Experimental Chagas' disease in dogs.

This paper describes the development of experimental Chagas' disease in 64 out-bred young dogs. Twenty-nine animals were inoculated with the Be-62 and 35 with Be-78 Trypanosoma cruzi strains. Twenty-six were infected with blood trypomastigotes by different inoculation routes and 38 with metacyclic trypomastigotes from the vector via the conjunctival route. Twenty of the 26 dogs infected with blood trypomastigotes were autopsied during the acute phase. Eleven died spontaneously and nine were sacrificed. Six remained alive until they died suddenly (two) or were autopsied. (four). Twelve of the 38 dogs infected with metacyclic trypomastigotes evolved naturally to the chronic phase and remained alive for 24-48 months. The parasitemia, clinical aspects and serology (IgM and IgG) as well as electrocardiogram, hemogram and heart anatomo-histopathologic patterns of acute and chronic cardiac forms of Chagas' disease as seen in human infections, were reproduced. The most important finding is the reproducibility of diffuse fibrosing chronic chagasic cardiopathy in all dogs infected with Be-78 T. cruzi strain autopsied between the 90th and 864th days of infection. Thus, the dog can be considered as a suitable experimental model to study Chagas' disease according to the requisites of the Word Health Organization (1984). Furthermore the animal is easily obtained and easy to handle and maintain in experimental laboratory conditions.     

Chagas' disease in pre-Columbian South America

The quest for the origin and dispersion of Chagas' disease, the second most important vector-borne disease in Latin America, has epidemiological, immunological, and genetical implications. Conjectures based on accounts of chroniclers, reviews of the archaeological literature and the present distribution of triatomine bugs, the vectors of the disease, held that the origin of the adaptation of Triatoma infestans (aspecies of the subfamily Triatominae) to human dwellings occurred in prehistoric times. The autopsy of 35 mummies exhumed in the Chilean desert, dated between 470 B.C. and 600 A.D., revealed the presence of clinical manifestations of Chagas' disease and put earlier speculations on a factual basis.     

Immunosensor for the diagnosis of Chagas' disease

Trypanosoma cruzi proteins from epimastigote membranes, herein referred as antigens, have been used for the construction of an amperometric immunosensor for serological diagnosis of Chagas' disease. The proteins used had a molecular mass ranging from 30 to 100 kDa. The gold electrode was treated with cysteamine and glutaraldehyde prior to antigen immobilization. Antibodies present in the serum of patients with Chagas' disease were captured by the immobilized antigens and the affinity interaction was monitored by chronoamperometry at a potential of -400 mV (versus Ag pseudo-reference electrode) using peroxidase-labeled IgG conjugate and hydrogen peroxide, iodide substrate. The incubation time to allow maximum antigen-antibody and antibody-peroxidase-labeled IgG interactions was 20 min with a reactivity threshold at -0.104 microA.     

Evaluation of Chagas' disease transmission through breast-feeding

One hundred milk or colostrum samples from 78 mothers with chronic Chagas' disease were parasitologically studied for Trypanosoma cruzi infection by means of direct examination and inoculation of mice. The mice were submitted to direct blood examination three times a week. At the end of 45 days, xenodiagnosis and indirect immunofluorescent test (IFAT) for T. cruzi antibodies were carried out in the animals. No parasitized sample was observed even though five mothers had parasitemia at milk collection. In addition, 97 breast-fed children of chronic chagasic mothers, born free of infection, were tested for IgG antibodies to T. cruzi using IFAT. No case of T. cruzi infection was detected. The authors conclude that breast-feeding should not be avoided for children of chronic chagasic women. However, as these mothers had intermittent parasitemia, they should avoid nursing when there is nipple bleeding.     

Problems related to the diagnosis of Chagas' disease

Trypanosoma cruzi may be transmitted to a susceptible human through different routes: a superficial lesion in the skin, such as a scraping of the small wound produced by the hematophagous triatomid bug vector, which becomes infected with its contaminated feces; the placenta, from the infected mother to the product of conception; a transfusion from an infected donor, or even by ingestion of diverse foods infected or contaminated with the parasite. Whichever may be the transmission of the protozoon, it is advisable to have in mind that it is able to produce an asymptomatic or a symptomatic infection, being possible in both cases, using appropriated methods, to detect the T. cruzi and/or the antibodies generated. From the clinical stand-point, Chagas' Disease may present itself as acute or as a chronic disease. Habitually, the acute disease is characterized by general involvement, fever, hepato-splenomegaly, polidenopathy, and occasionally myocarditis and/or encephalitis, whereas, the chronic form of the disease is characterized by presenting itself in an isolated way or combined, chronic myocardiopathy, megaesophagous or megacolon. At any rate, the problems center in the possibility of a reasonable diagnostic assurance which permits the adoption of adequate therapeutic measures. Some facts, which may help to confront these problems are: a) The epidemiological antecedents (origin in an endemic area, personal knowledge of the vector or of being bitten by it, whether the mother or other relatives are affected by the disease, etc.).(ABSTRACT TRUNCATED AT 250 WORDS)     

Trypanosoma cruzi clonal diversity and the epidemiology of Chagas' disease

Chagas' disease is caused by the protozoan Trypanosoma cruzi and it has a variable clinical outcome. The basis for this variability relies in part on the complexity of the parasite population consisting of multiple clones displaying distinct biological properties. A major current challenge is to correlate parasite genetic variability with pathogenesis.     

Natriuretic peptides as prognostic and diagnostic markers in Chagas' disease

Atrial natriuretic factor (ANF) is a hormone secreted predominantly from atrial myocardium in response to changes in wall tension. Chagas' disease is caused by the parasite Trypanosom cruzi (T. cruzi), the heart being one of the most affected organs, resulting in myocarditis and chronic cardiomyopathy. The inflammatory response of the myocardium may be the result of factors such as ischemia, direct parasite invasion, and autoimmune mechanisms. In this review, we discuss the current knowledge about ANF in Chagas' disease and describe our findings in studying: (1) the development of chagasic cardiomyophathy in T. cruzi-infected rats and its relationship with plasma ANF levels; (2) the evolution of plasma ANF in chagasic patients in different stages (asymptomatic, with conduction defects and with chronic heart failure [CHF]); and (3) the possible usefulness of plasma ANF as a prognostic factor of development of myocardial compromise and survival. In rats, the elevated ANF levels found could mirror the inflammatory response of myocardial cells to acute T. cruzi infection and of progressive failure of cardiac function in the chronic infection. In patients, plasma ANF could be a sensitive marker capable of detecting gradual impairments in cardiac function and poor survival in CHF patients and of myocardiopathy development in the asymptomatic state.