title: Chronic Chagas' disease cardiomyopathy patients display an increased IFN-gamma response to Trypanosoma cruzi infection.
abstract: One-third of all Trypanosoma cruzi -infected patients eventually develop chronic Chagas' disease cardiomyopathy (CCC), a particularly lethal inflammatory dilated cardiomyopathy, where parasites are scarce and heart-infiltrating mononuclear cells seem to be the effectors of tissue damage. Since T. cruzi is a major inducer of interleukin-12 production, the role of inflammatory cytokines in the pathogenesis of CCC was investigated. We assayed cytokine production by peripheral blood mononuclear cells (PBMC) from CCC and asymptomatic T. cruzi -infected (ASY) individuals, as well as by T cell lines from endomyocardial biopsies from CCC patients. PBMC from CCC and ASY patients produced higher IFN-gamma levels than normal (N) individuals in response to B13 protein and phytohaemagglutinin PHA; IFN-gamma high responders (> or =1 ng/ml) were 2-3 fold more frequent among CCC patients than ASY individuals. Conversely, IL-4 production in response to the same stimuli was suppressed among T. cruzi -infected patients. The frequency of PHA-induced IFN gammaproducing cells on PBMC was significantly higher among CCC than ASY and N individuals. IFN-gamma and TNF-alpha were produced by ten out of ten PHAstimulated T cell lines from CCC patients; IL-2 and IL-10 were produced by four out of ten and one out of ten lines, respectively; IL-4, IL-1alpha, IL-1beta, IL-6 and IL-12 were undetectable. Our results suggest that CCC and ASY patients may respond differentially to the IFN-gamma-inducing stimulus provided by T. cruzi infection. Given the T(1)-type cytokine profile of heart-infiltrating T cell lines from CCC patients, the ability to mount a vigorous IFN-gamma response may play a role on the differential susceptibility to CCC development.
authors.affiliation: Laboratory of Immunology, Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: L C
authors.initials: LC
authors.lastname: Abel
authors.forename: L V
authors.initials: LV
authors.lastname: Rizzo
authors.forename: B
authors.initials: B
authors.lastname: Ianni
authors.forename: F
authors.initials: F
authors.lastname: Albuquerque
authors.forename: F
authors.initials: F
authors.lastname: Bacal
authors.forename: D
authors.initials: D
authors.lastname: Carrara
authors.forename: E A
authors.initials: EA
authors.lastname: Bocchi
authors.forename: H C
authors.initials: HC
authors.lastname: Teixeira
authors.forename: C
authors.initials: C
authors.lastname: Mady
authors.forename: J
authors.initials: J
authors.lastname: Kalil
authors.forename: E
authors.initials: E
authors.lastname: Cunha-Neto
mesh_terms: D000328:Adult; D000818:Animals; D002460:Cell Line; D002465:Cell Movement / Q000276:immunology; D002598:Chagas Cardiomyopathy / Q000276:immunology* / Q000473:pathology; D002908:Chronic Disease; D016207:Cytokines / Q000096:biosynthesis; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000276:immunology / Q000473:pathology; D018417:Th1 Cells / Q000276:immunology / Q000378:metabolism; D018418:Th2 Cells / Q000276:immunology / Q000378:metabolism; D014349:Trypanosoma cruzi / Q000276:immunology*
chemical_list: D016207:Cytokines; D007371:Interferon-gamma