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Rodeles LM, Castro M, Zamora MAG, Savarino R, Peverengo LM, Prochetto ES, Marcipar I, Arias P, Vicco MH. Increased epicardial adipose tissue thickness associated with increased metabolic risk and the presence of heart failure in patients with Chronic Chagas disease. Trans R Soc Trop Med Hyg 2021; 115:1054-1060. [PMID: 33503657 DOI: 10.1093/trstmh/traa189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/25/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND It has been described that Trypanosoma cruzi is capable of promoting metabolic disturbances currently considered as cardiovascular risk factors. Moreover, it has been observed that the protozoa can remain in adipose tissue and alter its immune endocrine functions. The aim of this study was to characterize the thickness of epicardial adipose tissue (EAT) in patients with chronic Chagas disease (CCD) concerning their cardiovascular metabolic risk profile compared with those without CCD. METHODS A cross-sectional study was performed including T. cruzi seropositive individuals categorized according to a standard CCD classification and a matched seronegative control group. Complete clinical examination, metabolic laboratory tests and transthoracic echocardiography to assess cardiac function and to quantify EAT were performed. RESULTS Fifty-five individuals aged 46.7±11.9 y, 34 with CCD and 21 in the control group, were included. The CCD group presented higher EAT thickness in relation to controls (4.54±1.28 vs 3.22±0.99 mm; p=0.001), which was significantly associated with the presence of insulin resistance (OR=3, 95% CI 1.58 to 5.73; p<0.001). This group presented lower levels of plasmatic adiponectin than controls, especially in those patients with EAT ≥4.5 mm (p=0.005) who also presented with heart failure more frequently (p=0.01). CONCLUSION In patients with CCD, a higher EAT thickness is observed and is associated with an increased metabolic risk profile indicated mainly by insulin resistance.
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Affiliation(s)
- Luz María Rodeles
- Centro de Estudios en Salud Global, Facultad de Ciencias Médicas, Universidad Nacional del Litoral, Ciudad Universitaria, Paraje El Pozo, Ruta Nacional 168, Santa Fe, Argentina
| | - Maximiliano Castro
- Hospital J. B. Iturraspe, Provincia de Santa Fe, Av Blas Parera 8301, Santa Fe, Argentina
| | - María Ayelen Gaitán Zamora
- Centro de Estudios en Salud Global, Facultad de Ciencias Médicas, Universidad Nacional del Litoral, Ciudad Universitaria, Paraje El Pozo, Ruta Nacional 168, Santa Fe, Argentina
| | - Roberto Savarino
- Hospital J. B. Iturraspe, Provincia de Santa Fe, Av Blas Parera 8301, Santa Fe, Argentina
| | - Luz María Peverengo
- Laboratorio de Tecnología Inmunológica, Facultad de Bioquímicas y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, Paraje El Pozo, Ruta Nacional 168, Santa Fe, Argentina
| | - Estefanía Soledad Prochetto
- Laboratorio de Tecnología Inmunológica, Facultad de Bioquímicas y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, Paraje El Pozo, Ruta Nacional 168, Santa Fe, Argentina
| | - Iván Marcipar
- Centro de Estudios en Salud Global, Facultad de Ciencias Médicas, Universidad Nacional del Litoral, Ciudad Universitaria, Paraje El Pozo, Ruta Nacional 168, Santa Fe, Argentina.,Laboratorio de Tecnología Inmunológica, Facultad de Bioquímicas y Ciencias Biológicas, Universidad Nacional del Litoral, Ciudad Universitaria, Paraje El Pozo, Ruta Nacional 168, Santa Fe, Argentina
| | - Pablo Arias
- Cátedra de Fisiología Humana, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, Santa Fe, Argentina
| | - Miguel Hernán Vicco
- Centro de Estudios en Salud Global, Facultad de Ciencias Médicas, Universidad Nacional del Litoral, Ciudad Universitaria, Paraje El Pozo, Ruta Nacional 168, Santa Fe, Argentina
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Cabalén ME, Cabral MF, Sanmarco LM, Andrada MC, Onofrio LI, Ponce NE, Aoki MP, Gea S, Cano RC. Chronic Trypanosoma cruzi infection potentiates adipose tissue macrophage polarization toward an anti-inflammatory M2 phenotype and contributes to diabetes progression in a diet-induced obesity model. Oncotarget 2017; 7:13400-15. [PMID: 26921251 PMCID: PMC4924650 DOI: 10.18632/oncotarget.7630] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 01/12/2016] [Indexed: 12/26/2022] Open
Abstract
Chronic obesity and Chagas disease (caused by the protozoan Trypanosoma cruzi) represent serious public health concerns. The interrelation between parasite infection, adipose tissue, immune system and metabolism in an obesogenic context, has not been entirely explored. A novel diet-induced obesity model (DIO) was developed in C57BL/6 wild type mice to examine the effect of chronic infection (DIO+I) on metabolic parameters and on obesity-related disorders. Dyslipidemia, hyperleptinemia, and cardiac/hepatic steatosis were strongly developed in DIO mice. Strikingly, although these metabolic alterations were collectively improved by infection, plasmatic apoB100 levels remain significantly increased in DIO+I, suggesting the presence of pro-atherogenic small and dense LDL particles. Moreover, acute insulin resistance followed by chronic hyperglycemia with hypoinsulinemia was found, evidencing an infection-related-diabetes progression. These lipid and glucose metabolic changes seemed to be highly dependent on TLR4 expression since TLR4-/- mice were protected from obesity and its complications. Notably, chronic infection promoted a strong increase in MCP-1 producing macrophages with a M2 (F4/80+CD11c-CD206+) phenotype associated to oxidative stress in visceral adipose tissue of DIO+I mice. Importantly, infection reduced lipid content but intensified inflammatory infiltrates in target tissues. Thus, parasite persistence in an obesogenic environment and the resulting host immunometabolic dysregulation may contribute to diabetes/atherosclerosis progression.
