Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.407
Filtrar
2.
Rev Soc Bras Med Trop ; 53: e20200504, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33174962

RESUMO

Coronavirus disease 2019 (COVID-19) was first officially described in Brazil on February 26th, 2020. The accumulation of reports of concomitant infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and pathogens that cause diseases endemic to tropical countries, such as dengue and chikungunya fever, has started to draw attention. Chagas disease and leprosy remain public health problems in many developing countries, such as Brazil. In this manuscript, we describe a case of concomitant leprosy, Chagas disease, and COVID-19, highlighting the cutaneous manifestations of SARS-CoV-2 infection and the clinical behavior of household contacts who previously received prophylactic Bacillus Calmette-Guérin vaccines.


Assuntos
Doença de Chagas/complicações , Infecções por Coronavirus/complicações , Hanseníase Dimorfa/complicações , Pneumonia Viral/complicações , Vacina BCG/administração & dosagem , Betacoronavirus , Brasil , Características da Família , Humanos , Pandemias
3.
Arch. latinoam. nutr ; 70(2): 101-114, jun. 2020. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1140312

RESUMO

El propósito de este estudio fue describir la asociación entre el estado nutricional, la presencia de síndrome metabólico (SM), y el estado inflamatorio, en pacientes con Enfermedad de Chagas (ECh), atendidos en la consulta externa del Instituto de Medicina Tropical en Caracas. El estudio fue de tipo transversal y correlacional, en el cual se seleccionaron 34 pacientes a los cuales se les realizó un diagnóstico parasitológico, inmunológico y molecular de la ECh. Se evaluaron variables antropométricas, clínicas y bioquímicas, así como el SM el cual fue determinado por los criterios del III Panel estadounidense para el Tratamiento de Adultos del Programa Nacional de Educación sobre el Colesterol (ATP-III, por sus siglas en inglés). Se encontró que la mayoría de los pacientes presentaron sobrepeso u obesidad (73,5%), un porcentaje de grasa corporal (% GC) alto o muy alto (82,3%), y obesidad abdominal (61,8 %). La frecuencia de SM fue de 29,4% y más del 90% mostraron valores elevados de Proteína C Reactiva ultrasensible (PCRus). Valores más elevados del IMC se asociaron con un estadio más avanzado de la ECh. Los sujetos con presencia de ADN de Tripanosoma cruzi (T. cruzi) circulante en sangre, presentaron mayor % GC, y en su mayoría, fueron diagnosticados con SM. En conclusión, los pacientes evaluados mostraron un exceso de adiposidad, que puede favorecer el estado inflamatorio, el desarrollo de SM y la progresión de la ECh(AU)


The purpose of the study was to describe the association between nutritional and inflammatory status and the presence of metabolic syndrome (MS) on patients with Chagas disease (CD) treated at the Outpatient Services of the Tropical Medicine Institute in Caracas, Venezuela. The study was cross-sectional and correlational. Thirty-four (34) patients were selected and a molecular, immunological, and parasitological diagnostic test was ran for Chagas disease. Anthropometric, clinic, and biochemical variables were evaluated, and the MS was determined using National Cholesterol Education Program Expert/Adult Treatment Panel III (ATP-III) criteria. The results showed a high percentage of patients overweight or presenting obesity (73.5%), a high and very high percentage of body fat (82.3%), and abdominal obesity (61.8%). The prevalence of MS was 29,4% and more than 90% of patients showed elevated values of high sensitivity C-reactive protein (hsCRP). Higher body-mass index values were associated with advanced stages of the CD. Subjects in the presence of T. cruzi DNA in the blood showed a greater percentage of body fat and, most of them, were diagnosed with MS. In conclusion, the evaluated patients showed an excess of adiposity which may favor an inflammatory status, the development of the MS, and the progress of the CD(AU)


Assuntos
Humanos , Masculino , Feminino , Estado Nutricional , Doença de Chagas/complicações , Anormalidades Cardiovasculares , Síndrome Metabólica/etiologia , Antropometria , Reação em Cadeia da Polimerase , Inflamação
4.
Am J Trop Med Hyg ; 103(2): 745-751, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32431281

