Assessment of cross-reactive host-pathogen antibodies in patients with different stages of chronic Chagas disease.
OBJECTIVE
Trypanosoma cruzi infection has been shown to induce humoral autoimmune responses against host antigens tissues. Particularly, antibodies cross-reacting with myocardial antigens may play a role in the development of the severe forms of chronic Chagas disease. The aim of this study was to determine the association between clinical stage of the disease and the presence of autoantibodies in patients with chronic Chagasic disease.


METHODS
We performed a cross-sectional study in T. cruzi-seropositive patients divided into 3 groups according to the classic classification of chronic Chagas heart of Storino et al. All participants underwent complete clinical examination and their sera were used to measure autoantibody levels.


RESULTS
All patients had detectable levels of anti-p2β and anti-B13 autoantibodies but none had anti-Na-K-ATPase antibodies. No association was observed between electrocardiographic conduction disturbances and autoantibody levels. Patients with chronic Chagas disease stage III had the highest levels of anti-B13 antibodies and a high risk of mortality score, showing a clear association between disease stage and this score.


CONCLUSIONS
Anti-B13 antibodies were significantly higher in chronic Chagas disease stage III patients, suggesting that these antibodies may be involved in disease progression and that they might be a useful marker of poor prognosis in terms of heart compromise. Our results also reveal an important correlation between the level of anti-B13 autoantibodies and symptomatic heart failure and/or dilated cardiomyopathy.
Laboratorio de Tecnología Inmunológica, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina; Servicio de Clínica Médica, Hospital J.B. Iturraspe, Santa Fe, Argentina. Electronic address: mvicco@santafe-conicet.gov.ar.
Miguel H
MH
Vicco
Servicio de Clínica Médica, Hospital J.B. Iturraspe, Santa Fe, Argentina.
Franco
F
Ferini
Servicio de Clínica Médica, Hospital J.B. Iturraspe, Santa Fe, Argentina.
Luz
L
Rodeles
Laboratorio de Tecnología Inmunológica, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina.
Paula
P
Cardona
Laboratorio de Tecnología Inmunológica, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina.
Iván
I
Bontempi
Cátedra de Química Analítica Clínica, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Santa Fe, Argentina.
Susana
S
Lioi
Servicio de Cardiología, Hospital Provincial del Centenario, Carrera de Especialización en Cardiología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe, Argentina.
Juan
J
Beloscar
Departamento de Parasitología Celular y Molecular, Escuela de Medicina, Universidad de Juntendo, Tokyo, Japan.
Takeshi
T
Nara
Laboratorio de Tecnología Inmunológica, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina.
Iván
I
Marcipar
Instituto de Inmunología, Facultad de Medicina, Universidad Nacional de Rosario, Santa Fe, Argentina.
Oscar A
OA
Bottasso
D000328:Adult; D000368:Aged; D000913:Antibodies, Protozoan / Q000276:immunology; D001323:Autoantibodies / Q000032:analysis / Q000276:immunology*; D002598:Chagas Cardiomyopathy / Q000000981:diagnostic imaging / Q000276:immunology* / Q000401:mortality* / Q000503:physiopathology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D018450:Disease Progression; D015150:Echocardiography, Doppler / Q000379:methods; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D054884:Host-Pathogen Interactions / Q000276:immunology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D014349:Trypanosoma cruzi / Q000276:immunology*
D000913:Antibodies, Protozoan; D001323:Autoantibodies
Anti-B13 autoantibodies; Autoanticuerpos anti-B13; CCD; Chagas disease; Enfermedad de Chagas; Heart failure; IODN; Insuficiencia cardiaca; Trypanosoma cruzi; chronic Chagas disease; index of the optical density of autoantibodies in relation to the negative control