Níveis séricos de IgG anti-Trypanosoma cruzi na evolução da cardiopatia chagásica crônica, no período de 10 anos

Abstract

Apesar dos estudos longitudinais sobre a doença de Chagas demonstrarem o caráter progressivo das formas clínicas 2 3 6 8 13 , persistem as indagações em torno do papel de fatores ligados ao parasita, ao hospedeiro ou a ambos no processo evolutivo. Em relação ao hospedeiro, poucos estudos têm sido realizados principalmente em busca de marcadores genéticos, entretanto no campo dos fatores ligados à resposta imune tem sido demonstrada a participação da imunidade celular na patogenia da cardiopatia 20 Abstract In order to investigate the relationship between T. cruzi specific antibodies (IgG) levels and the clinical course of chronic chagasic cardiopathy, the authors analyzed sera from 140 non-treated patients with specific drugs from Virgem da Lapa, Minas Gerais, during 10 years. Of these patients, 92 were women and 48 men, varying from 10 to 70 years old (mean = 38 +13.5 years). Antibody levels were estimated by the mean of titers obtained by an indirect immunofluorescence test, indirect hemagglutination assay and by the mean reactivity indexes (OD/cut-off) obtained by ELISA tests using a conventional antigens and recombinant proteins (CRA+FRA). During the study period, the course of the disease was as follows: 49 did not present cardiac alterations, 29 coursed to cardiopathy, 33 maintained initial cardiopathy, 25 evolved with aggravation of the cardiopathy and 4 with normalization of the electrocardiogram. Statistical analysis showed a significant increase in antibody levels among patients in the group with progressive cardiopathy, as well as in patients with age interval of 20 to 59 years, independent of sex. These findings indicated a direct association between T. cruzi specific antibodies (IgG) levels and the clinical course of chronic chagasic cardiopathy.

Evolution of anti-Trypanosoma cruzi antibody production in patients with chronic Chagas disease: Correlation between antibody titers and development of cardiac disease severity

“…IgG has been described as a marker of Chagas disease progression. Zauza and Borges-Pereira [ 28 ] showed increasing levels of anti- T . cruzi IgG antibodies in CCC patients over 10 years of clinical follow-up, and this isotype might influence clinical outcome.…”

Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease

“…In this group, only 171 patients had at least two immunofluorescence tests, 160 treated with BNZ and 11 untreated. Zauza et al, analyzing 140 chronic patients without parasiticide treatment after 10 years of follow-up, found a statistically significant increase in immunofluorescence titers in patients with progressive clinical deterioration, especially in the age range of 20–59 years [ 24 ]. In our study, titers of immunofluorescence of the 11 untreated patients remained stable after 14 years of follow-up.…”

Chagas' disease: IgG isotypes against cytoplasmic (CRA) and flagellar (FRA) recombinant repetitive antigens of Trypanosoma cruzi in chronic Chagasic patients

“…Some studies, using complex T. cruzi antigens, have provided evidence of a stronger humoral immune response in patients who show severe forms of the disease compared with those who show no symptoms or who have slight cardiomyopathy (27,28). However, there is no evidence as to which isotypes may be involved in the immunopathology of these severe forms, possibly owing to the complex nature of the antigens used, which prevents detection of variations in the specificities of antibodies for different clinical forms of the disease (3,8).…”