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Nogueira LG, Frade AF, Ianni BM, Laugier L, Pissetti CW, Cabantous S, Baron M, de Lima Peixoto G, de Melo Borges A, Donadi E, Marin-Neto JA, Schmidt A, Dias F, Saba B, Wang HTL, Fragata A, Sampaio M, Hirata MH, Buck P, Mady C, Martinelli M, Lensi M, Siqueira SF, Pereira AC, Rodrigues V, Kalil J, Chevillard C, Cunha-Neto E. Functional IL18 polymorphism and susceptibility to Chronic Chagas Disease. Cytokine 2015; 73:79-83. [DOI: 10.1016/j.cyto.2015.01.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 01/09/2023]
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Ferreira LRP, Frade AF, Baron MA, Navarro IC, Kalil J, Chevillard C, Cunha-Neto E. Interferon-γ and other inflammatory mediators in cardiomyocyte signaling during Chagas disease cardiomyopathy. World J Cardiol 2014; 6:782-790. [PMID: 25228957 PMCID: PMC4163707 DOI: 10.4330/wjc.v6.i8.782] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 03/29/2014] [Accepted: 06/03/2014] [Indexed: 02/06/2023] Open
Abstract
Chagas disease cardiomyopathy (CCC), the main consequence of Trypanosoma cruzi (T.cruzi) infection, is an inflammatory cardiomyopathy that develops in up to 30% of infected individuals. The heart inflammation in CCC patients is characterized by a Th1 T cell-rich myocarditis with increased production of interferon (IFN)-γ, produced by the CCC myocardial infiltrate and detected at high levels in the periphery. IFN-γ has a central role in the cardiomyocyte signaling during both acute and chronic phases of T.cruzi infection. In this review, we have chosen to focus in its pleiotropic mode of action during CCC, which may ultimately be the strongest driver towards pathological remodeling and heart failure. We describe here the antiparasitic protective and pathogenic dual role of IFN-γ in Chagas disease.
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Frade AF, Teixeira PC, Ianni BM, Pissetti CW, Saba B, Wang LHT, Kuramoto A, Nogueira LG, Buck P, Dias F, Giniaux H, Llored A, Alves S, Schmidt A, Donadi E, Marin-Neto JA, Hirata M, Sampaio M, Fragata A, Bocchi EA, Stolf AN, Fiorelli AI, Santos RHB, Rodrigues V, Pereira AC, Kalil J, Cunha-Neto E, Chevillard C. Polymorphism in the alpha cardiac muscle actin 1 gene is associated to susceptibility to chronic inflammatory cardiomyopathy. PLoS One 2013; 8:e83446. [PMID: 24367596 PMCID: PMC3868584 DOI: 10.1371/journal.pone.0083446] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 11/04/2013] [Indexed: 11/19/2022] Open
Abstract
Aims Chagas disease, caused by the protozoan Trypanosoma cruzi is endemic in Latin America, and may lead to a life-threatening inflammatory dilated, chronic Chagas cardiomyopathy (CCC). One third of T. cruzi-infected individuals progress to CCC while the others remain asymptomatic (ASY). A possible genetic component to disease progression was suggested by familial aggregation of cases and the association of markers of innate and adaptive immunity genes with CCC development. Since mutations in multiple sarcomeric genes, including alpha-cardiac actin (ACTC1) have been involved in hereditary dilated cardiomyopathy, we investigated the involvement of the ACTC1 gene in CCC pathogenesis. Methods and Results We conducted a proteomic and genetic study on a Brazilian study population. The genetic study was done on a main cohort including 118 seropositive asymptomatic subjects and 315 cases and the replication was done on 36 asymptomatic and 102 CCC cases. ACTC1 protein and mRNA levels were lower in myocardial tissue from patients with end-stage CCC than those found in hearts from organ donors. Genotyping a case-control cohort of CCC and ASY subjects for all informative single nucleotide polymorphism (SNP) in the ACTC1 gene identified rs640249 SNP, located at the 5’ region, as associated to CCC. Associations are borderline after correction for multiple testing. Correlation and haplotype analysis led to the identification of a susceptibility haplotype. Functional assays have shown that the rs640249A/C polymorphism affects the binding of transcriptional factors in the promoter regions of the ACTC1 gene. Confirmation of the detected association on a larger independent replication cohort will be useful. Conclusions Genetic variations at the ACTC1 gene may contribute to progression to chronic Chagas Cardiomyopathy among T. cruzi-infected patients, possibly by modulating transcription factor binding to ACTC1 promoter regions.
