Chagas Disease: An Unknown and Neglected Disease

Oliveira, R. B.; Ballart, Cristina; Abràs, Alba; Gállego, Montserrat; Marin-Neto, J. Antonio

doi:10.1007/978-3-030-44054-1_1

Cited by 5 publications

(5 citation statements)

References 145 publications

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“…Given that neuronal depopulation and aperistalsis are considered to be the essential pathogenetic mechanism of digestive CD, 81,82 it was postulated that CCM would be caused by lack of vagal influence on the heart for 2 reasons. 83,84 First, it was thought that long-standing autonomic imbalance would eventually lead to catecholamineinduced cardiomyopathy. 61,62 Second, it was hypothesized that structural changes would occur due to impairment of the heart to adapt to transient changes in venous return and blood pressure.…”

Section: Consequences Of the Autonomic Remodeling In Chronic Ccmmentioning

confidence: 99%

Arrhythmogenic Manifestations of Chagas Disease: Perspectives From the Bench to Bedside

Roman-Campos,

Marin-Neto,

Santos-Miranda

et al. 2024

Circulation Research

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Chagas cardiomyopathy caused by infection with the intracellular parasite Trypanosoma cruzi is the most common and severe expression of human Chagas disease. Heart failure, systemic and pulmonary thromboembolism, arrhythmia, and sudden cardiac death are the principal clinical manifestations of Chagas cardiomyopathy. Ventricular arrhythmias contribute significantly to morbidity and mortality and are the major cause of sudden cardiac death. Significant gaps still exist in the understanding of the pathogenesis mechanisms underlying the arrhythmogenic manifestations of Chagas cardiomyopathy. This article will review the data from experimental studies and translate those findings to draw hypotheses about clinical observations. Human- and animal-based studies at molecular, cellular, tissue, and organ levels suggest 5 main pillars of remodeling caused by the interaction of host and parasite: immunologic, electrical, autonomic, microvascular, and contractile. Integrating these 5 remodeling processes will bring insights into the current knowledge in the field, highlighting some key features for future management of this arrhythmogenic disease.

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Section: Consequences Of the Autonomic Remodeling In Chronic Ccmmentioning

confidence: 99%

Arrhythmogenic Manifestations of Chagas Disease: Perspectives From the Bench to Bedside

Roman-Campos,

Marin-Neto,

Santos-Miranda

et al. 2024

Circulation Research

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“…Furthermore, it has been noted that these medications can cause oxidative damage in the parasite, which helps to eradicate it (75,76). Nevertheless, in the chronic stage of CD, only limited effectiveness of these treatments has been noted; this could be because of the parasite's persistence in some body tissues, its difficulty entering those tissues, the host's weakened immune system, and the disease-related tissue damage (77,78). Consequently, the primary focus of current research is on treating the chronic phase of CD, which is not treated by conventional medications.…”

Section: Summary Of Main Findingsmentioning

confidence: 99%

Treatment options for Chagas Disease: a systematic review and meta-analysis applied to the preclinical studies using animal models

Machaca-Luque,

Candia-Puma,

Roque-Pumahuanca

et al. 2024

Preprint

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Chagas disease (CD) is a neglected tropical disease endemic to Latin America and has emerged as a global health concern due to the migration of infected individuals. With its epidemiological complexity, difficulty in obtaining appropriate diagnoses, and poor treatment, the search for novel therapeutic options remains. In this context, we conducted a systematic review and meta-analysis of preclinical studies employing animal models to verify the progress in CD treatment. We searched the PubMed database for CD treatment studies published between 1990 and 2023, adhering to the PRISMA guidelines. Twelve papers met the inclusion criteria. The findings indicate that the fifteen treatment alternatives examined, mainly between 2010 and 2014, demonstrated efficacy in experimental CD models, evidenced by significant parasitemia reduction. Bis-triazole DO870 and VNI were effective in the acute and chronic phases, respectively. However, of these emerging therapies, only posaconazole and fexinidazole have progressed to clinical trials, yielding unsatisfactory outcomes as CD monotherapies. This meta-analysis highlights the existence of promising new drug candidates for CD treatment, but most remain in the preclinical stages. Those that reached clinical trials did not demonstrate optimal results, underscoring the ongoing challenges in CD therapy. Collaborative efforts among the academic community, pharmaceutical industries, funding agencies, and government agencies are urgently needed to accelerate the development of more effective medications against CD.

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Section: Introductionmentioning

confidence: 99%

“…Chagas disease is one of the conditions that can result in changes in the gastrointestinal and cardiac systems [ 2 ] . Chronic Chagas cardiomyopathy, an inflammatory and progressive immune response, can lead to myocardial fibrosis, heart failure, atrial and sinus node dysfunction, and intraventricular block, causing symptomatic or non-symptomatic arrhythmias [ 2 ] . In the chronic phase of this disease, chronic fibrosis myocarditis compromises myocardial contractility and the conduction system of the heart, leading to alterations in heart rhythm [ 2 ] .…”

Section: Introductionmentioning

confidence: 99%

Comparison of Anxiety and Depression Symptoms in Individuals According to their Sex, Type of Cardiac Device, and Diagnosis of Chagas Disease

Dessotte¹,

Grotti²,

Ignácio³

et al. 2022

Braz J Cardiovasc Surg

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Introduction Implantable cardiac pacemakers or cardioverter defibrillators are alternatives for the treatment of arrhythmias, however, their use has caused changes in the emotional state of patients. The objective of this study was to compare the measures of anxiety and depression symptoms in individuals according to their sex, type of cardiac device, and diagnosis of Chagas disease. Methods This is an observational and cross-sectional study conducted with adults with implantable cardiac pacemakers or cardioverter defibrillators. Data was collected using a sociodemographic and clinical questionnaire and the Hospital Anxiety and Depression Scale. We used the Student’s t-test for independent samples and the Chi-squared test, with a significance level of 0.05. Results Two hundred forty-four patients participated in the study, 168 with cardiac pacemakers and 76 with implantable cardioverter defibrillators; 104 had Chagas cardiomyopathy (85 with cardiac pacemakers and 19 with implantable cardioverter defibrillators). No statistically significant differences were found in measures of anxiety and depression symptoms according to device type (P=0.594 and P=0.071, respectively) and the presence of Chagas etiology (P=0.649 and P=0.354, respectively). Women had higher mean scores for anxiety (P=0.002) and depression symptoms (P<0.001). Conclusion In the comparison between the groups, according to the type of implanted device and the diagnosis of Chagas disease, no significant differences were found in the measures of anxiety and depression symptoms. Women showed higher means when compared to men, indicating the need to test and implement interventions to minimize these symptoms in this population.

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Chagas Disease: An Unknown and Neglected Disease

Cited by 5 publications

References 145 publications

Arrhythmogenic Manifestations of Chagas Disease: Perspectives From the Bench to Bedside

Arrhythmogenic Manifestations of Chagas Disease: Perspectives From the Bench to Bedside

Treatment options for Chagas Disease: a systematic review and meta-analysis applied to the preclinical studies using animal models

Comparison of Anxiety and Depression Symptoms in Individuals According to their Sex, Type of Cardiac Device, and Diagnosis of Chagas Disease

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