Zinc Supplementation: Immune Balance of Pregnancy During the Chronic Phase of the Chagas Disease.

BACKGROUND: Chagas disease or American trypanosomiasis is caused by the protozoan Trypanosoma cruzi and is endemic of the Americas. The control of the disease is restricted to toxic and potentially teratogenic drugs, which limit the use during pregnancy. The use of food supplementation offers a safe and low-cost form to alleviate Chagas disease symptoms, mostly in areas with alimentary risk. For example, zinc demonstrates positive effects in immune response, including in Chagas disease during pregnancy. PURPOSE: This study describes the innate response in pregnant rats chronically infected with T. cruzi and supplemented with zinc. METHODS: Pregnant female Wistar rats, infected with T. cruzi, were treated with 20 mg/kg/day zinc sulfate and euthanized on the 18th day. Samples (plasma, splenocytes, and peritoneal exudate) were collected and several immune parameters (nitric oxide, RT1B, CD80/CD86, MCP-1, CD11b/c, NK/NKT, IL-2, IL-10, INF-cc, and apoptosis) evaluated. RESULTS: Under Zinc supplementation and/or T. cruzi infection, the gestation developed normally. Several innate immune parameters such as RT1B, CD80/CD86, MCP-1 expressing lymphocytes, IL-2, and IL-17 were positively altered, whereas nitric oxide, CD11b/c, NK/NKT, apoptosis, INF-γ, and corticosterone demonstrated a pro-pregnancy pattern. CONCLUSION: Our results indicated that zinc has diverse effects on immune response during pregnancy. An anti-T. cruzi immunity, as well as a pro-gestation response, were observed after zinc supplementation. The complete comprehension of zinc supplementation in pregnancy will base an adequate strategy to alleviate Chagas disease symptoms and propagation, especially for populations from endemic areas.

Effects of ghrelin supplementation on the acute phase of Chagas disease in rats.

BACKGROUND: Trypanosoma cruzi is the causative agent of Chagas disease, which is endemic to subtropical and tropical Americas. The disease treatment remains partially ineffective, involving therapies directed to the parasite as well as palliative strategies for the clinical manifestations. Therefore, novel candidates for disease control are necessary. Additionally, strategies based on parasite inhibition via specific targets and application of compounds which improve the immune response against the disease is welcomed. Ghrelin is a peptide hormone pointed as a substance with important cardioprotective, vasodilatory, anti-apoptotic, anti-oxidative and immune modulatory functions. The aims of this study were to evaluate the immunomodulatory effects of ghrelin in male Wistar rats infected with the Y strain of T. cruzi. METHODS: In order to delineate an immune response against T. cruzi mediated by ghrelin, we evaluated the following parameters: quantification of blood and cardiac parasites; analysis of cell markers (CD3+, CD8+, NK, NKT, CD45RA+, macrophage and RT1B+); nitric oxide (NO) production; lymphoproliferation assays; splenocyte apoptosis; and INF-γ, IL-12 and IL-6 quantification in sera. RESULTS: The animals infected with T. cruzi and supplemented with ghrelin demonstrated an upregulated pattern in macrophage and NO production, whereas an anti-inflammatory response was observed in T cells and cytokines. The low response against T. cruzi mediated by T cells probably contributed to a higher colonization of the cardiac tissue, when compared to infected groups. On the other side, the peptide decreased the inflammatory infiltration in cardiac tissue infected with T. cruzi. CONCLUSIONS: Ghrelin demonstrated a dual function in animals infected with T. cruzi. Further studies, especially related to the decrease of cardiac tissue inflammation, are needed in order to determine the advantages of ghrelin supplementation in Chagas disease, mostly for populations from endemic areas.

The treatment with selenium increases placental parasitismin pregnant Wistar rats infected with the Y strain of Trypanosoma cruzi.

