Abstract
Chagas disease (CD) is an important public health problem in Brazil and worldwide. Aging and obesity are important matters in patients with CD, as is hypovitaminosis D3, which can decrease the quality of life of these patients. Immunomodulation mediated by vitamin D3, especially the production of antimicrobial peptides such as cathelicidin LL-37, might be related to the severity and symptoms of CD. This study aimed to determine the serum levels of vitamin D and LL-37 and VDR gene polymorphisms in patients with chronic CD. This study included male patients with cardiac and indeterminate clinical forms of CD. Clinical, anthropometric, and blood parameters were obtained. Serum levels of 25(OH)D3 and LL-37 were determined by chemiluminescence and enzyme-linked immunosorbent assay respectively. Fok (rs731236), Bsm (rs1544410), Apa (rs7975232), and Taq (rs731236) polymorphisms of the VDR gene were investigated by PCR-RFLP. Sixty-four patients were included in the study: 18 of the cardiac form and 46 of the indeterminate form. No differences in age, ethnicity, BMI, arterial hypertension, diabetes mellitus, or dyslipidemias were observed between groups. However, the serum levels of 25(OH)D3, but not of LL-37, were lower in the cardiac form group. The association among polymorphisms, vitamin D, and clinical form was not significant. Decreased levels of vitamin D suggest an association with the cardiac form of CD. Studies investigating the roles of vitamin D and LL-37 in the immune response and their associations with VDR polymorphisms and disease susceptibility are necessary.
Highlights
Chagas disease (CD) is an important public health problem in Brazil and worldwide
Chagas disease (CD), a neglected disease caused by the protozoan parasite Trypanosoma cruzi, is present in 21 Latin American countries
CD occurs in two distinct phases: an acute and a chronic phase that can progress to symptomatic forms and affect the gastrointestinal tract and/or heart[4]
Summary
Chagas disease (CD) is an important public health problem in Brazil and worldwide. This study aimed to determine the serum levels of vitamin D and LL37 and VDR gene polymorphisms in patients with chronic CD. Methods: This study included male patients with cardiac and indeterminate clinical forms of CD. The serum levels of 25(OH)D3, but not of LL-37, were lower in the cardiac form group. The association among polymorphisms, vitamin D, and clinical form was not significant. Conclusions: Decreased levels of vitamin D suggest an association with the cardiac form of CD. Studies investigating the roles of vitamin D and LL-37 in the immune response and their associations with VDR polymorphisms and disease susceptibility are necessary. Cardiac involvement is considered the most important CD manifestation given its high frequency and severity, with signs and symptoms ranging from conduction disturbances to more severe conditions such as cardiomegaly, heart failure, and sudden death[5,6]
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