Evaluation of Four Biomarkers in Patients Chronically Infected with Trypanosoma cruzi and Their Relationship with Disease Progression.

Abstract

This study evaluated four biomarkers of inflammation or fibrosis as progression indicators for heart disease in patients with Chagas disease. We compared values of these markers at the time of the first sample collection of blood (first time point) and at the time of the last collection of blood (second time point) for 103 individuals positive for Trypanosoma cruzi antibodies. They were split into two clinical groups: 52 individuals with the indeterminate form of the disease at the first time point and 51 controls that already had either cardiac involvement (N = 25) or megaviscera (megaesophagus and/or megacolon; N = 26) at that time. All individuals had an electrocardiogram performed both at the first and second time point (mean time between time points: 11 years). All samples were blind tested for galectin-3, brain natriuretic peptide (NT-proBNP), lysyl oxidase-like protein 2 (LOXL2), and troponin. Differences in concentrations between samples were analyzed using the months between samples as the covariate. This analysis showed that values for all markers, except troponin biomarkers had a significative increase at the second time point for the 91 patients without progression. A similar result was obtained for NT-proBNP and LOXL2 with sera from 12 patients that progressed with cardiac disease. The single marker that showed a significative difference between groups (P = 0.01) was galectin-3. We concluded that galectin-3 was the only marker with a prognostic value in relation to the progression or worsening of heart disease in patients with Chagas disease.