title: Chagas disease reactivation in HIV-coinfected patients: histopathological aspects.
abstract: BACKGROUND
  Chagas disease reactivation has been described in severely immunocompromised patients by various etiologies, including in HIV-coinfected patients.
  
  
  OBJECTIVE
  This study aimed to perform histopathological and immunohistochemical evaluation of the brain, myocardium, esophagus and large bowel of autopsied patients with CHD and/or acquired immunodeficiency syndrome in comparison with control patients.
  
  
  METHODS
  Autopsy reports were reviewed from 1998 to 2012 and eight adult subjects were selected and divided into four groups: RE, CH, AI and CO. Sections of brain, myocardium, esophagus and large bowel were collected from each subject and processed for histological and immunohistochemical analysis. The histological sections stained with HE, Giemsa and picrosirius were used to quantify the density of inflammatory cells, the density of mast cells, and the percentage of collagen, respectively. Immunohistochemical analysis of IL17 and CD31 was performed.
  
  
  RESULTS
  The density of mast cells in the myocardium was significantly higher in the CH group than in the other groups. The density of mast cells in the esophagus and in the large bowel was significantly higher when compared to the other groups. The percentage of collagen in the esophagus, myocardium and large bowel was significantly lower in the RE group than in the CO group. The CH group had a higher percentage of collagen in the myocardium and in the large bowel in relation to the other groups. The density of cells immunostained with anti-IL17 was significantly higher in the large bowel and in the myocardium in the CH group than in the CO group. There was higher density of vessels immunostained with anti-CD31 in the myocardium and esophagus of the AI group than in the other groups. There were no significant correlations between the density of mast cells and percentage of collagen in the RE, CO, CH and AI groups.
  
  
  CONCLUSIONS
  Brain lesions observed in patients with CDR, as well as the higher density of cells immunostained with anti-IL17 at these sites, suggest that this cytokine was increasing local inflammation with subsequent tissue damage due to inflammation. Furthermore, the higher density of mast cells in the esophagus and large bowel of these subjects suggests that these cells might play a major role in esophageal and intestinal inflammation.
authors.affiliation: Laboratory of Biopathology and Molecular Biology, University of Uberaba, Uberaba, Brazil.
authors.forename: Cristina Menezes
authors.initials: CM
authors.lastname: Gattoni
authors.affiliation: Laboratory of Biopathology and Molecular Biology, University of Uberaba, Uberaba, Brazil.
authors.forename: Isadora Figueiredo
authors.initials: IF
authors.lastname: Aleixo
authors.affiliation: Federal University of Triangulo Mineiro, Uberaba, Brazil.
authors.forename: Márcia Fernandes
authors.initials: MF
authors.lastname: de Araujo
authors.affiliation: Federal University of Triangulo Mineiro, Uberaba, Brazil.
authors.forename: Vicente de Paula Antunes
authors.initials: Vde P
authors.lastname: Teixeira
authors.affiliation: Laboratory of Biopathology and Molecular Biology, University of Uberaba, Uberaba, Brazil; Cefores, Federal University of Triangulo Mineiro, Uberaba, Brazil.
authors.forename: Denise Bertulucci Rocha
authors.initials: DB
authors.lastname: Rodrigues
authors.affiliation: Laboratory of Biopathology and Molecular Biology, University of Uberaba, Uberaba, Brazil; Cefores, Federal University of Triangulo Mineiro, Uberaba, Brazil. Electronic address: sanivia.pereira@uniube.br.
authors.forename: Sanívia Aparecida de Lima
authors.initials: SA
authors.lastname: Pereira
mesh_terms: D000328:Adult; D000368:Aged; D001344:Autopsy; D001921:Brain / Q000276:immunology* / Q000473:pathology; D014355:Chagas Disease / Q000150:complications / Q000276:immunology* / Q000821:virology; D060085:Coinfection; D003094:Collagen / Q000378:metabolism; D004947:Esophagus / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006678:HIV / Q000276:immunology*; D015658:HIV Infections / Q000150:complications / Q000276:immunology* / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D020381:Interleukin-17 / Q000378:metabolism*; D007420:Intestine, Large / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008407:Mast Cells / Q000276:immunology*; D008875:Middle Aged; D009206:Myocardium / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D055815:Young Adult
chemical_list: D020381:Interleukin-17; D003094:Collagen
keywords: AIDS; Chagas disease; HIV; Immunohistochemical; Reactivation