Early occurrence of anti-muscarinic autoantibodies and abnormal vagal modulation in Chagas disease

Ribeiro, Antônio Luiz Pinho; Giménez, Luis E.; Hernández, Ciria C.; Carvalho, Antônio Carlos Campos de; Teixeira, Mauro M.; Guedes, Valesca Costa; Barros, Márcio Vinícius Lins; Lombardi, Federico; Rocha, Manoel Otávio da Costa

doi:10.1016/j.ijcard.2006.04.053

Cited by 49 publications

(62 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…on the other hand, we know that chronic chagasic patients often present circulating active functional antibodies that affect isolated rabbit heart, by activation of adrenergic or muscarinic receptors respectively 6,7,22,23 . In fact these antibodies were positively correlated with vagal dysfunction in chronic chagasic patients 8 . So it is reasonable to think that the presence of circulating active functional antibodies could be related to autonomic nervous system dysfunction and brain white matter lesions.…”

Section: Discussionmentioning

confidence: 88%

See 1 more Smart Citation

The presence of antiautonomic membrane receptor antibodies do not correlate with brain lesions in Chagas' disease

Maciel

Pedrosa

et al. 2009

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

-We previously demonstrated correlation between parasympathetic dysfunction and brain white matter lesions in chronic chagasic patients. Objective: To correlate serum functional circulating antibodies with beta adrenergic (Ab-β), muscarinic (Ab-M) or muscarinic and beta adrenergic (Ab-Mβ) activity, the autonomic system function and brain lesions in chronic chagasic patients. Method: In fifteen consecutive chagasic patients, the autonomic nervous system was evaluated and brain magnetic resonance imaging (MRI) was performed. The sera of all patients were tested to the presence of circulating functional antibodies. Results: Sera from 11 of 15 chronic chagasic patients had some activity (Ab-β: 7; Ab-M: 1; Ab-Mβ: 3); however, there was no significant correlation between the presence of antibodies and the autonomic system function or the presence of hyperintensities in MRI. Conclusion: The mechanism involved in the genesis of hyperintense lesions seen in brain MRI of chronic chagasic patients is still unresolved, although apparently related to parasympathetic dysfunction.Key WoRdS: Chagas' disease, American trypanosomiasis, autonomic dysfunction, antibodies, magnetic resonance imaging, hyperintense lesions. a presença de anticorpos anti-autonômicos não se correlaciona a lesões cerebrais na doença de chagas resumo -A correlação entre disfunção parassimpática e lesões de substância branca cerebral em pacientes chagásicos já foi previamente demonstrada. Objetivo: Correlacionar a presença de anticorpos circulantes funcionais com atividade beta-adrenérgica (Ab-β), muscarínica (Ab-M) ou muscarínica e beta adrenérgica (Ab-Mβ), a presença de disautonomia e lesões de substância branca cerebral em pacientes chagásicos crônicos. Método: em quinze pacientes chagásicos consecutivos, foram realizados a avaliação do sistema nervoso autônomo e ressonância magnética (RM) do crânio. o soro dos pacientes foi testado para a presença de anticorpos funcionais circulantes. Resultados: o soro de 11 dos 15 pacientes chagásicos apresentou alguma atividade (Ab-β: 7; Ab-M: 1; Ab-Mβ: 3); porém não houve correlação significativa entre a presença de anticorpos circulantes e disautonomia ou de hiperintensidades à RM. Conclusão: o mecanismo envolvido na gênese das lesões hiperintensas à RM do crânio dos pacientes chagásicos crônicos não está esclarecida ainda, apesar de aparentemente relacionada à disfunção parassimpática.PAlAvRAS-ChAve: doença de Chagas, tripanossomíase americana, disfunção autonômica, anticorpos, ressonância magnética, lesões hiperintensas.

show abstract

Section: Discussionmentioning

confidence: 88%

“…These antiautonomic membrane receptor antibodies are able to activate, either, beta adrenergic-(Ab-β) 6 , muscarinic (Ab-M) or both, muscarinic and beta adrenergic (Ab-Mβ) autonomic receptors 7 . In addition, Ribeiro et al has shown strong correlation between the presence of Ab-M and abnormal vagal modulation in chronic chagasic patients 8 .…”

mentioning

confidence: 97%

The presence of antiautonomic membrane receptor antibodies do not correlate with brain lesions in Chagas' disease