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Affiliation(s)
- María E Cabalén
- Facultad de Ciencias Químicas, UA Área CS. AGR. ING. BIO Y S CONICET. Universidad Católica de Córdoba, Córdoba, Argentina
| | - María F Cabral
- Facultad de Ciencias Químicas, UA Área CS. AGR. ING. BIO Y S CONICET. Universidad Católica de Córdoba, Córdoba, Argentina
| | - Liliana M Sanmarco
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Córdoba, Argentina
| | - Marta C Andrada
- Facultad de Ciencias Químicas, UA Área CS. AGR. ING. BIO Y S CONICET. Universidad Católica de Córdoba, Córdoba, Argentina
| | - Luisina I Onofrio
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Córdoba, Argentina
| | - Nicolás E Ponce
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Córdoba, Argentina
| | - María P Aoki
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Córdoba, Argentina
| | - Susana Gea
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Córdoba, Argentina
| | - Roxana C Cano
- Facultad de Ciencias Químicas, UA Área CS. AGR. ING. BIO Y S CONICET. Universidad Católica de Córdoba, Córdoba, Argentina.,Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Córdoba, Argentina
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Rodeles LM, Vicco MH, Bontempi IA, Siano A, Tonarelli G, Bottasso OA, Arias P, Marcipar IS. Combined analysis of cross-reacting antibodies anti-β1AR and anti-B13 in advanced stages of Chagas heart disease. Trop Med Int Health 2016; 21:1545-1551. [PMID: 27699992 DOI: 10.1111/tmi.12791] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Autoantibodies cross-reacting with the β1 adrenergic receptor (anti-β1AR and anti-p2β) and cardiac myosin antigens (anti-B13) have been related to the pathogenesis of chronic Chagas heart disease (CCHD). Studies exploring their levels in different stages are scarce. We aimed to evaluate the relationship of these autoantibodies with the clinical profile of chronic patients, especially regarding their classificatory accuracy in severe presentation with heart failure. METHODS AND RESULTS We conducted a cross-sectional study of 155 T. cruzi-seropositive patients and 26 age- and gender-matched healthy controls. They were categorised in three stages of CCHD. Serum antibodies were measured by specific immunoassays. Symptomatic individuals showed increased levels of anti-β1AR and anti-B13, while anti-p2β antibodies were similar between groups. A composite logistic regression model including anti-B13, anti-β1AR antibody levels and age was able to predict systolic heart failure yielding an area under the curve of 83% (sensitivity of 67% and specificity of 89%). CONCLUSIONS In our study, anti-β1AR and anti-B13 antibodies were higher in individuals with chronic Chagas heart disease stage III, mainly in those with dilated cardiomyopathy associated with systolic heart failure. Logistic regression analysis showed that both antibodies were good predictors of severe CCHD. As well as being involved in disease progression, anti-β1AR and anti-B13 antibodies may be used as a serum marker of poor prognosis in terms of heart compromise.
