Curvo, Eduardo Ov; Ferreira, Roberto Rodrigues; Madeira, Fabiana S; Alves, Gabriel Farias; Chambela, Mayara C.; Mendes, Verônica Gonçalves; Sangenis, Luiz Henrique Conde; Waghabi, Mariana Caldas; Saraiva, Roberto Magalhães

doi:10.1590/0074-02760170440

Cited by 10 publications

(12 citation statements)

References 42 publications

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“…Patients with the cardiac form present an inflammatory profile that may be related to disease progression [ 42 ]. For instance, serum TNF levels are reported to be higher among patients with the chronic cardiac form than in patients with the indeterminate form [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Trypanosoma cruzi DTU TcII and chronic Chagas disease clinical presentation and outcome in an urban cohort in Brazil

et al. 2020

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Background The specific roles of parasite characteristics and immunological factors of the host in Chagas disease progression and prognosis are still under debate. Trypanosoma cruzi genotype may be an important determinant of the clinical chronic Chagas disease form and prognosis. This study aimed to identify the potential association between T. cruzi genotypes and the clinical presentations of chronic Chagas disease. Methodology/principal findings This is a retrospective study using T. cruzi isolated from blood culture samples of 43 patients with chronic Chagas disease. From 43 patients, 42 were born in Brazil, mainly in Southeast and Northeast Brazilian regions, and one patient was born in Bolivia. Their mean age at the time of blood collection was 52.4±13.2 years. The clinical presentation was as follows 51.1% cardiac form, 25.6% indeterminate form, and 23.3% cardiodigestive form. Discrete typing unit (DTU) was determined by multilocus conventional PCR. TcII (n = 40) and TcVI (n = 2) were the DTUs identified. DTU was unidentifiable in one patient. The average follow-up time after blood culture was 5.7±4.4 years. A total of 14 patients (32.5%) died and one patient underwent heart transplantation. The cause of death was sudden cardiac arrest in six patients, heart failure in five patients, not related to Chagas disease in one patient, and ignored in two patients. A total of 8 patients (18.6%) progressed, all of them within the cardiac or cardiodigestive forms. Conclusions/significance TcII was the main T. cruzi DTU identified in chronic Chagas disease Brazilian patients (92.9%) with either cardiac, indeterminate or cardiodigestive forms, born at Southeast and Northeast regions. Other DTU found in much less frequency was TcVI (4.8%). TcII was also associated to patients that evolved with heart failure or sudden cardiac arrest, the two most common and ominous consequences of the cardiac form of Chagas disease.

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Section: Discussionmentioning

confidence: 99%

Association between Trypanosoma cruzi DTU TcII and chronic Chagas disease clinical presentation and outcome in an urban cohort in Brazil

et al. 2020

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“…Due to its function in activating growth factors and directing tissue repair and remodeling, high levels of TGF-β have been independently linked to the induction of inflammation, fibrosis, and cardiac hypertrophy, and it is associated with a higher incidence of heart failure and death in patients with chronic Chagas disease (137,138). However, lower serum TGF-β together with elevated TNF-α are associated with decreased left ventricular function (139). Thus, TGF-β can have different effects depending on other factors.…”

Section: Adaptive Immunity To T Cruzi Infectionmentioning

confidence: 99%

Pathology and Pathogenesis of Chagas Heart Disease

Bonney

Luthringer

Kim

et al. 2019

Annu. Rev. Pathol. Mech. Dis.

189

201

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Chagas heart disease is an inflammatory cardiomyopathy that develops in approximately one-third of people infected with the protozoan parasite Trypanosoma cruzi. One way T. cruzi is transmitted to people is through contact with infected kissing bugs, which are found in much of the Western Hemisphere, including in vast areas of the United States. The epidemiology of T. cruzi and Chagas heart disease and the varied mechanisms leading to myocyte destruction, mononuclear cell infiltration, fibrosis, and edema in the heart have been extensively studied by hundreds of scientists for more than 100 years. Despite this wealth of knowledge, it is still impossible to predict what will happen in an individual infected with T. cruzi because of the tremendous variability in clonal parasite virulence and human susceptibility to infection and the lack of definitive molecular predictors of outcome from either side of the host–parasite equation. Further, while several distinct mechanisms of pathogenesis have been studied in isolation, it is certain that multiple coincident mechanisms combine to determine the ultimate outcome. For these reasons, Chagas disease is best considered a collection of related but distinct illnesses. This review highlights the pathology and pathogenesis of the most common adverse sequela of T. cruzi infection—Chagas heart disease—and concludes with a discussion of key unanswered questions and a view to the future.

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“…While cytokine levels were not significantly associated with the presence of LVD, the directly proportional correlation between ejection fraction percentage and serum IFN-γ levels in patients with CF and LVD suggests the role of other factors in the control of the cardiac inflammatory process and the reduced impairment of cardiac function in these patients. Accordingly, considering BNP level an important marker of congestive heart failure, including in patients with Chagas disease, [ 22 – 26 ] the negative correlations between BNP levels and ejection fraction percentage, between BNP and IFN-γ, and between BNP and BMI in CF patients with LVD also support the role of other factors in disease progression.…”

Section: Discussionmentioning

confidence: 99%

Metabolic and immunological evaluation of patients with indeterminate and cardiac forms of Chagas disease

Rocha

Marques

Moraes³

et al. 2020

Medicine

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Chagas disease affects approximately 7 million people, causing disability and mortality in the most productive life stages of infected individuals. Considering the lifestyle of the world population, metabolic syndrome is a synergistic factor for an increased cardiovascular risk of patients with Chagas disease. This study transversally evaluated the metabolic and immunological profiles of patients with indeterminate (IF) and cardiac (CF) forms of Chagas disease and their correlations with left ventricular dysfunction (LVD). Clinical and electrical bioimpedance analysis, levels of cytokines (interferon [IFN]-γ, tumor necrosis factor [TNF]-α, interleukin [IL]-17, IL-10, and IL-33) and adipocytokines (adiponectin, leptin, and resistin), metabolic syndrome components, and brain natriuretic peptide (BNP) levels were assessed in 57 patients (13 IF and 44 CF) with a mean age of 61.63 ± 12.1 years. Chest x-ray, electrocardiogram, and echocardiogram were performed to classify the clinical forms. The CF group had a higher number of individuals with metabolic syndrome components blood pressure altered, while more participants in the CF group with LVD had low high-density lipoprotein (HDL) levels. The IF group had more participants with a higher waist-to-hip ratio (WHR). No significant difference was observed between metabolic syndrome, cytokine and adipocytokine level, and clinical forms of the disease or in relation to LVD. Individuals with the IF showed metabolic and immunological profiles compatible with increased disease control, whereas those with CF showed marked inflammatory immune response.

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Correlation of transforming growth factor-β1 and tumour necrosis factor levels with left ventricular function in Chagas disease

Cited by 10 publications

References 42 publications

Association between Trypanosoma cruzi DTU TcII and chronic Chagas disease clinical presentation and outcome in an urban cohort in Brazil

Association between Trypanosoma cruzi DTU TcII and chronic Chagas disease clinical presentation and outcome in an urban cohort in Brazil

Pathology and Pathogenesis of Chagas Heart Disease

Metabolic and immunological evaluation of patients with indeterminate and cardiac forms of Chagas disease

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