RESUMO

Chronic Chagas disease can progress to myocardial involvement with intense fibrosis, which may predispose patients to sudden cardiac death through ventricular arrhythmia. The associations of myocardial fibrosis detected by cardiac magnetic resonance (CMR) parameters with non-sustained ventricular tachycardia (NSVT) were evaluated. This cross-sectional study included patients in early stages of Chagas disease (n = 47) and a control group (n = 15). Patients underwent cardiac evaluation, including CMR examination. Myocardial fibrosis assessment by CMR with measurement of late gadolinium enhancement (LGE), native T1, and extracellular volume (ECV) was performed. There was an increase in myocardial fibrosis CMR parameters and ventricular arrhythmias among different stages of Chagas disease, combined with a decrease in the left ventricular ejection fraction (LVEF) by CMR and also in the right ventricular systolic function by S' wave on tissue Doppler. Fibrosis mass and ECV were associated with the Rassi score, ventricular extrasystole, and E/e' ratio in a logistic regression model adjusted for age and gender. The ECV maintained an association with the presence of NSVT, even after adjustments for fibrosis mass and LVEF assessed by CMR. The receiver-operating characteristic area under the curve for global ECV (0.85; 95% CI: 0.71-0.99) and NSVT was greater than that for fibrosis mass (0.75; 95% CI: 0.54-0.96), although this difference was not statistically significant. Extracellular volume could be an early marker of increased risk of ventricular arrhythmia in Chagas disease, presenting an independent association with NSVT in the initial stages of chronic Chagas cardiomyopathy, even after adjustment for fibrosis mass and LVEF.


Assuntos
Cardiomiopatia Chagásica/fisiopatologia , Coração/diagnóstico por imagem , Taquicardia Ventricular/fisiopatologia , Idoso , Área Sob a Curva , Estudos de Casos e Controles , Cardiomiopatia Chagásica/complicações , Cardiomiopatia Chagásica/diagnóstico por imagem , Doença de Chagas/complicações , Doença de Chagas/diagnóstico por imagem , Doença de Chagas/fisiopatologia , Estudos Transversais , Ecocardiografia , Eletrocardiografia Ambulatorial , Espaço Extracelular , Feminino , Fibrose , Humanos , Modelos Logísticos , Imagem por Ressonância Magnética , Imagem Cinética por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Miocárdio/patologia , Tamanho do Órgão , Curva ROC , Volume Sistólico , Taquicardia Ventricular/etiologia , Função Ventricular Direita
6.
BMC Vet Res ; 16(1): 101, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228593

RESUMO

BACKGROUND: Chagas disease is increasingly recognized in the southern U.S., where triatomine vectors transmit Trypanosoma cruzi among wildlife and domestic dogs with occasional vector spillover to humans. As in humans, clinical outcome in dogs is variable, ranging from acute death to asymptomatic infections or chronic heart disease. In order to characterize cardiac manifestations of T. cruzi infections, we tracked a cohort of naturally-infected dogs and a matched cohort of uninfected dogs. We hypothesized that selected measures of cardiac disease (abnormal rate, abnormal rhythm, and elevated cardiac troponin I (cTnI; a biomarker of cardiac injury)) would occur more commonly in infected than uninfected dogs matched by age, breed, sex and location. In addition to the clearly positive and negative dogs, we specifically tracked dogs with discordant test results across three independent serological assays to gather clinical data that might elucidate the infection status of these animals and inform the utility of the different testing approaches. RESULTS: We placed an ambulatory ECG monitor (Holter) on 48 government working dogs and analyzed 39 successful recordings that met length and quality criteria from 17 T. cruzi-infected, 18 uninfected dogs and 4 dogs with discordant results. Overall, 76.5% of positive, 100.0% of discordant, and 11.1% of negative dogs showed > 1 ECG abnormality (p < 0.0001), and positive and discordant dogs had a higher mean number of different types of ECG abnormalities than negative dogs (p < 0.001-0.014). The most common cardiac abnormalities included supraventricular and ventricular arrhythmias and atrioventricular block. Positive dogs had higher serum concentrations of cTnI than both negative dogs (p = 0.044) and discordant dogs (p = 0.06). Based on dog handler reports, nearly all (4/5; 80%) dogs with reported performance decline or fatigue were T. cruzi-infected dogs. CONCLUSIONS: Further understanding cardiac manifestations in dogs naturally infected with T. cruzi is critical for prognostication, establishing a baseline for drug and vaccine studies, and better understanding of zoonotic risk.


