Abstract
BackgroundChagas disease is caused by the protozoan Trypanosoma cruzi and is characterized by heart failure and sudden death. Identifying which factors are involved in evolution and treatment response is actually challenging.Thus, the aim of this work was to determine the Th1/Th17 (IL-6, IL-2, TNF, IL-17 and IFN-γ) and Th2 (IL-4 and IL-10) serum profile in Venezuelan Chagasic patients stratified according amiodarone treatment, hypertension and arrhythmias.MethodsSera from 38 chagasic patients were analyzed to determine the level of cytokines by Multiplexed Bead-Based Immunoassays. ANOVA test was applied to determine differences for each group. Additionally, a Linear Discriminant Analysis (LDA) was applied to observe the accuracy of different cytokines to discriminate between the groups.ResultsThe levels of several cytokines were significantly higher in the high-risk of sudden death and untreated group. LDA showed that IL-2, IFN-γ and IL-10 were the best cytokines for discriminating between high-risk of sudden death and untreated patients versus low-risk of sudden death, treated and control groups.ConclusionsHigh IL-2 levels seem to identify patients with high-risk of sudden death and seems adequate as treatment efficacy marker. To our knowledge, this is the first report about the anti-inflammatory role of the amiodarone in Chagas disease, suggesting an inmunomodulatory effect that may be exploited as coadjutant therapy in chronic Chagas disease.
Highlights
Chagas disease is caused by the protozoan Trypanosoma cruzi and is characterized by heart failure and sudden death
The levels of serum cytokines were determined in different groups of patients including non-chagasic controls and cardiac chagasic patients with different clinical status per blood pressure, and Lown classifications and in those presenting symptomatic treatment of arrhythmias or not with amiodarone
When stratifying the patients according to the Lown classification, which is based on ventricular arrhythmias, in high- and low-risk of sudden death, a significant increment in all the cytokines studied was observed in the high-risk High risk for sudden death (SD) group, but not in the low-risk SD, respect to control group (Fig. 1)
Summary
Chagas disease is caused by the protozoan Trypanosoma cruzi and is characterized by heart failure and sudden death. Identifying which factors are involved in evolution and treatment response is challenging. Chagas disease is a neglected disease caused by the intracellular protozoan Trypanosoma cruzi. Chagas disease is characterized by an acute phase, generally asymptomatic or with mild unspecific symptoms, such as fever and hepatomegaly. Chronic disease is characterized by Several risk stratification systems have been proposed for Chagas disease. Some authors have postulated a classification that combines radiographic and echocardiographic criteria with QRS morphology and appearance of ventricular tachycardia [4, 5]. Other stratification systems have focused their attention in the differential cytokine response among patients with and without cardiomyopathy.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
