Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation
Background. One hundred years after the discovery of Chagas disease, it remains a major neglected tropical disease. Chronic Chagas heart disease (cChHD) is the most severe manifestation. Heart transplantation is the proper treatment for end-stage heart failure, although reactivation of disease may r...
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2010
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paper:paper_10584838_v51_n5_p485_Burgos2023-06-08T16:03:19Z Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation minicircle DNA adolescent adult Argentina article Chagas disease clinical article disease course DNA polymorphism female genotype heart failure heart transplantation human human tissue immunosuppressive treatment male myocarditis nonhuman nucleotide sequence parasite identification parasite transmission priority journal recurrent disease South America Trypanosoma cruzi Adolescent Adult Chagas Cardiomyopathy Chronic Disease Female Genotype Heart Heart Transplantation Humans Immunocompromised Host Immunosuppressive Agents Male Middle Aged Myocardium Recurrence Trypanosoma cruzi Young Adult Background. One hundred years after the discovery of Chagas disease, it remains a major neglected tropical disease. Chronic Chagas heart disease (cChHD) is the most severe manifestation. Heart transplantation is the proper treatment for end-stage heart failure, although reactivation of disease may result after receipt of immunosuppressive therapy. T. cruzi strains cluster into 6 discrete typing units (DTUs; I-VI) associated with different geographical distribution, transmission cycles and varying disease symptoms. In the southern cone of South America, T. cruzi II, V, and VI populations appear to be associated with Chagas disease and T. cruzi I with sylvatic cycles. Methods. Molecular characterization of DTUs, T. cruzi I genotypes (on the basis of spliced-leader gene polymorphisms), and minicircle signatures was conducted using cardiac explant specimens and blood samples obtained from a cohort of 16 Argentinean patients with cChHD who underwent heart transplantation and from lesion samples obtained from 6 of these patients who presented with clinical reactivation of Chagas disease. Results. Parasite persistence was associated with myocarditis progression, revealing T. cruzi I (genotype Id) in 3 explant samples and T. cruzi II, V, or VI in 5 explant samples. Post-heart transplantation follow-up examination of bloodstream DTUs identified T. cruzi I in 5 patients (genotypes Ia or Id) and T. cruzi II, V, or VI in 7 patients. T. cruzi I, V, and VI were detected in skin chagoma specimens, and T. cruzi V and VI were detected in samples obtained from patients with myocarditis reactivations. Multiple DTUs or genotypes at diverse body sites and polymorphic minicircle signatures at different cardiac regions revealed parasite histotropism. T. cruzi I infections clustered in northern Argentina (latitude, 23°S-27°S), whereas T. cruzi II, V, or VI DTUs were more ubiquitous. Conclusions. Multiple DTUs coexist in patients with Chagas disease. The frequent finding of T. cruzi I associated with cardiac damage was astounding, revealing its pathogenic role in cChHD at the southern cone. © 2010 by the Infectious Diseases Society of America. 2010 https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_10584838_v51_n5_p485_Burgos http://hdl.handle.net/20.500.12110/paper_10584838_v51_n5_p485_Burgos |
| institution |
Universidad de Buenos Aires |
| institution_str |
I-28 |
| repository_str |
R-134 |
| collection |
Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) |
| topic |
minicircle DNA adolescent adult Argentina article Chagas disease clinical article disease course DNA polymorphism female genotype heart failure heart transplantation human human tissue immunosuppressive treatment male myocarditis nonhuman nucleotide sequence parasite identification parasite transmission priority journal recurrent disease South America Trypanosoma cruzi Adolescent Adult Chagas Cardiomyopathy Chronic Disease Female Genotype Heart Heart Transplantation Humans Immunocompromised Host Immunosuppressive Agents Male Middle Aged Myocardium Recurrence Trypanosoma cruzi Young Adult |
| spellingShingle |
minicircle DNA adolescent adult Argentina article Chagas disease clinical article disease course DNA polymorphism female genotype heart failure heart transplantation human human tissue immunosuppressive treatment male myocarditis nonhuman nucleotide sequence parasite identification parasite transmission priority journal recurrent disease South America Trypanosoma cruzi Adolescent Adult Chagas Cardiomyopathy Chronic Disease Female Genotype Heart Heart Transplantation Humans Immunocompromised Host Immunosuppressive Agents Male Middle Aged Myocardium Recurrence Trypanosoma cruzi Young Adult Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation |
| topic_facet |
minicircle DNA adolescent adult Argentina article Chagas disease clinical article disease course DNA polymorphism female genotype heart failure heart transplantation human human tissue immunosuppressive treatment male myocarditis nonhuman nucleotide sequence parasite identification parasite transmission priority journal recurrent disease South America Trypanosoma cruzi Adolescent Adult Chagas Cardiomyopathy Chronic Disease Female Genotype Heart Heart Transplantation Humans Immunocompromised Host Immunosuppressive Agents Male Middle Aged Myocardium Recurrence Trypanosoma cruzi Young Adult |
| description |
Background. One hundred years after the discovery of Chagas disease, it remains a major neglected tropical disease. Chronic Chagas heart disease (cChHD) is the most severe manifestation. Heart transplantation is the proper treatment for end-stage heart failure, although reactivation of disease may result after receipt of immunosuppressive therapy. T. cruzi strains cluster into 6 discrete typing units (DTUs; I-VI) associated with different geographical distribution, transmission cycles and varying disease symptoms. In the southern cone of South America, T. cruzi II, V, and VI populations appear to be associated with Chagas disease and T. cruzi I with sylvatic cycles. Methods. Molecular characterization of DTUs, T. cruzi I genotypes (on the basis of spliced-leader gene polymorphisms), and minicircle signatures was conducted using cardiac explant specimens and blood samples obtained from a cohort of 16 Argentinean patients with cChHD who underwent heart transplantation and from lesion samples obtained from 6 of these patients who presented with clinical reactivation of Chagas disease. Results. Parasite persistence was associated with myocarditis progression, revealing T. cruzi I (genotype Id) in 3 explant samples and T. cruzi II, V, or VI in 5 explant samples. Post-heart transplantation follow-up examination of bloodstream DTUs identified T. cruzi I in 5 patients (genotypes Ia or Id) and T. cruzi II, V, or VI in 7 patients. T. cruzi I, V, and VI were detected in skin chagoma specimens, and T. cruzi V and VI were detected in samples obtained from patients with myocarditis reactivations. Multiple DTUs or genotypes at diverse body sites and polymorphic minicircle signatures at different cardiac regions revealed parasite histotropism. T. cruzi I infections clustered in northern Argentina (latitude, 23°S-27°S), whereas T. cruzi II, V, or VI DTUs were more ubiquitous. Conclusions. Multiple DTUs coexist in patients with Chagas disease. The frequent finding of T. cruzi I associated with cardiac damage was astounding, revealing its pathogenic role in cChHD at the southern cone. © 2010 by the Infectious Diseases Society of America. |
| title |
Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation |
| title_short |
Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation |
| title_full |
Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation |
| title_fullStr |
Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation |
| title_full_unstemmed |
Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation |
| title_sort |
molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation |
| publishDate |
2010 |
| url |
https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_10584838_v51_n5_p485_Burgos http://hdl.handle.net/20.500.12110/paper_10584838_v51_n5_p485_Burgos |
| _version_ |
1768543667745718272 |