Selenium (Se) is an essential micronutrient in the diet of mammals and has an important role in the immune function. Selenium is a key element in selenoproteins involved in the in the maintenance of the antioxidant defense. Diet with selenium is beneficial for the treatment of diseases correlated with high levels of oxidative stress, also observed in the Chagas disease. Chagas disease is a neglected disease caused by the protozoan Trypanosoma cruzi and several research groups are focused on the illness treatment. Immunomodulation of the infection using microelements is an important tool to avoid deleterious effects of the Chagas disease. Therefore, our objective was to evaluate the effects of selenium supplementation on pregnant Wistar rats infected with T. cruzi. Selenium treatment stimulated the weight and length of fetuses and placentas allied to the decrease of blood parasitemia. However, selenium demonstrated a low influence on T cells, diminishing the B cell population (CD45RA+). Moreover, the production of pro-inflammatory cytokines was downregulated under selenium administration. Low pro-inflammatory cytokines levels probably are related to the increase in the number of amastigote nests in infected and treated animals. Thus, selenium supplementation during pregnancy could impair the local placental immune response. Further studies are necessary to assess the interaction between selenium and the acute Chagas' disease during pregnancy, which will base future supplementation strategies.

Is the adaptive immune response in murine Trypanosoma cruzi infection influenced by zinc supplementation?

Chagas disease afflicts 7 to 8 million people worldwide and congenital Chagas' disease usually leads to changes in the maternal environment, culminating in fetal adaptations. Several articles have described the importance of micronutrients on pregnancy, which is sensitive to infections. In Trypanosoma cruzi endemic regions, the Chagas disease is aggravated by the lack of micronutrients in an average diet, to which pregnant women are more susceptible. The aim of this study was to evaluate distinct T cells phenotypes and intracellular cytokines by flow cytometry in pregnant Wistar rats under zinc therapy during experimental Chagas' disease. Twenty female Wistar rats were infected with 1×105 blood trypomastigotes (Y strain) and 30days after infection the animals were mated and grouped: pregnant infected (PI-n=5), pregnant infected/zinc supplied (PIZ-n=5), pregnant control (PC-n=5), control/zinc supplied (PCZ-n=5). Zinc supplementation: 20mg of zinc/Kg/day (gavage) for 18days followed by euthanasia. The immune parameters showed: decreased percentages of CD62LlowCD44high surface marker for infected and treated group (PIZ) when compared to PI (p<0.05). Concerning to T regulatory cells (Treg cells), a significantly lower percentage of splenic Treg cells was found in the infected and treated group (PIZ) as compared to the PI group (p<0.05). The expression of the co-stimulatory molecule CD28+ displayed a significant reduced percentage in TCD8+ for infected and zinc treated group (PIZ) as compared to (PI). The percentages of CD4+/CD11a+ T cells subsets were lower on PIZ as compared to PI. Concerning to CD45RA+ (B lymphocytes) analysis, infected pregnant and treated group (PIZ) showed a significant decrease in CD45RA percentage when compared to (PI) (p<0.05). The intracellular cytokine profiles for TCD4+ and TCD8+ producing IL-4 and IFN-γ revealed that zinc treated and untreated infected pregnant group (PI and PIZ) displayed increased cytokines concentrations as compared to zinc treated and untreated pregnant controls (PC and PCZ). Our data revealed the involvement of zinc as a signaling molecule in the modulation of the inflammatory process and immune response which occurs during pregnancy of T. cruzi infected rats. Zinc acted in a dual fashion, modulating the host's immune response in a way to protect the organism against the deleterious effects of the infection and an overwhelming pro-inflammatory response during pregnancy.

Does L-arginine availability during the early pregnancy alters the immune response of Trypanosoma cruzi infected and pregnant Wistar rats?

Chagas disease induces a strong immune response and L-arginine is an essential amino acid which plays an important role in homeostasis of the immune system. The aims of this study were to evaluate parasitemia, corticosterone levels, production of nitric oxide (NO), fetal morphological measurements, and histology of heart and placenta. Twenty pregnant Wistar rats (180-220 g) were grouped in: pregnant control (PC), pregnant control and L-arginine supplied (PCA), pregnant infected (PI), pregnant infected and L-arginine supplied (PIA). Females were infected with 1×10(5) trypomastigotes of the Y strain (3rd day of pregnancy). Animals were supplied with 21 mg of L-arginine/kg/day during 14 days. PIA showed significant decreased levels of corticosterone and parasitemia. For control groups, any alteration in NO production was found with L-arginine supplementation; for PIA, enhanced nitrite concentrations were observed as compared to PI. Weights and lengths of fetuses were higher in L-arginine treated and infected pregnant rats as compared to untreated ones. Placental weight from the PIA group was significantly increased when compared to PI. In L-arginine treated animals, cardiac tissue showed reduced amastigote burdens. PIA and PI displayed similar placental parasitism. Based on these results, L-arginine supplementation may be potentially useful for the protection against Trypanosoma cruzi during pregnancy.

