Chagas Cardiomyopathy in Latin America Review

Vieira, Jefferson L.; Távora, Fábio; Sobral, Maria Gyslane Vasconcelos; Filho, José Eurico de Vasconcelos; Almeida, Germana Porto Linhares; Fernandes, Juliana Rolim; Marinho, Laura Leite da Escóssia; Trompieri, Daniel Francisco de Mendonça; Neto, João David de Souza; Mejía, Juan Alberto Cosquillo

doi:10.1007/s11886-019-1095-y

Cited by 31 publications

(30 citation statements)

References 73 publications

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“…Assim, a natureza essencialmente arritmogênica da cardiopatia chagásica crônica e a evidência de que certos tipos de arritmias, sobretudo as arritmias ventriculares complexas, predispõem à morte súbita, motivam buscas por medidas profiláticas e terapêuticas, medicamentosas ou não, aumentando os custos de saúde pública para esta doença tão prevalente [17]. A relevância da cardiomiopatia chagásica crônica não se restringe apenas às áreas endêmicas, sendo um problema mundial diante das populações migrantes e da globalização [18]. Imigrantes infectados transferem a infecção por meio da transfusão de sangue ou doação de órgãos [19,20]…”

Section: Dentre As Causas De Ic a Doença De Chagas (Dc) Corresponde unclassified

Biomarcadores de perfil proteico em pacientes portadores de cardiomiopatia chagásica crônica pré-transplante cardíaco

Alencastro¹,

Wichrowski²,

Araújo³

2019

PIC

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A insuficiência cardíaca (IC) é uma síndrome clínica de alta prevalência, com altas taxas de mortalidade e morbidade, sendo a doença de Chagas (DC) a sua terceira maior causa no Brasil. Para insuficiência cardíaca refratária, o transplante cardíaco é reconhecido como opção curativa, na ausência de contraindicação. O prognóstico pós-transplante de IC pacientes por DC, porém, é pior do que outras causas e ainda não se sabe conhece bem o porquê e sua patogenicidade. O objetivo é identificar marcadores de perfil proteico plasmático e tecidual associados à patogênese da IC, com foco em DC. O método envolve coleta de amostras de plasma e miocárdio de pacientes de cardiomiopatia dilatada por DC (grupo patológico), por causa idiopática e isquêmica (controle positivo) e pacientes não doentes (controle negativo), cujos materiais são analisados por espectometria de massa, processados em bioinformática (PeaksX) e as informações finais cruzadas com bases de dados universais (UniProt/SWISS-PROT e UniProt/TrEMBL). A amostra contém 15 pacientes cujo perfil clínico-epidemiológico é de 21.4% de chagásicos, com idade média de 62,6 anos, 63,3% masculino, 50% em NYHA III e 85,7% com fração de ejeção de ventrículo esquerdo reduzida abaixo de 40%. Resultados iniciais do piloto indicam a presença de 119 proteínas na amostra de tecido e 47 na de plasma. Destas, 5 foram observadas em ambas: haptoglobina, cadeia beta e alfa de fibrinogênio, proteína ligante secretora de esperma do epidídimo e serotransferrina. A tarefa de identificação de proteínas foi cumprida, devendo ser continuada futuramente e permitindo pesquisas futuras para compreensão da função dessas cadeias na patogênese da IC por DC. Este trabalho é parte de um projeto maior em parceira com a Universidade de Brasília e o Instituto do Coração do Distrito Federal e terá continuidade de coletas e análises para aprofundamento

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Section: Dentre As Causas De Ic a Doença De Chagas (Dc) Corresponde unclassified

Biomarcadores de perfil proteico em pacientes portadores de cardiomiopatia chagásica crônica pré-transplante cardíaco

