Abstract
BackgroundChagas disease is endemic in Latin America and still represents an important public health problem in the region. Chronic cardiomyopathy is the most significant chronic form due to its association with morbidity and mortality. The last decade has seen increasing evidence that inflammatory cytokines and chemokines are responsible for the generation of inflammatory infiltrate and tissue damage, with chronic chagasic cardiomyopathy patients presenting a pro-inflammatory immune response. Although studies have evaluated the role of chemokines in experimental T. cruzi infection, few have addressed their systemic profile, especially for human infection and in aging populations. The present work aimed to use the data from a large population based study of older adults, conducted in an endemic area for Chagas disease, to examine the association between serum levels of cytokines and chemokines, T. cruzi infection and electrocardiogram (ECG) abnormality.MethodsThe present work evaluated serum levels of CCL2, CXCL9, CXCL10, CCL5, CXCL8, IL-1β, IL-6, TNF, IL-12 and IL-10 by Flow Cytometric Bead Array assay (CBA) and the results expressed in pg/ml. The baseline survey started in January 1st 1997, with 1284 participants of an aged population-based cohort. Participants signed an informed consent at baseline and at each subsequent visit and authorized death certificate and medical records verification.ResultsOur results demonstrated that Chagas disease patients had higher serum levels of CXCL9, CXCL10 and IL-1β and lower serum levels of CCL5 than non-infected subjects. Moreover, our data demonstrated that CXCL9 and CXCL10 increased in an age-dependent profile in Chagas disease patients.ConclusionTogether, this study provided evidences that serum biomarkers increase along the age continuum and may have potential implications for establishing clinical management protocols and therapeutic intervention in Chagas disease patients.
Highlights
Chagas disease is endemic in Latin America and still represents an important public health problem in the region
Multivariate analysis of inflammatory markers and T. cruzi infection The statistically significant results of the multivariate analysis of the association between Trypanosoma cruzi infection and biomarkers are presented at Table 3
After adjustments for potential confounders, positive and independent positive associations were found from the biomarkers evaluated showing that the groups CH (N) ECG and CH (Ab) ECG presented an odds ratio (OR) of 4.14 and 3.02 for C-X-C motif chemokine ligand-9 (CXCL9); 2.26 and 2.95 for C-X-C motif chemokine ligand-10 (CXCL10); 2.65 and 1.57 for C-C motif chemokine ligand 5 (CCL5); 5.02 and 3.94 for the cytokine Interleukin 1 beta (IL-1β), respectively, suggesting significant differences in the levels of cytokines/chemokines among the groups studied
Summary
Chagas disease is endemic in Latin America and still represents an important public health problem in the region. The present work aimed to use the data from a large population based study of older adults, conducted in an endemic area for Chagas disease, to examine the association between serum levels of cytokines and chemokines, T. cruzi infection and electrocardiogram (ECG) abnormality. There are estimates that about 8 de Araújo et al Infectious Diseases of Poverty (2020) 9:51 million people are currently infected with T. cruzi, mainly in Latin America, with risk of developing chronic forms of the disease [3]. Cardiac cardiomyopathy is the most important chronic form of Chagas disease, because of its association with morbidity and mortality and the consequent medical and social impact [4]. Infected patients with the chronic indeterminate form evolve to Chagas cardiomyopathy at a rate of 2% annually [5], but which patients and why they develop heart diseases (and others do not) is largely unknown
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