Molecular and Clinical Aspects of Chronic Manifestations in Chagas Disease: A State-of-the-Art Review

Medina-Rincón, Germán José; Gallo-Bernal, Sebastián; Jiménez, Paula Andrea; Cruz-Saavedra, Lissa; Ramírez, Juan David; Rodríguez, María Juliana; Medina-Mur, Ramón; Díaz-Nassif, Gustavo; Valderrama-Achury, María Daniela; Medina, Héctor M.

doi:10.3390/pathogens10111493

Cited by 17 publications

(17 citation statements)

References 243 publications

(318 reference statements)

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“…As for megaesophagus, the surgical indication may occur earlier in the progression of the disease. Conservative alternatives include peroral endoscopic myotomy and lower esophageal sphincter pneumatic dilatation [ 32 , 33 ]. In addition, the surgical approach mainly includes laparoscopic Heller’s myotomy with partial fundoplication or esophagectomy.…”

Section: Discussionmentioning

confidence: 99%

Hospitalizations due to gastrointestinal Chagas disease: National registry

Bierrenbach

Quintino²,

Moreira³

et al. 2022

PLoS Negl Trop Dis

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Objectives Analyze the hospitalizations of patients admitted for Chagas disease with gastro-intestinal involvement (CD-GI) in the Brazilian Unified Health System, describe the epidemiological profile, mortality and costs. Methods This is an observational study that uses secondary data from the National Hospital Information System (SIH-SUS) for the years 2017–2019. CD-GI admissions were defined by specific ICD-10 codes that identify the main diagnosis. Results From 2017 to 2019, there were 4,407 hospitalizations for CD-GI in Brazil, considering only public hospitals and those associated with the SUS. This corresponds to an average of 1,470 hospitalizations per year, or 0.6 per 100,000 inhabitants, with significant regional variation. Hospitalizations increased with age and were slightly higher in men. More than 60% were emergencies and in 50% the procedure performed was surgical. The most used code was the one for megaesophagus followed by megacolon. In-hospital mortality was 5.8% and 17.2% went to intensive care units. The median cost was USD$ 553.15 per hospitalization, and an overall cost of USD$ 812,579.98 per year to the SUS budget. Conclusion The numbers, rates and costs presented here are possibly underestimated but they give us an idea of the overall profile of hospitalizations due to CD-GI, which are not rare and are related to significant in-hospital mortality. CD-GI is a neglected manifestation of a neglected disease.

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Section: Discussionmentioning

confidence: 99%

Hospitalizations due to gastrointestinal Chagas disease: National registry

Bierrenbach

Quintino²,

Moreira³

et al. 2022

PLoS Negl Trop Dis

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“…Tropism is a crucial part of parasite development, but it is not just an intermittent feature of the life cycle. In fact, it is actually linked to key clinical phenotypes …”

Section: Current Life Cyclementioning

confidence: 99%

An Updated View of the Trypanosoma cruzi Life Cycle: Intervention Points for an Effective Treatment

et al. 2022

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Chagas disease (CD) is a parasitic, systemic, chronic, and often fatal illness caused by infection with the protozoan Trypanosoma cruzi . The World Health Organization classifies CD as the most prevalent of poverty-promoting neglected tropical diseases, the most important parasitic one, and the third most infectious disease in Latin America. Currently, CD is a global public health issue that affects 6–8 million people. However, the current approved treatments are limited to two nitroheterocyclic drugs developed more than 50 years ago. Many efforts have been made in recent decades to find new therapies, but our limited understanding of the infection process, pathology development, and long-term nature of this disease has made it impossible to develop new drugs, effective treatment, or vaccines. This Review aims to provide a comprehensive update on our understanding of the current life cycle, new morphological forms, and genetic diversity of T. cruzi , as well as identify intervention points in the life cycle where new drugs and treatments could achieve a parasitic cure.

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“…In the symptomatic chronic phase, the disease is related to the development of cardiac and/or digestive tract changes (megaesophagus and/or megacolon). Digestive forms comprise up to 10-21% of symptomatic CD cases, with megaesophagus having the highest incidence, followed by megacolon [ 2 ]. Unfortunately, there is a lack of effective treatments at this stage [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Pharmacologically, laxatives are also used. Surgical interventions are only used in severe cases, such as severe refractory constipation and other complications [ 2 ]. Thus, most treatments for CD help with the symptoms of digestive forms and can be invasive.…”

Section: Introductionmentioning

confidence: 99%

Neuroprotective Treatments for Digestive Forms of Chagas Disease in Experimental Models: A Systematic Review

Neto

Guerra

Rodrigues

et al. 2022

Oxidative Medicine and Cellular Longevity

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Chagas disease is an anthropozoonosis caused by the protozoan Trypanosoma cruzi and is characterized as a neglected disease. It is currently endemic in 21 countries on the Latin American continent, including Bolivia, Argentina, and Paraguay. Unfortunately, there are no optimally effective treatments that can reduce the damage caused in the digestive form of the disease, such as the neuronal destruction of the myenteric plexus of both the esophagus and the colon. Therefore, the objective of this systematic review was to report the possible pharmacological neuroprotective agents that were tested in murine models of the digestive form of Chagas disease. Inclusion criteria are in vivo experimental studies that used different murine models for digestive forms of Chagas disease related to pharmacological interventions with neuroprotective potential, without year and language restriction. On the other hand, the exclusion criteria were studies that did not approach murine models with the digestive form of the disease or did not use neuroprotective treatments, among others. The search in the PubMed, Web of Science, Embase, and LILACS databases was performed on September 4, 2021. In addition, a manual search was performed using the references of the included articles. The risk of bias assessment of the studies was performed based on the SYRCLE tool guidelines, and the data from the selected articles are presented in this review as a narrative description and in tables. Eight articles were included, 4 of which addressed treatment with acetylsalicylic acid, 3 with cyclophosphamide, and 1 with Lycopodium clavatum 13c. In view of the results of the studies, most of them show neuroprotective activity of the treatments, with the potential to reduce the number of damaged neurons, as well as positive changes in the structure of these cells. However, more studies are needed to understand the mechanisms triggered by each drug, as well as their safety and immunogenicity. Systematic review registration is as follows: PROSPERO database (CRD42022289746).

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Molecular and Clinical Aspects of Chronic Manifestations in Chagas Disease: A State-of-the-Art Review

Cited by 17 publications

References 243 publications

Hospitalizations due to gastrointestinal Chagas disease: National registry

Hospitalizations due to gastrointestinal Chagas disease: National registry

An Updated View of the Trypanosoma cruzi Life Cycle: Intervention Points for an Effective Treatment

Neuroprotective Treatments for Digestive Forms of Chagas Disease in Experimental Models: A Systematic Review

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