Oral myiasis in an elderly patient.

BACKGROUND: Myiasis is the invasion of living tissue of humans and other mammals by eggs or maggots of flies of the order of Diptera. It occurs mainly in the Tropics and is associated with inadequate public and personal hygiene. Oral myiases in an older man appears to be rare. OBJECTIVE: To relate a case of oral myiases in a debilitated older man treated by mechanical removal of the maggots, identifying the adult insect that caused the infestation. METHODS: The diagnosis of oral myiasis was established by the clinical examination and it was detected that the infestation involved only soft tissue and the sinus cavity. The patient was submitted to two mechanical removal of the visible maggots. RESULTS: Total of 110 maggots was removed from the oral cavity of the patient and adult insects was identified as belonging to the Calliphoridae Family, Cochliomyia hominivorax species. The patient died two days after the second procedure by severe systemic complications. CONCLUSIONS: The mechanic removal and the identification of the maggots must be adopted as soon as possible to prevent further tissue damage and bacterial infection in cases of oral myiasis. Special attention should be given to the debilitated old patients that are particularly susceptible to oral myiasis infestation.

Melatonin and zinc treatment: distinctive modulation of cytokine production in chronic experimental Trypanosoma cruzi infection.

Melatonin by exhibiting antioxidant, anti-aging, and immunomodulatory properties favorably modulate the immune function, protecting the hosts from several infectious diseases. Zinc is an essential trace element important for the efficiency of the immune system in reason of its widespread role in the activity of enzymes, transcription factors and cytokines. The etiology of Chagas' disease, caused by a protozoan parasite Trypanosoma cruzi, has been the focus of considerable discussion, although chronic phase still remains not fully understood. This study showed that zinc and melatonin treatment did not affect the percentage of both CD4+ and CD8+ T lymphocytes subsets in chronically infected animals. Increased levels of IL-2 and IL-10, as well as, enhanced thymocyte proliferation in T. cruzi infected groups under zinc and melatonin therapy was observed as compared to untreated group. Conversely, during the chronic phase of infection, macrophages counts were reduced in melatonin and zinc-melatonin treated animals. The combined actions of zinc and melatonin have beneficial effects in counteracting parasite-induced immune dysregulation, protecting animals against the harmful actions of chronic T. cruzi infection. Furthermore, our results provide an experimental basis for further studies on the role of immunomodulatory therapies.

Trypanosoma cruzi: do different sylvatic strains trigger distinct immune responses?

Strains of Trypanosoma cruzi are multiclonal populations that can be classified in groups or genotypes, differing in pathogenicity, virulence, and histotropism. In this experiment the distinct behavior of two strains of T. cruzi, MORC-1 and MORC-2, was documented. Blood parasitemia, spleen proliferation, nitric oxide, histopathology of the spleen and heart were used as tools to evaluate parasite persistence. Groups of male mice were separated and divided in three groups: Control (C), Infected (IM-1) and Infected (IM-2). The peak of parasitemia occurred on 10days post infection for both strains. LPS stimulated animals, infected MORC-2 group displayed significant higher concentrations of NO when compared to infected MORC-1 group (P<0.05). For ConA stimulated lymphoproliferation, infected MORC-1 group displayed higher proliferation index as compared to infected MORC-2 group. An opposite behavior for IL-4 and TNF-alpha was observed according to the strain. For MORC-1 enhanced concentrations of IL-4 were present with concomitant reduced levels of TNF-alpha, while for MORC-2 enhanced concentrations of TNF-alpha and reduced levels of IL-4 were found. The histopathology of heart and spleen showed important differences in which MORC-1 displayed statistically enhanced number of amastigote in the heart and spleen as compared to MORC-2. Concluding, each strain triggered a distinct immune response with enhanced cytokine TH-1 profile for MORC-2 and TH-2 for MORC-1.