Assuntos
Doença de Chagas/veterinária , Doenças do Cão/parasitologia , Cardiopatias/veterinária , Animais , Arritmias Cardíacas/complicações , Arritmias Cardíacas/veterinária , Doença de Chagas/complicações , Doença de Chagas/epidemiologia , Doenças do Cão/epidemiologia , Cães , Eletrocardiografia Ambulatorial/veterinária , Feminino , Masculino , Testes Sorológicos/veterinária , Texas/epidemiologia , Troponina I/sangue , Trypanosoma cruzi/isolamento & purificação
7.
J. coloproctol. (Rio J., Impr.) ; 40(2): 172-174, Apr.-Jun. 2020. ilus
Artigo em Inglês | LILACS | ID: biblio-1134978

RESUMO

ABSTRACT Chagasic megacolon is the second most frequent cause of manifestation of the digestive forms of Chagas disease (trypanosoma cruzi parasitosis), characterized by progressive pseudo-occlusive symptoms or chronic constipation, caused by an alteration in the functioning of the colonic wall musculature. In Venezuela, cases of chagasic disease reported in the past are referred to chagasic heart disease, this being the first documented case of chagasic megacolon. We broach herein a case of chagasic megacolon in which early diagnosis and prompt surgical treatment led to a successful outcome.


RESUMO O megacólon chagásico é a segunda causa mais frequente de manifestação das formas digestivas da doença de Chagas (parasitose do Trypanosoma cruzi), caracterizado por sintomas pseudo-oclusivos progressivos ou constipação crônica, causado por uma alteração no funcionamento da musculatura da parede do cólon. Na Venezuela, os casos da doença chagásica relatados no passado são referidos como doença cardíaca chagásica, sendo este o primeiro caso documentado de megacólon chagásico. Neste artigo, abordamos um caso de megacólon chagásico no qual o diagnóstico precoce e o tratamento cirúrgico imediato levaram a um resultado bem-sucedido.


Assuntos
Humanos , Masculino , Doença de Chagas/complicações , Constipação Intestinal , Megacolo/cirurgia , Trypanosoma cruzi , Doenças do Colo , Megacolo/diagnóstico
8.
Trends Parasitol ; 36(4): 368-381, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32191851

RESUMO

To successfully infect, Trypanosoma cruzi evades and modulates the host immune response. T. cruzi calreticulin (TcCalr) is a multifunctional, endoplasmic reticulum (ER)-resident chaperone that, translocated to the external microenvironment, mediates crucial host-parasite interactions. TcCalr binds and inactivates C1 and mannose-binding lectin (MBL)/ficolins, important pattern- recognition receptors (PRRs) of the complement system. Using an apoptotic mimicry strategy, the C1-TcCalr association facilitates the infection of target cells. T. cruzi infection also seems to confer protection against tumorigenesis. Thus, recombinant TcCalr has important antiangiogenic properties, detected in vitro, ex vivo, and in ovum, most likely contributing at least in part, to its antitumor properties. Consequently, TcCalr is useful for investigating key issues of host-parasite interactions and possible new immunological/pharmacological interventions in the areas of Chagas' disease and experimental cancer.