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Affiliation(s)
- Luz M Rodeles
- Laboratory of Immunological Techniques, National University of Littoral, Santa Fe, Argentina.,Internal Medicine Department, National University of Littoral, Santa Fe, Argentina
| | - Miguel H Vicco
- Laboratory of Immunological Techniques, National University of Littoral, Santa Fe, Argentina.,Internal Medicine Department, National University of Littoral, Santa Fe, Argentina
| | - Iván A Bontempi
- Laboratory of Immunological Techniques, National University of Littoral, Santa Fe, Argentina
| | - Alvaro Siano
- Organic Chemistry Department, National University of Littoral, Santa Fe, Argentina
| | - Georgina Tonarelli
- Organic Chemistry Department, National University of Littoral, Santa Fe, Argentina
| | - Oscar A Bottasso
- Institute of Clinical and Experimental Immunology, UNR-CONICET, Rosario, Argentina
| | - Pablo Arias
- Human Physiology Department, National University of Rosario, Rosario, Argentina
| | - Iván S Marcipar
- Laboratory of Immunological Techniques, National University of Littoral, Santa Fe, Argentina
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Peverengo L, Rodeles L, Vicco MH, Marcipar I. The potential influence of atherogenic dyslipidemia on the severity of chronic Chagas heart disease. Rev Assoc Med Bras (1992) 2016; 62:45-7. [PMID: 27008492 DOI: 10.1590/1806-9282.62.01.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 05/31/2015] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION chronic Chagas heart disease (CCHD) is the most common manifestation of American Trypanosomiasis, causing about 50,000 deaths annually. Several factors bear correlation with the severity of CCHD. However, to our knowledge, the assessment on the contribution of major cardiovascular risk factors (CRF), such as hypertension and atherogenic dyslipidemia (AD) to CCHD severity is scarce, despite their well-established role in coronary artery disease, heart failure and stroke. OBJECTIVE to explore the potential relationship of blood pressure and AD with the clinical profile of patients with CCHD. METHODS we performed a cross-sectional study in T. cruziseropositive patients categorized according to a standard CCHD classification. All individuals were subjected to complete clinical examination. Autoantibodies induced by T. cruzi were assessed by ELISA. RESULTS we observed that Atherogenic index (AI) levels rose significantly in relation to the severity of the CCHD stage, with CCHD III cases showing the highest values of AI. Furthermore, those patients with globally dilated cardiomyopathy with reduced ejection fraction showed higher levels of AI. In regard to autoantibodies, anti-B13 also showed relation with the severity of the disease. CONCLUSION we observed that AI correlated with CCHD stages and contributed, in association with anti-B13 antibodies and age, to the prediction of systolic heart failure.
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Affiliation(s)
- Luz Peverengo
- Immunological Technology Laboratory, School of Biochemistry and Biological Sciences, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Luz Rodeles
- Internal Medicine Division, School of Medical Sciences, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Miguel Hernan Vicco
- Internal Medicine Division, School of Medical Sciences, Universidad Nacional del Litoral, Santa Fe, Argentina
| | - Iván Marcipar
- Immunological Technology Laboratory, School of Biochemistry and Biological Sciences, Universidad Nacional del Litoral, Santa Fe, Argentina
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Fabbro DL, Olivera V, Bizai ML, Denner S, Diez C, Marcipar I, Mancipar I, Streiger M, Arias E, del Barco M, Mendicino D, Bottasso O. Humoral immune response against P2β from Trypanosoma cruzi in persons with chronic Chagas disease: its relationship with treatment against parasites and myocardial damage. Am J Trop Med Hyg 2011; 84:575-80. [PMID: 21460013 DOI: 10.4269/ajtmh.2011.10-0261] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We investigated the relationship between potentially pathogenic antibodies against a Trypanosoma cruzi ribosomal protein (P2β) and the evolution of Chagas disease and the effect of trypanocidal treatment on these variables. Seventy-eight patients with chronic Chagas disease who were followed-up for more than 20 years were divided into three groups: 30 asymptomatic persons undergoing specific treatment (group A), 37 asymptomatic persons not undergoing specific treatment (group B), and 11 patients with chronic chagasic cardiomyopathy (CCC) who were not treated. Five patients in group B showed evolution to myocardial abnormalities. Among persons with CCC, six showed no changes; the remaining persons showed progression of cardiac involvement. Levels of antibodies to P2β in persons in group A decreased from their initial values. This finding was not observed in persons in groups B and C. Comparisons at the end of the follow-up showed lower amounts of antibodies to P2β in groups A and C. These findings support the benefits of specific treatment during chronic infection.
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Affiliation(s)
- Diana L Fabbro
- Centro de Investigaciones Sobre Endemias Nacionales, Laboratorio de Tecnología Inmunológica, Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa Fe, Argentina.
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Moretti E, Castro I, Franceschi C, Basso B. Chagas disease: serological and electrocardiographic studies in Wichi and Creole communities of Misión Nueva Pompeya, Chaco, Argentina. Mem Inst Oswaldo Cruz 2011; 105:621-7. [PMID: 20835607 DOI: 10.1590/s0074-02762010000500004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 04/13/2010] [Indexed: 11/22/2022] Open
Abstract
Chagas disease, which is caused by Trypanosoma cruzi, affects nearly 16 million people in Latin America and causes 75-90 million people to be at risk of infection. The disease is urbanizing and globalizing due to frequent migrations. There are regions of high prevalence of infection, including the north-eastern provinces of Argentina and the entire phytogeographic region known as the Gran Chaco. In the province of Chaco, Argentina, there are places inhabited by native populations such as the Wichi and Toba communities, among others. Many Creole populations resulting from miscegenation with European colonists and immigrants coexist within these communities. It has been widely accepted that in the chronic phase of the disease, between 25-30% of individuals develop some form of cardiac disease, with the right bundle-branch block being the most typical condition described so far. The aim of this work was to study the prevalence of Chagas infection and its electrocardiographic profile in the Wichi and Creole populations of Misión Nueva Pompeya, in the area known as Monte Impenetrable in Chaco, to determine the prevalence and the pattern of heart diseases produced by Chagas disease in this region.
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Affiliation(s)
- Edgardo Moretti
- Facultad de Ciencias Médicas, Universidad Nacional de Córdoba and Coordinación Nacional de Control de Vectores, Córdoba, Argentina.
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