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Affiliation(s)
- Amanda Farage Frade
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
- Institute for Investigation in Immunology (iii), Instituto Nacional de ciencias e tecnologia, São Paulo, São Paulo, Brazil
- Aix-Marseille Université, Marseille, France
| | - Priscila Camilo Teixeira
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
- Institute for Investigation in Immunology (iii), Instituto Nacional de ciencias e tecnologia, São Paulo, São Paulo, Brazil
| | - Barbara Maria Ianni
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Cristina Wide Pissetti
- Laboratory of Immunology, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Bruno Saba
- Instituto de Cardiologia Dante Pazzanese, São Paulo, São Paulo, Brazil
| | - Lin Hui Tzu Wang
- Instituto de Cardiologia Dante Pazzanese, São Paulo, São Paulo, Brazil
| | - Andréia Kuramoto
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
- Institute for Investigation in Immunology (iii), Instituto Nacional de ciencias e tecnologia, São Paulo, São Paulo, Brazil
| | - Luciana Gabriel Nogueira
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
- Institute for Investigation in Immunology (iii), Instituto Nacional de ciencias e tecnologia, São Paulo, São Paulo, Brazil
| | - Paula Buck
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Fabrício Dias
- School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | | | - Sthefanny Alves
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Andre Schmidt
- School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Eduardo Donadi
- School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - José Antonio Marin-Neto
- School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mario Hirata
- Instituto de Cardiologia Dante Pazzanese, São Paulo, São Paulo, Brazil
| | - Marcelo Sampaio
- Instituto de Cardiologia Dante Pazzanese, São Paulo, São Paulo, Brazil
| | - Abílio Fragata
- Instituto de Cardiologia Dante Pazzanese, São Paulo, São Paulo, Brazil
| | - Edimar Alcides Bocchi
- Division of Clinical Immunology and Allergy, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Antonio Noedir Stolf
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Alfredo Inacio Fiorelli
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | | | - Virmondes Rodrigues
- Laboratory of Immunology, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Alexandre Costa Pereira
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Jorge Kalil
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
- Institute for Investigation in Immunology (iii), Instituto Nacional de ciencias e tecnologia, São Paulo, São Paulo, Brazil
- Division of Clinical Immunology and Allergy, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
| | - Edecio Cunha-Neto
- Heart Institute (InCor), University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
- Institute for Investigation in Immunology (iii), Instituto Nacional de ciencias e tecnologia, São Paulo, São Paulo, Brazil
- Division of Clinical Immunology and Allergy, University of São Paulo School of Medicine, São Paulo, São Paulo, Brazil
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Frade AF, Pissetti CW, Ianni BM, Saba B, Lin-Wang HT, Nogueira LG, de Melo Borges A, Buck P, Dias F, Baron M, Ferreira LRP, Schmidt A, Marin-Neto JA, Hirata M, Sampaio M, Fragata A, Pereira AC, Donadi E, Kalil J, Rodrigues V, Cunha-Neto E, Chevillard C. Genetic susceptibility to Chagas disease cardiomyopathy: involvement of several genes of the innate immunity and chemokine-dependent migration pathways. BMC Infect Dis 2013; 13:587. [PMID: 24330528 PMCID: PMC3866603 DOI: 10.1186/1471-2334-13-587] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Accepted: 12/04/2013] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Chagas disease, caused by the protozoan Trypanosoma cruzi is endemic in Latin America. Thirty percent of infected individuals develop chronic Chagas cardiomyopathy (CCC), an inflammatory dilated cardiomyopathy that is, by far, the most important clinical consequence of T. cruzi infection. The others remain asymptomatic (ASY). A possible genetic component to disease progression was suggested by familial aggregation of cases and the association of markers of innate and adaptive immunity genes with CCC development. Migration of Th1-type T cells play a major role in myocardial damage. METHODS Our genetic analysis focused on CCR5, CCL2 and MAL/TIRAP genes. We used the Tag SNPs based approach, defined to catch all the genetic information from each gene. The study was conducted on a large Brazilian population including 315 CCC cases and 118 ASY subjects. RESULTS The CCL2rs2530797A/A and TIRAPrs8177376A/A were associated to an increase susceptibility whereas the CCR5rs3176763C/C genotype is associated to protection to CCC. These associations were confirmed when we restricted the analysis to severe CCC, characterized by a left ventricular ejection fraction under 40%. CONCLUSIONS Our data show that polymorphisms affecting key molecules involved in several immune parameters (innate immunity signal transduction and T cell/monocyte migration) play a role in genetic susceptibility to CCC development. This also points out to the multigenic character of CCC, each polymorphism imparting a small contribution. The identification of genetic markers for CCC will provide information for pathogenesis as well as therapeutic targets.