Influence sexual dimorphism on the persistence of blood parasites in infected Calomys callosus / Influence sexual dimorphism on the persistence of blood parasites in infected Calomys callosus

Gender has long been known to be a contributory factor in the incidence and progression of disorders associated with immune system disregulation. The aims of this experiment were to verify the influences of sexual dimorphism on the persistence of blood parasites out of

the acute phase of infection. Male and female Calomys callosus were separated and infected with two strains of Trypanosoma cruzi, and let age until 120 days. Xenogiagnostic, culture of organs and blood, histopathology and lytic antibody percentages were evaluated on late

chronic phase. Xenodiagnosis, hemoculture and lytic antibody percentages were positive from 45 until 120 days. For both strains in adrenal

and heart, amastigote burdens were present until 45 days, scarcely found on 60 days and absent on 120 days. Steroid hormones, although having a protective role, does not enable animals to get completely rid of the infection. Even without showing apparent signs

of pathological unbalance, parasite persists, hidden throughout the host’s body.

Estudio cariométrico de placentas de ratones con infección aguda por diferentes cepas de Trypanosoma cruzi / Karyometric study of placentas from mice with acute infection by different strains of Trypanosoma cruzi

El objetivo de este trabajo fue evaluar cariometricamente las alteraciones causadas por diferentes cepas de T. cruzi en la placenta del ratón. Ratones hembras de 60 días, grávidas, fueron inoculadas, intraperitonealmente, con 2 x 10(5) tripomastigotes sanguíneos de las cepas colombiana, Y, Solivia o RC del T. cruzi. Fueron observadas claras diferencias en las alteraciones cariométricas de las células trofoblásticas gigantes y de las células trofoblásticas de la zona esponjosa. Los resultados demostraron que las cepas colombiana y RC causan alteraciones tanto en las células trofoblásticas gigantes como en las células del trofoblasto esponjoso, mientras que las cepas Y y Bolivia provocan alteraciones solamente en las células trofoblásticas gigantes. Es posible concluir que cada cepa posee características propias y que, a pesar del tipo similar de transmisión, presenta matices diferenciales en el proceso de la patogénesis placentaria.

The objective of this work was to evaluate karyometrically the alterations caused by different strains of Trypanosoma cruzi in the mouse placenta. Pregnant mice, 60-day old, were intraperitoneally inoculated with 2 x 10(5) bloodstream trypomastigotes of the Colombian, Y, Bolivia or RC strain of T cruzi. There were observed clear differences in the karyometric alterations of the trophoblast giant cells and in the spongiotrophoblast cells. The results demonstrate that the Colombian and RC strains cause alterations both in the trophoblast giant cells and in the spongiotrophoblast cells, whereas the Y and Bolivia strains provoke alterations only in the trophoblast giant cells. It is possible concluding that each strain has its own characteristics and that, in spite of the similar type of transmission, it show differential nuances in the placental pathogenic process.

Alterations triggered by steroid gonadal hormones in triglycerides and the cellular immune response of Calomys callosus infected with the Y strain of Trypanosoma cruzi.

Calomys callosus is a wild rodent found naturally infected with different Trypanosoma cruzi strains. In the work described here, groups of male and female C. callosus were subjected to orchiectomy, ovariectomy and sham operation. One month after surgery, animals were inoculated intraperitoneally (i.p.) with 4x10(4) blood trypomastigotes of the "Y" strain of T. cruzi. Parasitemia, triglycerides, nitric oxide (NO) and concanavalin A (ConA)-induced proliferation were evaluated. Parasitemia during the course of infection was significantly higher in infected and sham operated animals as compared to infected orchiectomized animals. The opposite was observed in the ovariectomized and infected group. Orchiectomized and infected animals displayed elevated triglyceride levels, as well as a more vigorous immune response, with higher splenocyte proliferation and elevated concentrations of NO. Ovariectomy resulted in an impaired immune response, as observed by a reduction of splenocyte proliferation and NO concentration. The results suggest a pivotal role for gonadal hormones in the modulation of triglyceride levels and the magnitude of the immune response during the acute phase of T. cruzi infection.