Maciel

Pedrosa

et al. 2009

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…The second extracellular (o2) and the third intracellular loops (i3), of these receptors, are considered as autoimmune epitopes in patients with chronic Chagas' disease 22,40. The autoimmune response occurs early on the natural history of the disease and it is considered to be responsible for the abnormalities of parasympathetic control of heart rate 14,21,23,[41][42][43][44] . These investigations have demonstrated that, the chronotropic responses to cardiac autonomic tests are apparently impaired in the indeterminate form of the disease.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the frequency and time domain indexes of parasympathetic modulation may be suppressed in the supine position, but become similar to controls in the standing position and while performing isometric exercise 6,24,27,45 . Since, muscarinic auto-antibodies may behave as positive allosteric modulators of parasympathetic activity 25 ; a diminished high frequency component of heart rate variability 41 and the presence of a slow heart rate 44 could be an indirect expression of the agonist effect. Thus, an alternative explanation for the "impaired" chronotropic response to the cardiac autonomic tests would be over stimulation with saturation of the parasympathetic system 3,11,12,42 .…”

Section: Introductionmentioning

confidence: 99%

Muscarinic antibodies and heart rate responses to dynamic exercise and to the Valsalva maneuver in chronic chagasic patients

Neves¹,

Bacilio²,

Berrueta

et al. 2013

Rev. Inst. Med. trop. S. Paulo

View full text Add to dashboard Cite

SUMMARYWe have studied the cardiac chronotropic responses to the Valsalva maneuver and to dynamic exercise of twenty chronic chagasic patients with normal left ventricular function and no segmental wall abnormalities by two-dimensional echocardiogram. The absolute increase in heart rate of the patients (∆ = 21.5 ± 10 bpm, M±SD) during the maneuver was significantly diminished when compared to controls (∆ = 31.30 ± 70, M±SD, p = 0.03). The minimum heart rate (58.24 ± 8.90 vs. 62.80 ± 10, p = 0.68) and the absolute decrease in heart rate at the end of the maneuver (∆ = 38.30 ± 13 vs. ∆ = 31.47 ± 17, p = 0.10) were not different from controls. The initial heart rate acceleration during dynamic exercise (∆ = 12 ± 7.55 vs. ∆ = 19 ± 7.27, M±SD, p = 0.01) was also diminished, but the heart rate recovery during the first ten seconds was more prominent in the sero-positive patients (Median: 14, Interquartile range: (9.75-17.50 vs. 5(0-8.75, p = 0.001). The serum levels of muscarinic cardiac auto-antibodies were significantly higher in the chagasic patients (Median: 34.58, Interquartile Range: 17-46.5, Optical Density) than in controls (Median: 0, Interquartile Range: 0-22.25, p = 0.001) and correlated significantly and directly (r = 0.68, p = 0.002) with early heart rate recovery during dynamic exercise. The results of this investigation indirectly suggest that, the cardiac muscarinic auto-antibodies may have positive agonist effects on parasympathetic heart rate control of chagasic patients.

show abstract

“…Nevertheless, in contrast to the studies of other cardiopathies, previous studies in our group indicate that in ChD, autonomic dysfunction precedes LV dysfunction, and this phenomenon may be observed even in asymptomatic patients with cardiopathy 2 . Indeed, specifi c processes may occur in ChD leading to parasympathetic impairment, which occurs because of the destruction of the vagal ganglia and nerve terminations due to the infl ammatory process 12 and the inhibition of muscarinic receptors by autoantibodies 13 . However, our data indicate that as LV dysfunction and heart failure progress, vagal heart dysfunction worsens because of mechanisms that appear to be common with those of other heart diseases.…”

mentioning

confidence: 99%

Is autonomic function associated with left ventricular systolic function in Chagas heart disease patients undergoing treatment for heart failure?

Raadschilders

Rocha

Sousa

et al. 2014

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

Introduction:The association between cardiac autonomic and left ventricular (LV) dysfunction in Chagas disease (ChD) is controversial. Methods: A standardized protocol that includes the Valsalva maneuver, a respiratory sinus arrhythmia (RSA) test, and an echocardiographic examination was used. Spearman correlation coeffi cients (rho) were used to investigate associations. Results: The study population consisted of 118 ChD patients undergoing current medical treatment, with an average LV ejection fraction of 51.4±2.6%. The LV ejection fraction and diastolic dimension were correlated with the Valsalva index (rho=0.358, p<0.001 and rho=-0.266, p=0.004, respectively) and the RSA (rho=0.391, p<0.001 and rho=-0.311, p<0.001, respectively). Conclusions:The impairment of LV function is directly associated with a reduction of cardiac autonomic modulation in ChD.

show abstract

Early occurrence of anti-muscarinic autoantibodies and abnormal vagal modulation in Chagas disease

Cited by 49 publications

References 23 publications

The presence of antiautonomic membrane receptor antibodies do not correlate with brain lesions in Chagas' disease

The presence of antiautonomic membrane receptor antibodies do not correlate with brain lesions in Chagas' disease

Muscarinic antibodies and heart rate responses to dynamic exercise and to the Valsalva maneuver in chronic chagasic patients

Is autonomic function associated with left ventricular systolic function in Chagas heart disease patients undergoing treatment for heart failure?

Contact Info

Product

Resources

About