Assuntos
Calreticulina/imunologia , Carcinogênese/imunologia , Doença de Chagas/complicações , Doença de Chagas/imunologia , Interações Hospedeiro-Parasita/imunologia , Neoplasias/etiologia , Trypanosoma cruzi/patogenicidade , Animais , Doença de Chagas/parasitologia , Doença de Chagas/patologia , Humanos , Evasão da Resposta Imune/imunologia , Neoplasias/imunologia , Trypanosoma cruzi/fisiologia , Fatores de Virulência/imunologia
9.
Parasitol Res ; 119(6): 1829-1843, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32206887

RESUMO

The underlying pathogenic mechanisms of cardiomyopathy in Chagas disease are still unsolved. In order to better clarify the role of fat on the evolution of cardiomyopathy, the present study employed three murine models of chronic Trypanosoma cruzi infection: (1) aP2-RIDα/ß transgenic mice (RID mice; an adipose tissue model which express a gain-of-function potent anti-inflammatory activity), (2) allograft inflammatory factor-1 knockout mice (Aif1-/-), and (3) a Swiss outbred mice. RID mice and non-transgenic mice (wild type, WT) were infected with blood trypomastigotes of Brazil strain. During the acute stage of infection, RID mice had lower parasitemia, lower heart inflammation, and a decrease in the relative distribution of parasite load from cardiac muscle tissue toward epididymal fat. Nevertheless, comparable profiles of myocardial inflammatory infiltrates and relative distribution of parasite load were observed among RID and WT at the chronic stage of infection. Aif1-/- and Aif1+/+ mice were infected with bloodstream trypomastigotes of Tulahuen strain and fed with high-fat diet (HFD) or regular diet (RD). Interestingly, Aif1+/+ HFD infected mice showed the highest mortality. Swiss mice infected with blood trypomastigotes of Berenice-78 strain on a HFD had higher levels of TNFα and more inflammation in their heart tissue than infected mice fed a RD. These various murine models implicate adipocytes in the pathogenesis of chronic Chagas disease and suggest that HFD can lead to a significant increase in the severity of parasite-induced chronic cardiac damage. Furthermore, these data implicate adipocyte TLR4-, TNFα-, and IL-1ß-mediated signaling in pro-inflammatory pathways and Aif-1 gene expression in the development of chronic Chagas disease.


Assuntos
Cardiomiopatia Chagásica/patologia , Doença de Chagas/complicações , Dieta Hiperlipídica , Trypanosoma cruzi , Animais , Cardiomiopatia Chagásica/parasitologia , Doença de Chagas/parasitologia , Doença de Chagas/patologia , Modelos Animais de Doenças , Feminino , Coração/parasitologia , Inflamação/parasitologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Camundongos Transgênicos , Miocárdio/patologia , Carga Parasitária , Trypanosoma cruzi/fisiologia , Fator de Necrose Tumoral alfa/metabolismo
10.
Am J Trop Med Hyg ; 102(5): 1075-1077, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32207404

RESUMO

In recent decades and because of migration, Chagas disease has become a global public health problem. A significant focus has been placed on pregnant women who can transmit the disease to their offspring. Here, we report four cases of women who did not know that they were pregnant while they were being treated with benznidazole. A diagnosis was established according to serology and Trypanosoma cruzi polymerase chain reaction (PCR)-standardized tests. Treatment was discontinued when pregnancy was confirmed, and a thorough follow-up was carried out. Although each case was different, none of the mothers developed health problems during pregnancy, and their newborns were delivered without any teratogenic effects.


Assuntos
Doença de Chagas/complicações , Nitroimidazóis/uso terapêutico , Complicações Parasitárias na Gravidez/tratamento farmacológico , Tripanossomicidas/uso terapêutico , Adolescente , Adulto , Bolívia , Doença de Chagas/congênito , Doença de Chagas/tratamento farmacológico , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/tratamento farmacológico , Doenças do Recém-Nascido/parasitologia , Nitroimidazóis/efeitos adversos , Gravidez , Tripanossomicidas/efeitos adversos , Trypanosoma cruzi
12.
Am J Trop Med Hyg ; 102(5): 1086-1089, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32100696

