title: Treatment Success in Trypanosoma cruzi Infection Is Predicted by Early Changes in Serially Monitored Parasite-Specific T and B Cell Responses.
abstract: BACKGROUND
  Chagas disease is the highest impact parasitic disease in Latin America. We have proposed that changes in Trypanosoma cruzi-specific immune responses might serve as surrogate indicators of treatment success. Herein, we addressed in a long-term follow-up study whether cure achieved after treatment can be predicted by changes in non-conventional indexes of anti-parasite serological and T cell activities.
  
  
  RESULTS
  T. cruzi-specific T cell responses, as measured by interferon-γ ELISPOT and T. cruzi-specific antibodies assessed by ELISA, hemagglutination and immunofluorescence tests as well as by a multiplex assay incorporating 14 recombinant T. cruzi proteins were measured in 33 patients at 48-150 months post-benznidazole treatment. Cure - as assessed by conventional serological tests - was associated with an early decline in T. cruzi-specific IFN-γ-producing T cells and in antibody titers measured by the multiplex serological assay. Changes in the functional status and potential of T. cruzi-specific T cells, indicative of reduced antigen stimulation, provided further evidence of parasitological cure following benznidazole treatment. Patients showing a significant reduction in T. cruzi-specific antibodies had higher pre-therapy levels of T. cruzi-specific IFN-γ- producing T cells compared to those with unaltered humoral responses post-treatment.
  
  
  CONCLUSIONS
  Monitoring of appropriate immunological responses can provide earlier and robust measures of treatment success in T. cruzi infection.
authors.affiliation: Hospital Interzonal General de Agudos Eva Perón, Buenos Aires, Argentina.
authors.forename: María G
authors.initials: MG
authors.lastname: Alvarez
authors.affiliation: Hospital Interzonal General de Agudos Eva Perón, Buenos Aires, Argentina.
authors.forename: Graciela L
authors.initials: GL
authors.lastname: Bertocchi
authors.affiliation: Center for Tropical and Emerging Global Diseases, Athens, Georgia, United States of America.
authors.forename: Gretchen
authors.initials: G
authors.lastname: Cooley
authors.affiliation: Instituto Nacional de Parasitología Dr. Mario Fatala Chaben, Buenos Aires, Argentina.
authors.forename: María C
authors.initials: MC
authors.lastname: Albareda
authors.affiliation: Hospital Interzonal General de Agudos Eva Perón, Buenos Aires, Argentina.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Viotti
authors.affiliation: Instituto Nacional de Parasitología Dr. Mario Fatala Chaben, Buenos Aires, Argentina.
authors.forename: Damián E
authors.initials: DE
authors.lastname: Perez-Mazliah
authors.affiliation: Hospital Interzonal General de Agudos Eva Perón, Buenos Aires, Argentina.
authors.forename: Bruno
authors.initials: B
authors.lastname: Lococo
authors.affiliation: Instituto Nacional de Parasitología Dr. Mario Fatala Chaben, Buenos Aires, Argentina.
authors.forename: Melisa
authors.initials: M
authors.lastname: Castro Eiro
authors.affiliation: Hospital Interzonal General de Agudos Eva Perón, Buenos Aires, Argentina.|Instituto Nacional de Parasitología Dr. Mario Fatala Chaben, Buenos Aires, Argentina.
authors.forename: Susana A
authors.initials: SA
authors.lastname: Laucella
authors.affiliation: Center for Tropical and Emerging Global Diseases, Athens, Georgia, United States of America.
authors.forename: Rick L
authors.initials: RL
authors.lastname: Tarleton
mesh_terms: D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood; D001402:B-Lymphocytes / Q000276:immunology*; D014355:Chagas Disease / Q000188:drug therapy* / Q000276:immunology; D016903:Drug Monitoring / Q000379:methods*; D058501:Enzyme-Linked Immunospot Assay; D005500:Follow-Up Studies; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D008875:Middle Aged; D009593:Nitroimidazoles / Q000627:therapeutic use*; D011379:Prognosis; D013601:T-Lymphocytes / Q000276:immunology*; D016896:Treatment Outcome; D014349:Trypanosoma cruzi / Q000276:immunology*; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D009593:Nitroimidazoles; D007371:Interferon-gamma; C009999:benzonidazole