title: Immunity and immune modulation in Trypanosoma cruzi infection.
abstract: Chagas disease is caused by the protozoan Trypanosoma cruzi. The parasite reaches the secondary lymphoid organs, the heart, skeletal muscles, neurons in the intestine and esophagus among other tissues. The disease is characterized by mega syndromes, which may affect the esophagus, the colon and the heart, in about 30% of infected people. The clinical manifestations associated with T. cruzi infection during the chronic phase of the disease are dependent on complex interactions between the parasite and the host tissues, particularly the lymphoid system that may either result in a balanced relationship with no disease or in an unbalanced relationship that follows an inflammatory response to parasite antigens and associated tissues in some of the host organs and/or by an autoimmune response to host antigens. This review discusses the findings that support the notion of an integrated immune response, considering the innate and adaptive arms of the immune system in the control of parasite numbers and also the mechanisms proposed to regulate the immune response in order to tolerate the remaining parasite load, during the chronic phase of infection. This knowledge is fundamental to the understanding of the disease progression and is essential for the development of novel therapies and vaccine strategies.
authors.affiliation: Oswaldo Cruz Foundation, Bahia, Rua Waldemar Falcão 121, Salvador 40295-001, Brazil.
authors.forename: Fabíola
authors.initials: F
authors.lastname: Cardillo
authors.affiliation: Laboratório de Imunologia Clínica, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil.
authors.forename: Rosa Teixeira
authors.initials: RT
authors.lastname: de Pinho
authors.affiliation: Laboratório de Imunologia Clínica, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil.
authors.forename: Paulo Renato Zuquim
authors.initials: PR
authors.lastname: Antas
authors.affiliation: Laboratório de Imunologia Clínica, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil Faculty of Medicine of Petropolis, FMP-FASE, 25680-120, Petrópolis, Rio de Janeiro, Brazil jomengel@fiocruz.br.
authors.forename: José
authors.initials: J
authors.lastname: Mengel
mesh_terms: D056704:Adaptive Immunity; D000818:Animals; D014355:Chagas Disease / Q000276:immunology* / Q000473:pathology*; D054884:Host-Pathogen Interactions; D006801:Humans; D057131:Immune Evasion; D007108:Immune Tolerance; D007113:Immunity, Innate; D014349:Trypanosoma cruzi / Q000276:immunology* / Q000472:pathogenicity
keywords: Trypanosoma cruzi; gamma delta T cell; interleukin-17; memory T cell; myeloid-derived suppressor cell (MDSC); regulatory T cell