Alencastro¹,

Wichrowski²,

Araújo³

2019

PIC

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“…6) PWS patients with severe obesity are predisposed to have cor pulmonale, an alteration in the structure (e.g., hypertrophy or dilatation) and function of the right ventricle (RV) of the heart caused by a primary disorder of the respiratory system resulting in pulmonary hypertension. 7) Therefore, severe obesity is the most serious and most common problem contributing to morbidity and mortality in adults with PWS. 2) We describe a case of a 21-year-old PWS male with a life-threatening complication, cor pulmonale, due to marked obesity and OSA whose condition improved with multidisciplinary management, including weight reduction through calorie restriction, diuretics, respiratory support, skin care, and rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Tailored management of life-threatening complications related to severe obesity in a young adult with Prader-Willi syndrome

Kim¹,

Kim²,

Cho³

et al. 2022

Ann Pediatr Endocrinol Metab

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Prader-Willi syndrome (PWS) is characterized by hypotonia, distinctive facial features, hyperphagia, obesity, short stature, hypogonadism, mental retardation, and behavior problems.Uncontrolled hyperphagia can lead to dangerous food-seeking behavior with life-threatening obesity. Severe obesity is prone to obstructive sleep apnea (OSA) and can lead to cor pulmonale. This study reports on a case involving a 21-year-old man with PWS who developed OSA due to severe obesity, leading to cor pulmonale, a life-threatening complication. Multidisciplinary care provided in the intensive care unit included weight reduction, ventilation support, antipsychotics, sedative drugs, rehabilitation, and meticulous skin care. The patient did recover. To prevent severe obesity in adults with PWS, hyperphagia must be controlled and the patient must be managed by an endocrinologist throughout childhood.

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“…This stage has a very low parasite load only detected in specific organs, and whose severity depends on the time since infection, host immune status or genetic background [7]. It is characterised by parasites remaining within the muscles and the myocardium that evoke a chronic immune reaction related to death by a long-term heart condition called chronic chagasic cardiomyopathy [8], or severe gastrointestinal complications characterised by megacolon and/or megaesophagus [9].…”

Section: Introductionmentioning

confidence: 99%

Characterisation of Macrophage Polarisation in Mice Infected with Ninoa Strain of Trypanosoma cruzi

2021

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Macrophages (MΦ) play a key role in the development of the protective immune response against Trypanosoma cruzi infection. To determine the role of MΦ subtypes M1 and M2 in the development of immunity against the Mexican strain of T. cruzi (Ninoa strain), we have analysed in a time course the infection and characterised the M1 and M2 subtypes in two mouse models, BALB/c and C57BL/6. After infection, BALB/c mice developed an increased blood parasite load and the parasites were cleared from the blood one week later than in C57BL/6 mice. However, similar cellular infiltrate and cardiac alterations were observed between BALB/c and C57BL/6 mice. At 36 days, the T. cruzi infection differentially modulated the expression of immune cells, and both the BALB/c and C57BL/6 mice significantly reduced TCD4+ cells. However, BALB/c mice produced significantly more TCD8+ than C57BL/6 mice in the spleen and lymph nodes. Furthermore, BALB/c mice produce significantly more MΦ in the spleen, while C57BL/6 produce similar levels to uninfected mice. The M1 MΦ ratio increased significantly at 3–5 days post-infection (dpi), but then decreased slightly. On the contrary, the M2 MΦ were low at the beginning of the infection, but the proportion of M1 and M2 MΦ at 36 dpi was similar. Importantly, the MΦ subtypes M2c and M2d significantly increased the induction of tissue repair by the end of the acute phase of the infection. These results indicate that the Ninoa strain has developed strategies to modulate the immune response, with fine differences depending on the genetic background of the host.

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Chagas Cardiomyopathy in Latin America Review

Cited by 31 publications

References 73 publications

Biomarcadores de perfil proteico em pacientes portadores de cardiomiopatia chagásica crônica pré-transplante cardíaco

Biomarcadores de perfil proteico em pacientes portadores de cardiomiopatia chagásica crônica pré-transplante cardíaco

Tailored management of life-threatening complications related to severe obesity in a young adult with Prader-Willi syndrome

Characterisation of Macrophage Polarisation in Mice Infected with Ninoa Strain of Trypanosoma cruzi

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