[Histometry of the sublingual gland in male and female mice (Mus musculus) infected with the RAL strain of the Chagas parasite, Trypanosoma cruzi]. / Histometria de la glándula sublingual de ratones (Mus musculus) machos y hembras infectados con la cepa RAL del parásito de Chagas, Trypanosoma cruzi.

The aim of this work was to analyze histologically and histometrically the sublingual gland of mice infected with the RAL strain of T. cruzi, according to the sex. Swiss mice (Mus musculus) were inoculated with 2 x 10(4) blood trypomastigotes of the RAL strain of T. cruzi. In the peak of the parasitemia (12th day) the mice were sacrificed, and the sublingual glands were fixed in ALFAC. HE-stained histological sections were evaluated histometrically. The parasitemia was higher in females. Histopatologically, acini of the infected animals were smaller, with scanty production of secretion, and smaller striated ducts. The nuclei of the demilunes were smaller and showed amastigote nests in the cytoplasm. Karyometrically, nuclei of the acini, demilunes and striated ducts were smaller in the infected mice. Stereologically, it was observed that relative volumes of acini and ducts were smaller and, inversely, relative volumen were greater for the conjunctive tissue in the infected males. The surface densities of acini and ducts were bigger and the diameter and thickness of the wall were smaller in this group. On the other hand, relative volume of acini was smaller and those of the ducts and conjunctive tissue were bigger in the infected females. The diameter and thickness of the wall of acini were smaller, and those of the striated ducts were bigger in this group. The RAL strain of T. cruzi caused general atrophy in the sublingual gland, with numerous nests of parasites in the glandular parenchyma.

Morfometría de la parótida de ratón infectado por la cepa RAL de Trypanosoma cruzi en función del sexo / Morphometry of the parotid Gland in mice infected by the RAL strain of Trypanosoma cruzi in function of the sex

Fueron estudiadas las alteraciones y el nivel de deterioro de las parótidas de animales infectados con la cepa RAL de Trypanosoma cruzi. Se utilizaron ratones albinos (Mus musculus) de ambos sexos, debido al dimorfismo sexual de las glándulas salivares, inoculados con 2 x 104 tripomastigotes sanguíneos de la cepa RAL del T. cruzi. Los animales fueron sacrificados al 12° día de infección, coincidiendo con el pico parasitémico. La parótida fue procesada histológicamente y, posteriormente, evaluada histopatológica y morfométricamente. Los resultados permitieron verificar intenso parasitismo en la glándula, la que presentó desorganización estructural y atrofia generalizada de acinos y conductos, más intensos en las hembras. Concluyendo, la cepa RAL del T. cruzi mostró un comportamiento atípico en relación a otras cepas, causando modificaciones más evidentes en las hembras, debido, posiblemente, a alteraciones hormonales desencadenadas por el T. cruzi.

They were studied the alterations and the level of deterioration of the parotid gland in mice infected with the RAL strain oí Trypanosoma cruzi. They were used albino mice (Mus musculus) of both sexes, due to the existence of sexual dimorphism of the salivary glands, inoculated with 2 x 104 blood trypomastigotes of the RAL strain of T cruzi. The animals were sacrificed at the 12th day of infection, coinciding with the parasitemic peak, and the parotid gland was histologically processed and histopathologically and histometrically studied. The results allow verifying intense parasitism in the parotid gland with structural disorganization and widespread atrophy of acini and ducts, more marked in the females. Concluding, the RAL strain of T cruzi shows an atypical behavior in relation to other strains, provoking more clear modifications in the females, probably due to the hormonal alterations motivated by the T cruzi.

