Evolution of anti-Trypanosoma cruzi antibody production in patients with chronic Chagas disease: Correlation between antibody titers and development of cardiac disease severity

• Published in: PLoS neglected tropical diseases Vol. 11; no. 7; p. e0005796
• Main Authors: Georg, Ingebourg, Hasslocher-Moreno, Alejandro Marcel, Xavier, Sergio Salles, Holanda, Marcelo Teixeira de, Roma, Eric Henrique, Bonecini-Almeida, Maria da Gloria
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.07.2017; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies; Antibodies, Protozoan - blood; Biology and Life Sciences; Biomarkers; Biomarkers - blood; Cardiomyopathy; Care and treatment; Chagas Cardiomyopathy - pathology; Chagas disease; Chronic Disease; Chronic illnesses; Cohorts; Coronary artery disease; Correlation; Disease; Disease Progression; Diseases; Echocardiography; Female; Funding; Heart; Heart diseases; Humans; Immunoglobulin A; Immunoglobulin E; Immunoglobulin E - blood; Immunoglobulin G; Immunoglobulin G - blood; Immunoglobulin M; Immunoglobulins; Immunology; Infections; Levels; Longitudinal Studies; Male; Medicine and Health Sciences; Middle Aged; Mortality; Patients; Protozoa; Reduction; Research and Analysis Methods; Retrospective Studies; Roles; Tropical diseases; Trypanosoma cruzi; Trypanosoma cruzi - immunology; Vector-borne diseases; Ventricle; Young Adult; Brazil; Rio de Janeiro Brazil
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0005796

Chagas disease is one of the most important endemic infections in Latin America affecting around 6-7 million people. About 30-50% of patients develop the cardiac form of the disease, which can lead to severe cardiac dysfunction and death. In this scenario, the identification of immunological markers of disease progression would be a valuable tool for early treatment and reduction of death rates. In this observational study, the production of anti-Trypanosoma cruzi antibodies through a retrospective longitudinal follow-up in chronic Chagas disease patients´ cohort and its correlation with disease progression and heart commitment was evaluated. Strong inverse correlation (ρ = -0.6375, p = 0.0005) between anti-T. cruzi IgG1 titers and left ventricular ejection fraction (LVEF) in chronic Chagas cardiomyopathy (CCC) patients were observed after disease progression. Elevated levels of anti-T. cruzi IgG3 titers were detected in all T. cruzi-infected patients, indicating a lack of correlation of this IgG isotype with disease progression. Furthermore, low levels of anti-T. cruzi IgG2, IgG4, and IgA were detected in all patients through the follow-up. Although without statistical significance anti-T. cruzi IgE tends to be more reactive in patients with the indeterminate form (IND) of the disease (p = 0.0637). As this study was conducted in patients with many years of chronic disease no anti-T. cruzi IgM was detected. Taken together, these results indicate that the levels of anti-T. cruzi IgG1 could be considered to seek for promising biomarkers to predict the severity of chronic Chagas disease cardiomyopathy.