Inflammatory and prothrombotic activation with conserved endothelial function in patients with chronic, asymptomatic Chagas disease.
Previously, our group showed a prothrombotic state in asymptomatic patients with chronic Chagas disease. The current paper studies the inflammatory status and endothelial function in these patients.


METHODS
In 40 patients and 40 healthy volunteers, we evaluated prothrombotic state, blood parasitemia (molecular biology: polymerized chain reaction [PCR]-amplification), tissue factor pathway inhibitor antibodies (aTFPI), interleukin 6 (IL-6), and vascular cell adhesion molecule-1 (VCAM-1). Endothelial function was determined by reactive hyperemia (pulse plethysmography).


RESULTS
In patients, prothrombin fragment 1 + 2, d-dimer, PAI-1, and fibrinogen were higher. Amplification of 121/122 primers (Trypanosoma cruzi) was positive in 45% of the patients. Patients presented higher values of aTFPI- immunoglobulin G (IgG; P < .05), aTFPI-IgM (P < .001), IL-6 (P = .004), and VCAM-1 (P = .00001). In both groups, endothelial function was preserved.


CONCLUSIONS
We found that asymptomatic patients with chronic Chagas disease presented a prothrombotic/inflammatory status. The fact that endothelial function is still preserved suggests that prothrombosis and inflammation are primarily implicated in the beginning of cardiovascular damage.
Herrera
Ramón N
RN
Haemostasis and Thrombosis Department, Zenón J. Santillán Hospital Health Center, Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina.
Díaz de Amaya
Elba I
EI
Pérez Aguilar
Rossana C
RC
Joo Turoni
Claudio
C
Marañón
Rodrigo
R
Berman
Sofía G
SG
Luciardi
Héctor L
HL
Coviello
Alfredo
A
Peral de Bruno
María
M
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D014355:Chagas Disease / Q000097:blood* / Q000150:complications / Q000469:parasitology; D002908:Chronic Disease; D004730:Endothelium, Vascular / Q000378:metabolism / Q000469:parasitology; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D006940:Hyperemia / Q000097:blood* / Q000469:parasitology; D007249:Inflammation / Q000097:blood / Q000469:parasitology; D015850:Interleukin-6 / Q000097:blood; D008074:Lipoproteins / Q000097:blood; D008297:Male; D018512:Parasitemia; D010446:Peptide Fragments / Q000097:blood*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011516:Prothrombin; D013927:Thrombosis / Q000097:blood / Q000209:etiology / Q000469:parasitology; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D001323:Autoantibodies; D005338:Fibrin Fibrinogen Degradation Products; C508600:IL6 protein, human; D015850:Interleukin-6; D008074:Lipoproteins; D010446:Peptide Fragments; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D019010:Vascular Cell Adhesion Molecule-1; C036309:fibrin fragment D; C051928:lipoprotein-associated coagulation inhibitor; C045879:prothrombin fragment 1.2; D011516:Prothrombin