Antigenuria in infants with acute and congenital Chagas' disease

Abstract

Detection and partial characterization of Trypanosoma cruzi soluble antigens (SAg) in urine, as well as demonstration of parasite circulating antigens (CAg) in serum from pediatric patients with acute (10 patients) and congenital (10 patients) Chagas' disease, are reported. Classical techniques for parasite detection and antibody serology were also conducted in both groups. Samples collected before the onset of parasiticidal drug treatment were tested by an enzyme-linked immunosorbent assay for SAg and CAg demonstration. The control population consisted of 6 children with acute toxoplasmosis, 6 with cutaneous leishmaniasis, and 20 healthy individuals. Patients with acute cases were 100% positive for both SAg and CAg, whereas patients with congenital disease were 80% CAg positive and 100% SAg positive. Controls yielded negative results in all cases. Partial characterization of SAg from two patients with acute disease was performed by iodination, affinity chromatography, immunoprecipitation, and two-dimensional gel electrophoresis. Two different antigenic glycoproteins (80 kilodaltons, pI 6 to 6.5 and 55 kilodaltons, pI 6.5 to 7) were identified by these methods. Traditional serology and classical parasitologic tests failed, each in a different way, to provide an accurate diagnosis in the total of our patients. The enzyme-linked immunosorbent assay for SAg detection proved to be the most effective procedure for achieving early and precise proof of infection in acute and congenital cases of Chagas' disease.

Noninvasive Biological Samples to Detect and Diagnose Infections due to Trypanosomatidae Parasites: A Systematic Review and Meta-Analysis

“…The crossing of T. cruzi to urine in experimentally infected mice is apparently independent of renal injuries [189]. The presence of DNA in urine is associated with the presence of parasite DNA in blood and heart and with a high level of parasite DNA in blood, but not with the presence of parasites in kidney or kidney injury [189][190][191]. The detection of antigens within the urine of patients suffering from acute [192] or chronic CD [193] has opened up some new innovative approaches for diagnosis.…”

Chagas' disease.

“…The utility of parasite antigen detection in urine has also been studied. It has been demonstrated that T. cruzi antigens can readily be detected in urine from patients with acute Chagas' disease (87), but more recent work suggests that this method will not be useful for diagnosis of patients with chronic T. cruzi infection (116).…”

Detection of antibodies in sera from Chagas' disease patients using a Trypanosoma cruzi immunodominant recombinant antigen

“…Out of the 147 chronic chagasic patients, 26 presented clinical symptoms of cardiac disease, two showed gastrointestinal lesions and 14 patients were in the indeterminate phase of the disease. Acute and congenital chagasic sera (n=76) were obtained from patients with patent parasitaemia and clinical manifestations of acute infection detected 15 to 80 days before blood collection (Luquetti et al 1986, Freilij et al 1987. These sera were also collected before treatment.…”