Chagas disease and anticardiolipin antibodies in older adults

Godoy, Maria de Fátima Guerreiro; Cação, João de Castilho; Godoy, José María Pereira de; Brandão, Antônio Carlos; Souza, Dorotéia Silva Rossi

doi:10.1016/j.archger.2005.04.001

Cited by 6 publications

(1 citation statement)

References 10 publications

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“…The presence of aPLs in older adults may increase the risk of cardiovascular events [ 78 , 79 ]. However, mixed findings have been reported, with studies showing a link between aCL and dementia and stroke [ 80 , 81 ], while others suggest that aCL and β2-GPI-Ab may be incidental findings in the older population [ 82 , 83 , 84 ]. Indeed, the prevalence of aPL positivity increases with age, both in healthy individuals [ 74 ] and in those with a variety of conditions (e.g., rheumatoid factor positivity [ 85 , 86 ], advanced renal or hepatic failure [ 87 , 88 ], giant-cell arteritis [ 89 ], and cancer [ 81 , 90 ]).…”

Section: Cardiovascular Implications Of Antiphospholipid Syndrome In ...mentioning

confidence: 99%

Management of Cardiovascular Complications in Antiphospholipid Syndrome: A Narrative Review with a Focus on Older Adults

Bernardi,

Spadafora,

Andaloro

et al. 2024

JCM

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Antiphospholipid syndrome (APS), also known as Hughes syndrome, is an acquired autoimmune and procoagulant condition that predisposes individuals to recurrent thrombotic events and obstetric complications. Central is the role of three types of antiphospholipid antibodies that target phospholipid-binding proteins: lupus anticoagulant (LAC), anti-β2-glycoprotein I (β2-GPI-Ab), and anti-cardiolipin (aCL). Together with clinical data, these antibodies are the diagnostic standard. However, the diagnosis of APS in older adults may be challenging and, in the diagnostic workup of thromboembolic complications, it is an underestimated etiology. The therapeutic management of APS requires distinguishing two groups with differential risks of thromboembolic complications. The standard therapy is based on low-dose aspirin in the low-risk group and vitamin K antagonists in the high-risk group. The value of direct oral anticoagulants is currently controversial. The potential role of monoclonal antibodies is investigated. For example, rituximab is currently recommended in catastrophic antiphospholipid antibody syndrome. Research is ongoing on other monoclonal antibodies, such as daratumumab and obinutuzumab. This narrative review illustrates the pathophysiological mechanisms of APS, with a particular emphasis on cardiovascular complications and their impact in older adults. This article also highlights advancements in the diagnosis, risk stratification, and management of APS.

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Section: Cardiovascular Implications Of Antiphospholipid Syndrome In ...mentioning

confidence: 99%

Management of Cardiovascular Complications in Antiphospholipid Syndrome: A Narrative Review with a Focus on Older Adults

Bernardi,

Spadafora,

Andaloro

et al. 2024

JCM

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Apoptotic lymphocytes treated with IgG from Trypanosoma cruzi infection increase TNF‐α secretion and reduce parasite replication in macrophages

et al. 2010

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Phagocytic removal of apoptotic lymphocytes exacerbates replication of Trypanosoma cruzi in macrophages. We investigated the presence of Ab against apoptotic lymphocytes in T. cruzi infection and the role of these Ab in parasite replication. Both control and chagasic serum contained IgG Ab that opsonized apoptotic lymphocytes. Treatment of apoptotic lymphocytes with purified IgG from chagasic, but not control serum, reduced T. cruzi replication in macrophages. The protective effect of chagasic IgG depended on Fcc receptors, as demonstrated by the requirement for the intact Fc portion of IgG, and the effect could be abrogated by treating macrophages with an anti-CD16/CD32 Fab fragment. Chagasic IgG displayed increased reactivity against a subset of apoptotic cell Ag, as measured by flow cytometry and immunoblot analyses. Apoptotic lymphocytes treated with chagasic IgG, but not control IgG, increased production of TNF-a, while decreasing production of TGF-b1 by infected macrophages. Increased control of parasite replication required TNF-a production. Previous immunization with apoptotic cells or injection of apoptotic cells opsonized with chagasic IgG reduced parasitemia in infected mice. These results indicate that Ab raised against apoptotic cells could play a protective role in control of T. cruzi replication by macrophages.Key words: Ab . Apoptosis . Fc receptors . Phagocytosis . Trypanosoma cruzi IntroductionInfection with Trypanosoma cruzi, the causative agent of Chagas' disease, induces Ab against both parasite Ag [1-4] and self molecules [5][6][7]. Ab play a protective role in T. cruzi infection [1][2][3][4][5]7], but the mechanisms involved are not completely understood.Infection with T. cruzi induces lymphocyte apoptosis [8][9][10][11][12], and the phagocytic clearance of apoptotic lymphocytes drives replication of T. cruzi in macrophages [13]. Parasite replication results from a biochemical cascade that originates from binding of apoptotic cells Ã These authors contributed equally to this work. Eur. J. Immunol. 2010. 40: 417-425 DOI 10.1002 Immunity to infection 417 to a V b 3 integrin, followed by production of PGE 2 and TGF-b1, induction of ornithine decarboxylase and increased production of the polyamine putrescine [13]. T. cruzi is unable to synthesize putrescine and depends on uptake of exogenous putrescine for intracellular growth [14]. Phagocytosis of apoptotic cells induces production of TGF-b1, but not proinflammatory cytokines [15]. However, phagocytosis of apoptotic cells is enhanced by serum opsonins, including Ab [16], and Ab to apoptotic cells can lead to secretion of proinflammatory cytokines [15,17].Immunization with apoptotic cells induces production of autoantibodies [18]. However, it is unclear whether such autoantibodies play an immunoregulatory role. In the present study, we sought to determine whether infection with T. cruzi elicited production of Ab against apoptotic lymphocytes. We found that apoptotic lymphocytes treated with chagasic IgG induced a proinflammatory cytokine resp...

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Antiphospholipid Syndrome

Levine¹,

Lockshin²

2014

Contraception and Pregnancy in Patients With Rheumatic Disease

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Chagas disease and anticardiolipin antibodies in older adults

Cited by 6 publications

References 10 publications

Management of Cardiovascular Complications in Antiphospholipid Syndrome: A Narrative Review with a Focus on Older Adults

Management of Cardiovascular Complications in Antiphospholipid Syndrome: A Narrative Review with a Focus on Older Adults

Apoptotic lymphocytes treated with IgG from Trypanosoma cruzi infection increase TNF‐α secretion and reduce parasite replication in macrophages

Antiphospholipid Syndrome

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