RESUMO

Chagas disease, caused by Trypanosoma cruzi, is transmitted by insect vectors, and through transfusions, transplants, insect feces in food, and mother to child during gestation. An estimated 30% of infected persons will develop lifelong, potentially fatal cardiac or digestive complications. Treatment of infants with benznidazole is highly efficacious in eliminating infection. This work evaluates the costs of maternal screening and infant testing and treatment for Chagas disease in the United States, including the cost of commercially available benznidazole. We compare costs of testing and treatment for mothers and infants with the lifetime societal costs without testing and consequent morbidity and mortality due to lack of treatment or late treatment. We constructed a decision-analytic model, using one tree that shows the combined costs for every possible mother-child pairing. Savings per birth in a targeted screening program are $1,314, and with universal screening, $105 per birth. At current screening costs, universal screening results in $420 million in lifetime savings per birth-year cohort. We found that a congenital Chagas screening program in the United States is cost saving for all rates of congenital transmission greater than 0.001% and all levels of maternal prevalence greater than 0.06% compared with no screening program.


Assuntos
Doença de Chagas/congênito , Programas de Rastreamento/economia , Nitroimidazóis/uso terapêutico , Complicações Parasitárias na Gravidez/tratamento farmacológico , Tripanossomicidas/uso terapêutico , Doença de Chagas/complicações , Doença de Chagas/tratamento farmacológico , Doença de Chagas/epidemiologia , Redução de Custos/economia , Redução de Custos/métodos , Redução de Custos/estatística & dados numéricos , Análise Custo-Benefício , Feminino , Humanos , Transmissão Vertical de Doença Infecciosa/economia , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Programas de Rastreamento/métodos , Nitroimidazóis/economia , Gravidez , Complicações Parasitárias na Gravidez/diagnóstico , Complicações Parasitárias na Gravidez/economia , Tripanossomicidas/economia , Estados Unidos/epidemiologia
13.
Clin Immunol ; 212: 108346, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31954803

RESUMO

Previous studies showed that circulating autoantibodies against M2 muscarinic receptors (anti-M2R Ab) are associated with decreased cardiac parasympathetic modulation in patients with chronic Chagas disease (CD). Here we investigated whether the exposure of M2R to such antibodies could impair agonist-induced receptor activation, leading to the inhibition of associated signaling pathways. Preincubation of M2R-expressing HEK 293T cells with serum IgG fractions from chagasic patients with cardiovascular dysautonomia, followed by the addition of carbachol, resulted in the attenuation of agonist-induced Gi protein activation and arrestin-2 recruitment. These effects were not mimicked by the corresponding Fab fractions, suggesting that they occur through receptor crosslinking. IgG autoantibodies did not enhance M2R/arrestin interaction or promote M2R internalization, suggesting that their inhibitory effects are not likely a result of short-term receptor regulation. Rather, these immunoglobulins could function as negative allosteric modulators of acetylcholine-mediated responses, thereby contributing to the development of parasympathetic dysfunction in patients with CD.


Assuntos
Autoanticorpos/imunologia , Doenças do Sistema Nervoso Autônomo/imunologia , Doença de Chagas/imunologia , Receptor Muscarínico M2/imunologia , Adulto , Idoso , Regulação Alostérica , Autoanticorpos/metabolismo , Autoanticorpos/farmacologia , Doenças do Sistema Nervoso Autônomo/etiologia , Doenças do Sistema Nervoso Autônomo/metabolismo , Doenças do Sistema Nervoso Autônomo/fisiopatologia , Carbacol/farmacologia , Doença de Chagas/complicações , Doença de Chagas/metabolismo , Doença de Chagas/fisiopatologia , Agonistas Colinérgicos/farmacologia , Feminino , Subunidades alfa Gi-Go de Proteínas de Ligação ao GTP/metabolismo , Subunidades alfa Gq-G11 de Proteínas de Ligação ao GTP/metabolismo , Células HEK293 , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Receptor Muscarínico M2/efeitos dos fármacos , Receptor Muscarínico M2/metabolismo , beta-Arrestina 1/metabolismo
14.
Arq Bras Cardiol ; 115(6): 1051-1060, 2020 12.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33470300

