title: Molecular mechanisms of myocarditis caused by Trypanosoma cruzi.
abstract: OBJECTIVE
  American trypanosomiasis, or Chagas disease, is a lifelong and persistent infection caused by the protozoan Trypanosoma cruzi and is the most significant cause of morbidity and mortality in South and Central America. Owing to immigration and additional risks from blood transfusion and organ transplantation, the number of reported cases of Chagas disease has increased recently in Europe and the USA. The disease is caused by a moderate to intense lasting inflammatory response that triggers local expression of inflammatory mediators and activates and recruits leukocytes to various tissues to eliminate the parasites.
  
  
  RESULTS
  This long-term inflammatory process triggers biochemical, physiological and morphological alterations and clinical changes in the digestive, nervous and cardiac (e.g. myocarditis, arrhythmias, congestive heart failure, autonomic dysfunctions and microcirculatory disturbances) systems. Indeed, the pathogenesis of Chagas disease is intricate and multifactorial, and the roles of the parasite and the immune response in initiating and maintaining the disease are still controversial.
  
  
  CONCLUSIONS
  In this review, we discuss the current knowledge of 'strategies' employed by the parasite to persist in the host and host defence mechanisms against Trypanosoma cruzi infection, which can result in equilibrium (absence of the disease) or disease development, mainly in the cardiac systems.
authors.affiliation: aDepartment of Biochemistry and Immunology bInstitute of Biological Sciences and Program in Health Sciences: Infectious Diseases and Tropical Medicine, Medical School, Federal University of Minas Gerais, Belo Horizonte cDepartment of Biological Sciences and Center for Research in Biological Science (NUPEB), Federal University of Ouro Preto, Minas Gerais, Brazil.
authors.forename: Lísia
authors.initials: L
authors.lastname: Esper
authors.forename: André
authors.initials: A
authors.lastname: Talvani
authors.forename: Pollyana
authors.initials: P
authors.lastname: Pimentel
authors.forename: Mauro M
authors.initials: MM
authors.lastname: Teixeira
authors.forename: Fabiana S
authors.initials: FS
authors.lastname: Machado
mesh_terms: D000913:Antibodies, Protozoan / Q000097:blood; D015551:Autoimmunity; D014355:Chagas Disease / Q000276:immunology / Q000469:parasitology / Q000473:pathology / Q000503:physiopathology*; D006321:Heart / Q000469:parasitology; D006790:Host-Parasite Interactions; D006801:Humans; D007249:Inflammation / Q000469:parasitology*; D009206:Myocardium / Q000473:pathology*; D014344:Trypanocidal Agents / Q000627:therapeutic use*; D014349:Trypanosoma cruzi / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D000913:Antibodies, Protozoan; D014344:Trypanocidal Agents