Estudio morfométrico del hígado de ratón en la enfermedad de Chagas experimental / Morphometrical study of the mouse liver in the experimental Chagas' disease

El objetivo de este trabajo fue caracterizar histopatológicamente y morfométricamente las alteraciones del tejido hepático de ratón, durante la fase aguda de la infección por la cepa MORC-2 de Trypanosoma cruzi. Esta cepa mostró acentuado tropismo por el hígado, con numerosos nidos de amastigotes en los cortes examinados. El hígado de los animales infectados estaba constituido por células menores, con citoplasma granuloso. En algunas áreas, los sinusoides estaban congestionados y las células de Kupffer hipertróficas e hiperplásicas. El tejido hepático mostró focos circunscritos de células inflamatorias en áreas de necrosis, sinusoides, en torno de las venas centrolobulillares y de los espacios porta. La vena centrolobulillar estaba dilatada y congestionada, con necrosis focales y ruptura de la pared en algunos campos. Los espacios porta estaban desorganizados, a veces, con intenso infiltrado inflamatorio. En algunas áreas fue posible observar degeneración cística (spongis hepatis). Por todo el tejido hepático se observaron nidos de amastigotes, de tamaño variable, algunos rodeados por infiltrado inflamatorio crónico. En el espacio porta, el volumen relativo de los conductos biliares y vasos sanguíneos, así como la densidad de superficie de las arterias fueron mayores en el grupo infectado.

The objective of this work was to characterize histopatologically and morphometrically the alterations of the mouse liver during the acute infection by the MORC-2 strain of Trypanosoma cruzi. This strain showed marked tropism by the liver, with numerous nests of amastigotes in the examined sections. The liver of the infected animals was constituted by smaller cells, with granular cytoplasm. In some areas, the sinusoids were congested and the Kuppfer cells were hipertrofied and hiperplasic. The hepatic tissue showed circumscribed foci of inflammatory cells into necrotic areas, sinusoids, around the contrilobular veins and the portal spaces. The centrilobular vein was dilated and congested, with focal necrosis and rupture of the wall in some regions. The portal spaces were disorganized, sometimes with intense inflammatory infiltrate. In some areas it was possible to observe cystic degeneration (spongis hepatis). In the hepatic tissue, nests of amastigotes, of variable sizes, were observed, some surrounded by chronic inflammatory infiltrate. In the portal space, the relative volume of the biliary ducts and blood vessels, as well as the surface density of the arteries was greater in the infected group.

Histological and morphometric investigations of changes induced by the RAL strain of Trypanosoma cruzi in the mouse placenta

Pregnant Swiss mice (Mus musculus) were inoculated intraperitoneally with 2 x `1O POT. 5ï trypomastigotes of the RAL strain of Trypanosoma cruzi on the 7th day of pregnancy and sacrificed on the 19th day of pregnancy. The placenta was sectioned for the assessment of histological and morphometric changes. The RAL strain showed intense tropism for the placenta, with parasitism reaching the three placental layers. There was involvement of the maternal and fetal portions of the placentas, and also of giant cells and spongioblasts. The placentas of infected animals presented sparse areas of degeneration and necrosis, with mild dystrophic calcification of the decidua. The inflammatory process consisted of plasmocytes and lymphocytes, revealing involvement of the decidua...

Estudios morfológico y morfométrico del hígado de fetos de ratas con enfermedad de Chagas aguda / Morphologic and morphometric study of the fetus liver from mice with acute Chagas' disease

Fueron estudiados los fetos de la enfermedad de Chagas aguda, durante la preñez en fetos de ratas, particularmente las posibles alteraciones provocadas en las células hepáticas. Fue demostrado un retardo en el crecimiento intrauterino de los fetos, que presentaron peso y longitud menores que el grupo control. A nivel hepático no fue identificada la presencia de nidos de parásitos. Sin embargo, el hígado de los fetos del grupo inoculado presentaba algunos hepatocitos degenerados y con desorganización arquitectural, mientras que los capilares sinusoides estaban congestivos y dilatados. Morfométricamente se verificó la ausencia de alteraciones nucleares en los hepatocitos de los fetos del grupo inoculado. El volumen relativo ocupado por hepatocitos, fue significativamente mayor en el hígado de los fetos del grupo inoculado que en el grupo control, al contrario de lo observado con el volumen relativo de los sinusoides. Así, aún dilatados y congestionados, el volumen relativo de los sinusoides hepáticos en los fetos del grupo inoculado, fue menor que en los controles, reflejando una disminución del número de capilares sinusoides