RESUMO

BACKGROUND: In Chagas' disease endemic regions, there has been for many years a recurrent empirical observation that coronary artery disease (CAD) is uncommon in patients with Chagas' disease. Previous pathological and invasive coronary angiography studies led to controversial results. OBJECTIVE: We sought to investigate whether CAD is less prevalent and less severe in patients with chronic Chagas' disease when compared with a matched population with a similar CAD risk profile. METHODS: A total of 86 participants, 43 consecutive patients with chronic Chagas' disease and 43 asymptomatic individuals, without any prior history of cardiac disease or known CAD (control group), were included. Patients and controls were matched according to gender, age, and Framingham risk score. All participants underwent coronary calcium scoring and coronary computed tomography angiography on a 320-row detector scanner. Statistical significance level adopted was p < 0.05. RESULTS: The coronary artery calcium score (CACS) was significantly lower in patients with Chagas' disease than in controls (p<0.05). The presence of coronary atherosclerotic plaques was significantly less frequent in patients with Chagas' disease than in controls (20.9% versus 41.9%, p=0.037). After adjustment for the Framingham score, the odds ratio for the presence of any coronary artery calcium (CAC) in Chagas patients was 0.26 (95%CI: 0.07-0.99, p=0.048). The pattern is similar for CACS > 10 (OR: 0.11, 95%CI: 0.01-0.87, p=0.04) and for the presence of any stenosis (OR: 0.06, 95%CI: 0.01-0.47, p=0.001). Propensity score matching also indicated an effect of Chagas disease on the CACS (-21.6 points in the absolute score and 25% less of patients with CACS >10, p=0.015). CONCLUSIONS: CAD is less prevalent and less severe in patients with chronic Chagas' disease when compared with a matched population with a similar CAD risk profile. (Arq Bras Cardiol. 2020; 115(6):1051-1060).


Assuntos
Doença de Chagas , Doença da Artéria Coronariana , Doença de Chagas/complicações , Doença de Chagas/diagnóstico por imagem , Doença de Chagas/epidemiologia , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/etiologia , Humanos , Valor Preditivo dos Testes , Prevalência , Fatores de Risco
17.
Sci Rep ; 9(1): 18885, 2019 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-31827186

RESUMO

We evaluated the influence of metabolic syndrome (MS) on acute Trypanosoma cruzi infection. Obese Swiss mice, 70 days of age, were subjected to intraperitoneal infection with 5 × 102 trypomastigotes of the Y strain. Cardiovascular, oxidative, inflammatory, and metabolic parameters were evaluated in infected and non-infected mice. We observed higher parasitaemia in the infected obese group (IOG) than in the infected control group (ICG) 13 and 15 days post-infection. All IOG animals died by 19 days post-infection (dpi), whereas 87.5% of the ICG survived to 30 days. Increased plasma nitrite levels in adipose tissue and the aorta were observed in the IOG. Higher INF-γ and MCP-1 concentrations and lower IL-10 concentrations were observed in the IOG compared to those in the ICG. Decreased insulin sensitivity was observed in obese animals, which was accentuated after infection. Higher parasitic loads were found in adipose and hepatic tissue, and increases in oxidative stress in cardiac, hepatic, and adipose tissues were characteristics of the IOG group. Thus, MS exacerbates experimental Chagas disease, resulting in greater damage and decreased survival in infected animals, and might be a warning sign that MS can influence other pathologies.