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Affiliation(s)
- Amanda Farage Frade
- Heart Institute (InCor), University of São Paulo School of Medicine (FMUSP), Av. Dr. Enéas de Carvalho Aguiar, 44 Bloco 2 9º andar, São Paulo, SP 06504-000, Brazil
- Institute for Investigation in Immunology (iii), INCT, São Paulo, SP, Brazil
- Aix-Marseille Université, INSERM, GIMP UMR_S906, Faculté de médecine, 27 bd Jean Moulin, Marseille, cedex 05 13385, France
| | - Cristina Wide Pissetti
- Laboratory of Immunology, Universidade Federal do Triângulo Mineiro (UFTM), 40 Frei Paulino, Uberaba, MG 48036-180, Brazil
| | - Barbara Maria Ianni
- Heart Institute (InCor), University of São Paulo School of Medicine (FMUSP), Av. Dr. Enéas de Carvalho Aguiar, 44 Bloco 2 9º andar, São Paulo, SP 06504-000, Brazil
| | - Bruno Saba
- Instituto de Cardiologia Dante Pazzanese (IDPC), Avenida Dante Pazzanese 500 - Ibirapuera, Sâo Paulo, SP 04012-909, Brazil
| | - Hui Tzu Lin-Wang
- Instituto de Cardiologia Dante Pazzanese (IDPC), Avenida Dante Pazzanese 500 - Ibirapuera, Sâo Paulo, SP 04012-909, Brazil
| | - Luciana Gabriel Nogueira
- Heart Institute (InCor), University of São Paulo School of Medicine (FMUSP), Av. Dr. Enéas de Carvalho Aguiar, 44 Bloco 2 9º andar, São Paulo, SP 06504-000, Brazil
- Institute for Investigation in Immunology (iii), INCT, São Paulo, SP, Brazil
| | - Ariana de Melo Borges
- Laboratory of Immunology, Universidade Federal do Triângulo Mineiro (UFTM), 40 Frei Paulino, Uberaba, MG 48036-180, Brazil
| | - Paula Buck
- Heart Institute (InCor), University of São Paulo School of Medicine (FMUSP), Av. Dr. Enéas de Carvalho Aguiar, 44 Bloco 2 9º andar, São Paulo, SP 06504-000, Brazil
| | - Fabrício Dias
- School of Medicine of Ribeirão Preto (FMRP), University of São Paulo, Av. Bandeirantes, 4900 - Monte Alegre 15059-900, Ribeirão Preto, SP, Brazil
| | - Monique Baron
- Heart Institute (InCor), University of São Paulo School of Medicine (FMUSP), Av. Dr. Enéas de Carvalho Aguiar, 44 Bloco 2 9º andar, São Paulo, SP 06504-000, Brazil
| | - Ludmila Rodrigues Pinto Ferreira
- Heart Institute (InCor), University of São Paulo School of Medicine (FMUSP), Av. Dr. Enéas de Carvalho Aguiar, 44 Bloco 2 9º andar, São Paulo, SP 06504-000, Brazil
| | - Andre Schmidt
- School of Medicine of Ribeirão Preto (FMRP), University of São Paulo, Av. Bandeirantes, 4900 - Monte Alegre 15059-900, Ribeirão Preto, SP, Brazil
| | - José Antonio Marin-Neto
- School of Medicine of Ribeirão Preto (FMRP), University of São Paulo, Av. Bandeirantes, 4900 - Monte Alegre 15059-900, Ribeirão Preto, SP, Brazil
| | - Mario Hirata
- Instituto de Cardiologia Dante Pazzanese (IDPC), Avenida Dante Pazzanese 500 - Ibirapuera, Sâo Paulo, SP 04012-909, Brazil
| | - Marcelo Sampaio
- Instituto de Cardiologia Dante Pazzanese (IDPC), Avenida Dante Pazzanese 500 - Ibirapuera, Sâo Paulo, SP 04012-909, Brazil
| | - Abílio Fragata
- Instituto de Cardiologia Dante Pazzanese (IDPC), Avenida Dante Pazzanese 500 - Ibirapuera, Sâo Paulo, SP 04012-909, Brazil
| | - Alexandre Costa Pereira
- Heart Institute (InCor), University of São Paulo School of Medicine (FMUSP), Av. Dr. Enéas de Carvalho Aguiar, 44 Bloco 2 9º andar, São Paulo, SP 06504-000, Brazil
| | - Eduardo Donadi
- School of Medicine of Ribeirão Preto (FMRP), University of São Paulo, Av. Bandeirantes, 4900 - Monte Alegre 15059-900, Ribeirão Preto, SP, Brazil
| | - Jorge Kalil
- Heart Institute (InCor), University of São Paulo School of Medicine (FMUSP), Av. Dr. Enéas de Carvalho Aguiar, 44 Bloco 2 9º andar, São Paulo, SP 06504-000, Brazil
- Institute for Investigation in Immunology (iii), INCT, São Paulo, SP, Brazil
- Division of Clinical Immunology and Allergy, University of São Paulo School of Medicine, São Paulo, SP 06504-000, Brazil
