title: Induction of cardiac autoimmunity in Chagas heart disease: a case for molecular mimicry.
abstract: Up to 18 million of individuals are infected by the protozoan parasite Trypanosoma cruzi in Latin America, one third of whom will develop chronic Chagas disease cardiomyopathy (CCC) up to 30 years after infection. Cardiomyocyte destruction is associated with a T cell-rich inflammatory infiltrate and fibrosis. The presence of such lesions in the relative scarcity of parasites in the heart, suggested that CCC might be due, in part, to a postinfectious autoimmune process. Over the last two decades, a significant amount of reports of autoimmune and molecular mimicry phenomena have been described in CCC. The authors will review the evidence in support of an autoimmune basis for CCC pathogenesis in humans and experimental animals, with a special emphasis on molecular mimicry as a fundamental mechanism of autoimmunity.
authors.affiliation: Heart Institute (InCor), Laboratory of Immunology, São Paulo, Brazil. edecunha@usp.br
authors.forename: Edecio
authors.initials: E
authors.lastname: Cunha-Neto
authors.forename: Angelina M
authors.initials: AM
authors.lastname: Bilate
authors.forename: Kenneth V
authors.initials: KV
authors.lastname: Hyland
authors.forename: Simone G
authors.initials: SG
authors.lastname: Fonseca
authors.forename: Jorge
authors.initials: J
authors.lastname: Kalil
authors.forename: David M
authors.initials: DM
authors.lastname: Engman
mesh_terms: D000818:Animals; D001327:Autoimmune Diseases; D002598:Chagas Cardiomyopathy / Q000276:immunology*; D006801:Humans; D018716:Molecular Mimicry / Q000276:immunology*