Functional implications of circulating muscarinic cholinergic receptor autoantibodies in chagasic patients with achalasia

Differences between idiopathic and chagasic achalasia

“…In addition epiphrenic diverticula is more frequent on idiopathic achalasia (3.6% to 7.4%) than in Chagas' disease (1.5%) [13] . Also, high prevalence of circulating antibodies against M2 acethilcholine muscarinic receptor has been found in Chagas' disease patients with achalasia (84%), compared with patients with idiopathic achalasia (28%) [26] . …”

Pathogenesis and Pathology of Chagas' Chronic Myocarditis

“…These antibodies also caused accumulation of inositol phosphate and nitric oxide synthase stimulation, with a negative inotropic effect on myocardium (Sterin-Borda Leonor, et al, 1997). As mentioned before, anti-muscarinic autoantibodies are positively related to the presence of dysautonomia (Goin J. C., et al, 1994), the presence of achalasia in chagasic patients (Goin J. C., et al, 1999), sinus node dysfunction (Altschuller, et al, 2007), but are not related with the degree of myocardial dysfunction (Altschuller, et al, 2007, Talvani Andre, et al, 2006, nor with the presence of brain lesions (Py, et al, 2009). In fact, patients with cardiomyopathy and left ventricular dysfunction but without autonomic dysfunction show low levels of anti-muscarinic antibodies (Sterin-Borda Leonor & Borda, 2000).…”

Advances in Serological Diagnosis of Chagas' Disease by Using Recombinant Proteins

“…(Leon & Engman, 2001) Among these antigens we should mention cruzipain, (Giordanengo et al, 2000;Goin et al, 1999;Duschak et al, 2001) sulfo-cerebrosides (Avila et al, 1993) and the ribosomal protein TcP2. (Levitus et al, 1991) Precursor works had described that this ribosomal antigen that shares the C terminal region with its homologous from humans, generated autoimmune antibodies, whose concentration was increased in patients who had developed chagasic cardiopathy.…”

“…Also, muscarinic acetylcholine receptor subtype II, in this case a host antigen, has shown to be quite auspicious to monitor the chronic infection. (Goin et al, 1999) Nevertheless, recent studies suggest that it is not apparent that this protein is useful to discriminate between different stages of the illness. (Tovar et al, 2009;Talvani et al, 2006) The difficulties to establish clear illness evolution markers lead to the present state, where we do not count yet with useful tools to evaluate Chagas' disease prognosis.…”