title: Congenital Chagas disease as an ecological model of interactions between Trypanosoma cruzi parasites, pregnant women, placenta and fetuses.
abstract: The aim of this paper is to discuss the main ecological interactions between the parasite Trypanosoma cruzi and its hosts, the mother and the fetus, leading to the transmission and development of congenital Chagas disease. One or several infecting strains of T. cruzi (with specific features) interact with: (i) the immune system of a pregnant woman whom responses depend on genetic and environmental factors, (ii) the placenta harboring its own defenses, and, finally, (iii) the fetal immune system displaying responses also susceptible to be modulated by maternal and environmental factors, as well as his own genetic background which is different from her mother. The severity of congenital Chagas disease depends on the magnitude of such final responses. The paper is mainly based on human data, but integrates also complementary observations obtained in experimental infections. It also focuses on important gaps in our knowledge of this congenital infection, such as the role of parasite diversity vs host genetic factors, as well as that of the maternal and placental microbiomes and the microbiome acquisition by infant in the control of infection. Investigations on these topics are needed in order to improve the programs aiming to diagnose, manage and control congenital Chagas disease.
authors: Laboratoire de Parasitologie, Faculté de Médecine, Université Libre de Bruxelles (ULB), CP 616, Route de Lennik 808, 1070 Bruxelles, Belgium; Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University, Suite 2210, 1440 Canal Street, New Orleans, LA 70112-2797, USA. Electronic address: ycarlier@ulb.ac.be.
authors: Yves
authors: Y
authors: Carlier
authors: Laboratoire de Parasitologie, Faculté de Médecine, Université Libre de Bruxelles (ULB), CP 616, Route de Lennik 808, 1070 Bruxelles, Belgium. Electronic address: ctruyens@ulb.ac.be.
authors: Carine
authors: C
authors: Truyens
mesh_terms: D000328:Adult; D000818:Animals; D014355:Chagas Disease / Q000151:congenital* / Q000276:immunology* / Q000469:parasitology / Q000635:transmission; D003141:Communicable Diseases / Q000276:immunology / Q000635:transmission; D004463:Ecology; D005260:Female; D005333:Fetus / Q000276:immunology / Q000469:parasitology*; D006790:Host-Parasite Interactions / Q000235:genetics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008875:Middle Aged; D010920:Placenta / Q000276:immunology / Q000469:parasitology*; D011247:Pregnancy; D037841:Pregnant People; D014349:Trypanosoma cruzi / Q000276:immunology / Q000469:parasitology*; D055815:Young Adult
keywords: Congenital Chagas disease; Congenital T. cruzi infection; Maternal and fetal/neonatal immune responses; Maternal–fetal transmission; Placenta; Trypanosoma cruzi