Associação entre os níveis plasmáticos de TNF-α, IFN-γ, IL-10, óxido nítrico e os isotipos de IgG específicos nas formas clínicas da doença de Chagas crônica

Abstract

Na década de 90, a doença de Chagas foi considerada pelo Banco Mundial como a doença parasitária mais importante na América Latina, com impacto socioeconômico consideravelmente maior do que os efeitos combinados de outras infecções parasitárias 6 . A doença, cujo agente etiológico é Trypanosoma cruzi, RESUMOA doença de Chagas é uma importante doença parasitária crônica, que acomete cerca de 9-11 milhões de pessoas na América Latina. Provavelmente, uma combinação de fatores relacionados ao parasito e ao hospedeiro podem ser os responsáveis pela patogênese na fase crônica da doença. Dentre os fatores relacionados ao hospedeiro, a resposta imunológica é um parâmetro de especial interesse. Objetivamos avaliar os níveis plasmáticos das citocinas interferon gama, interleucina 10, fator de necrose tumoral alfa e das imunoglobulinas G total, 3 e 4, por ELISA e do óxido nítrico, pela reação de Griess, entre indivíduos soronegativos e soropositivos para Trypanosoma cruzi, com as formas clínicas cardíaca, indeterminada e digestiva. Os indivíduos soropositivos para Trypanosoma cruzi produziram níveis significativamente mais elevados de imunoglobulinas G total e G3. Indivíduos com a forma digestiva apresentam níveis mais elevados de imunoglobulina G4 e interleucina 10. Entretanto, tais indivíduos apresentaram menores níveis de óxido nítrico do que controles. Os resultados sugerem que os maiores níveis de IL-10 observados nos indivíduos com a forma digestiva poderiam contribuir com os maiores níveis de IgG4 específicos observados. Palavras-chaves: Doença de Chagas. Imunoglobulinas. IFN-. IL-10. TNF-. Óxido nítrico. ABSTRACTChagas disease is an important chronic parasitic disease that affects around 9-11 million people in Latin America. A combination of parasite and host-related factors are probably responsible for pathogenesis in the chronic phase of the disease. Among the host-related factors, the immunological response is a parameter of special interest. Our aim here was to evaluate the plasma levels of the cytokines interferon gamma, interleukin 10 and tumor necrosis factor alpha and the immunoglobulins total IgG and its subclasses 3 and 4, by means of ELISA, and the levels of nitric oxide by means of the Griess reaction, among individuals who were seropositive for Trypanosoma cruzi, presenting the cardiac, indeterminate and digestive clinical forms of the disease, and among seronegative individuals. The seropositive individuals produced significantly higher levels of total IgG and IgG-3. Individuals with the digestive form presented higher levels of IgG-4 and interleukin 10. However, these individuals presented lower levels of nitric oxide than the controls did. The results suggest that the higher levels of interleukin 10 observed among individuals with the digestive form may contribute towards the higher levels of the specific IgG-4 that were seen. . A prevalência global da doença foi reduzida de 16-18 milhões de indivíduos infectados na década de 90 para aproximadamente 9 milhões e pode diminuir ainda mais devido às al...

Genetic and Functional Role of TNF-alpha in the Development Trypanosoma cruzi Infection

“…Our results differ from those reported by Ferreira et al [29] and Talvani et al [30]. However, a previous study from our group analyzing plasma TNF-alpha levels was unable to show differences between the clinical forms of chronic Chagas disease [33]. TNF-alpha plays a potential dual role, controlling parasite growth or promoting tissue damage.…”

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

“…cruzi IgG 1 in Chagas patients. However, Pissetti, et al [ 29 ] showed that elevated levels of IL-10 correlated with elevated levels of total IgG 4 in the serum of patients with the digestive form of Chagas disease, indicating that IL-10 could contribute to total IgG 4 production in these patients. In fact, low production of anti- T .…”

Cytokine Profiling in Chagas Disease: Towards Understanding the Association with Infecting Trypanosoma cruzi Discrete Typing Units (A BENEFIT TRIAL Sub-Study)

“…This parasitic disease is caused by the protozoan Trypanosoma cruzi, transmitted by different routes: via the feces of infected triatomine bugs, contaminated blood transfusion, oral (contaminated food/juices), vertical transmission, organs transplantation and laboratory accidents. Approximately 60% of patients in the chronic phase are clinically asymptomatic, around 30% manifest cardiomyopathy, 8% megavisceral syndromes and the remaining 2% both cardiomyopathy and digestive involvement [4], [5], [6], [7].…”