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

PLoS Negl Trop Dis. 2017 Jul 19;11(7):e0005796. doi: 10.1371/journal.pntd.0005796. eCollection 2017 Jul.

Abstract

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.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Protozoan / blood*
  • Biomarkers / blood
  • Chagas Cardiomyopathy / pathology*
  • Chronic Disease
  • Disease Progression
  • Female
  • Humans
  • Immunoglobulin E / blood
  • Immunoglobulin G / blood
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Retrospective Studies
  • Trypanosoma cruzi / immunology*
  • Young Adult

Substances

  • Antibodies, Protozoan
  • Biomarkers
  • Immunoglobulin G
  • Immunoglobulin E

Grants and funding

This study was funded by regular annual grant provided by Fundação Oswaldo Cruz for the Laboratory of Immunology and Immunogenetics in Infectious Disease at Instituto Nacional de Infectologia Evandro Chagas. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.