Changing epidemiology and approaches to therapy for Chagas disease

Kirchhoff, Louis V.

doi:10.1007/s11908-003-0066-y

Cited by 25 publications

(13 citation statements)

References 53 publications

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“…A large fraction of these will die a premature death, usually of cardiac complications (7). The disease's reservoir lies in Ͼ100 different mammal species of wild animals.…”

Section: A Brief Description Of Chagas' Disease Todaymentioning

confidence: 99%

A 9,000-year record of Chagas' disease

Aufderheide

Salo

Madden

et al. 2004

Proc. Natl. Acad. Sci. U.S.A.

339

197

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“…A large fraction of these will die a premature death, usually of cardiac complications (7). The disease's reservoir lies in Ͼ100 different mammal species of wild animals.…”

Section: A Brief Description Of Chagas' Disease Todaymentioning

confidence: 99%

A 9,000-year record of Chagas' disease

Aufderheide

Salo

Madden

et al. 2004

Proc. Natl. Acad. Sci. U.S.A.

339

197

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“…Chagas disease is a neglected disease in the world, and in Latin America there are nearly 10 million patients infected with Trypanosoma cruzi [1] . In 2005, it was estimated that, in Brazil, there were approximately 2 million infected [2] .…”

Section: Introductionmentioning

confidence: 99%

Cardiac resynchronization therapy in patients with chronic Chagas cardiomyopathy: long-term follow up

Araújo¹,

Chamlian²,

Peroni³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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IntroductionChagas disease is a major cause of cardiomyopathy and sudden death in our country. It has a high mortality when their patients develop New York Heart Association (NYHA) class IV.ObjectiveThe objective of this study is to analyze the clinical outcome of patients with Chagas' cardiomyopathy with congestive heart failure with optimized pharmacological therapy, undergoing cardiac resynchronization therapy.MethodsBetween January 2004 and February 2009, 72 patients with Chagas' cardiomyopathy in NYHA class III and IV underwent cardiac resynchronization therapy and were monitored to assess their clinical evolution. We used the t test or the Wilcoxon test to compare the same variable in two different times. A P value < 0.05 was established as statistically significant.ResultsThe average clinical follow-up was 46.6 months (range 4-79 months). At the end of the evaluation, 87.4% of patients were in NYHA class I or II (P<0.001). There was response to therapy in 65.3% of patients (P<0.001), with an overall mortality of 34.7%.ConclusionIn patients with chronic Chagas cardiomyopathy undergoing cardiac resynchronization therapy, we found the following statistically significant changes: improvement in NYHA class and increase of left ventricle ejection fraction, a decrease of the systolic final diameter and systolic final left ventricle volume and improvement of patient survival.

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“…Infection by the protozoan parasite Trypanosoma cruzi causing South American Trypanosomiasis (Chagas' disease) (Chagas 1909) is a significant public health issue in the developing world, affecting 16-18 million of the Latin American population (Kirchhoff 2003). The most damaging and established sequel is that of fatal cardiomyopathy, however the digestive tract is also commonly affected with extensive destruction of ganglion cells (Ribeiro et al 1998;da Silveira et al 2007) leading to altered motility manifest as functional obstruction with eventual progression to hypertrophy of the smooth muscle and marked dilatation (i.e.…”

Section: Chagas' Diseasementioning

confidence: 99%

The role of humoral autoimmunity in gastrointestinal neuromuscular diseases

Hubball

Martin

Lang

et al. 2009

Progress in Neurobiology

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Dysfunction of the gastrointestinal neuromuscular apparatus (including interstitial cells ofCajal) is presumed to underlie a heterogeneous group of disorders collectively termed gastrointestinal neuromuscular diseases (GINMDs). Humoral (antibody)-mediated autoimmunity directed against ligand-or voltage-gated ion channels or associated proteins involved in neuromuscular transmission is associated with several acquired neuromuscular diseases of the periphery and is now implicated in an increasing number of less well-characterised diseases. Anti-channel antibodies have been reported in small numbers of patients with GINMD, particularly in those with GI dysfunction secondary to an underlying disease such as neoplasia or infection. However, little is known of humoral autoimmunity in primary GINMDs.This thesis investigated the association between anti-channel antibodies and GINMD, and the human GI tract as a potential target of anti-channel antibodies. The presence of antivoltage-and ligand-gated antibodies was investigated in the serum of patients with primary achalasia, enteric dysmotility and intestinal pseudo-obstruction, and in those with GINMD secondary to Chagas' disease. The functional effect of sera from some of these patients on colonic smooth muscle contractility was also characterised. Finally, the distribution of six voltage-gated potassium channels (VGKCs), which serve essential roles in the peripheral and central nervous systems and are known targets of pathological autoantibodies, were investigated in all layers of the human GI tract.Our findings suggest that currently recognised anti-channel antibodies are not a common pathogenic factor in primary GINMDs. Anti-channel antibodies, in particular anti-VGKC antibodies, were however found in a significant number of individuals with Chagas' disease. Furthermore, circulating factors in patients with chagasic GI disease altered GI smooth muscle contractility in vitro which may have pathological relevance to GI

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Changing epidemiology and approaches to therapy for Chagas disease

Cited by 25 publications

References 53 publications

A 9,000-year record of Chagas' disease

A 9,000-year record of Chagas' disease

Cardiac resynchronization therapy in patients with chronic Chagas cardiomyopathy: long-term follow up

The role of humoral autoimmunity in gastrointestinal neuromuscular diseases

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