Assuntos
Tecido Adiposo/metabolismo , Doença de Chagas/metabolismo , Inflamação/metabolismo , Fígado/metabolismo , Síndrome Metabólica/metabolismo , Miocárdio/metabolismo , Estresse Oxidativo/fisiologia , Tecido Adiposo/patologia , Animais , Doença de Chagas/complicações , Doença de Chagas/patologia , Citocinas/sangue , Modelos Animais de Doenças , Fígado Gorduroso/metabolismo , Fígado Gorduroso/patologia , Inflamação/complicações , Inflamação/patologia , Resistência à Insulina/fisiologia , Fígado/patologia , Masculino , Síndrome Metabólica/complicações , Síndrome Metabólica/patologia , Camundongos , Miocárdio/patologia , Trypanosoma cruzi
18.
Sci Rep ; 9(1): 17539, 2019 11 26.
Artigo em Inglês | MEDLINE | ID: mdl-31772338

RESUMO

Some reports suggest that exposure to organophosphorus (OP) pesticides increases the incidence of infections. Ethylated dialkylphosphates (EtDAPs) are metabolites of OP pesticides widely distributed with immunomodulatory potential. Chagas disease is produced by Trypanosoma cruzi parasites, and resolution of this infection requires the activation of inflammatory macrophages (MΦ), which results in cardiac fibrosis. Some reports indicate that EtDAPs increase the amount of the anti-inflammatory alternatively activated MΦ (M2; CD206+F4/80+). Therefore, we analyzed the course of T. cruzi infection, MΦ profiles from peritoneal exudate cells (PECs), inflammatory cell infiltration and fibrosis in the heart of BALB/c mice exposed to diethyldithiophosphate (DEDTP), diethylthiophosphate (DETP) or diethylphosphate (DEP, 0.01 g/kg), common DAPs produced by OP pesticides, 24 h before infection with T. cruzi. We found that DEDTP increased the parasite burden in blood by 99% at the peak of the infection and enhanced the myocardial damage due to an increase in infiltrated inflammatory cells (induced by DEDTP or DETP) and fibrosis (induced by EtDAPs). In the PECs, exposure to EtDAPs increased the proportion of the MΦ subpopulations of M2a, M2b and M2d, which are associated with tissue repair. These results indicate that exposure to EtDAPs can exacerbate the acute phase of a parasitic infection and increase the long-term damage to the heart.


Assuntos
Cardiomiopatia Chagásica/complicações , Compostos Organofosforados/efeitos adversos , Praguicidas/efeitos adversos , Animais , Cardiomiopatia Chagásica/induzido quimicamente , Doença de Chagas/complicações , Modelos Animais de Doenças , Exposição Ambiental/efeitos adversos , Feminino , Fibrose , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Miocárdio/patologia , Intoxicação por Organofosfatos/complicações , Intoxicação por Organofosfatos/patologia , Organofosfatos/efeitos adversos , Organotiofosfatos/efeitos adversos , Pirrolidinas/efeitos adversos
19.
BMC Infect Dis ; 19(1): 956, 2019 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-31706289

RESUMO

BACKGROUND: Current available treatments (benznidazole and nifurtimox) for Chagas disease (CD) show limited efficacy in chronic phase and frequent undesirable effects. Ergosterol synthesis inhibitors (ESI) had been considered as promising drugs for CD treatment and despite its recent poor results in several clinical trials, different strategies have been proposed to optimize its role in this infection. CASE PRESENTATION: We present a case of chronic Chagas disease in patient diagnosed with HIV who received treatment for histoplasmosis with itraconazol during twelve months. Even though T. cruzi rt-PCR was persistently negative during treatment, when itraconazol was stopped she presented with a positive blood rt-PCR. CONCLUSION: Several studies using different ESI had been published for CD treatment. Either in vitro or in vivo assays demonstrated activity against T. cruzi of the different triazole derivatives so different clinical trials had been carried out to evaluate its efficacy and safety. Despite contradictory evidence in the animal model, longer treatments along with other treatment strategies previously proposed suggests that ESI failure rates in positive peripheral blood rt-PCR are higher than that obtained with the current treatments of choice.


Assuntos
Doença de Chagas/tratamento farmacológico , Itraconazol/uso terapêutico , Tripanossomicidas/uso terapêutico , Adulto , Animais , Contagem de Linfócito CD4 , Doença de Chagas/complicações , Doença Crônica , Feminino , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Humanos , Itraconazol/farmacologia , Tomografia Computadorizada por Raios X , Tripanossomicidas/farmacologia , Trypanosoma cruzi/efeitos dos fármacos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...