Immunological Challenges to the Development of Chagasic Mega Syndromes

Abstract

Chagas´ disease is one of the most serious parasitic diseases in Latin America, with a social and economic impact that far outweighs the combined effects of other parasitic diseases such as malaria, leishmaniasis and schistosomiasis. Chagas' disease presents two well-defined phases, the acute phase and the chronic phase. The acute phase lasts for approximately two or three months. After this phase, the patient enters an asymptomatic state, which characterizes the beginning of the chronic phase. In the chronic phase of the disease, the destruction of components of the enteric nervous system leads to the development of megaesophagus and megacolon. Mega syndromes are characterized as dilatation of the organ associated with an inflammatory infiltrate that is the main responsible for the destruction of the enteric neurons. This review aims at organizing the data previously known about the challenges faced by the immune system in the presence of Chagas disease and the establishment of the chagasic megaesophagus and megacolon in an attempt to discover which is the key mechanism that defines the installation and the protection against the digestive form of this pathology.