| | - Virmondes Rodrigues
- Laboratory of Immunology, Universidade Federal do Triângulo Mineiro (UFTM), 40 Frei Paulino, Uberaba, MG 48036-180, Brazil
| | - Edecio Cunha-Neto
- Heart Institute (InCor), University of São Paulo School of Medicine (FMUSP), Av. Dr. Enéas de Carvalho Aguiar, 44 Bloco 2 9º andar, São Paulo, SP 06504-000, Brazil
- Institute for Investigation in Immunology (iii), INCT, São Paulo, SP, Brazil
- Division of Clinical Immunology and Allergy, University of São Paulo School of Medicine, São Paulo, SP 06504-000, Brazil
| | - Christophe Chevillard
- Aix-Marseille Université, INSERM, GIMP UMR_S906, Faculté de médecine, 27 bd Jean Moulin, Marseille, cedex 05 13385, France
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Deng X, Sabino EC, Cunha-Neto E, Ribeiro AL, Ianni B, Mady C, Busch MP, Seielstad M, Component I. Genome wide association study (GWAS) of Chagas cardiomyopathy in Trypanosoma cruzi seropositive subjects. PLoS One 2013; 8:e79629. [PMID: 24324551 PMCID: PMC3854669 DOI: 10.1371/journal.pone.0079629] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 09/24/2013] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Familial aggregation of Chagas cardiac disease in T. cruzi-infected persons suggests that human genetic variation may be an important determinant of disease progression. OBJECTIVE To perform a GWAS using a well-characterized cohort to detect single nucleotide polymorphisms (SNPs) and genes associated with cardiac outcomes. METHODS A retrospective cohort study was developed by the NHLBI REDS-II program in Brazil. Samples were collected from 499 T. cruzi seropositive blood donors who had donated between 1996 and 2002, and 101 patients with clinically diagnosed Chagas cardiomyopathy. In 2008-2010, all subjects underwent a complete medical examination. After genotype calling, quality control filtering with exclusion of 20 cases, and imputation of 1,000 genomes variants; association analysis was performed for 7 cardiac and parasite related traits, adjusting for population stratification. RESULTS The cohort showed a wide range of African, European, and modest Native American admixture proportions, consistent with the recent history of Brazil. No SNPs were found to be highly (P<10(-8)) associated with cardiomyopathy. The two mostly highly associated SNPs for cardiomyopathy (rs4149018 and rs12582717; P-values <10(-6)) are located on Chromosome 12p12.2 in the SLCO1B1 gene, a solute carrier family member. We identified 44 additional genic SNPs associated with six traits at P-value <10(-6): Ejection Fraction, PR, QRS, QT intervals, antibody levels by EIA, and parasitemia by PCR. CONCLUSION This GWAS identified suggestive SNPs that may impact the risk of progression to cardiomyopathy. Although this Chagas cohort is the largest examined by GWAS to date, (580 subjects), moderate sample size may explain in part the limited number of significant SNP variants. Enlarging the current sample through expanded cohorts and meta-analyses, and targeted studies of candidate genes, will be required to confirm and extend the results reported here. Future studies should also include exposed seronegative controls to investigate genetic associations with susceptibility or resistance to T. cruzi infection and non-Chagas cardiomyopathy.
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Affiliation(s)
- Xutao Deng
- Blood Systems Research Institute, San Francisco, California, United States of America
| | - Ester C. Sabino
- Department of Infectious Disease/Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - Edecio Cunha-Neto
- Laboratory of Immunology, Heart Institute (InCor)/Division of Clinical Immunology and Allergy, University of São Paulo, São Paulo, Brazil
- Institute for Investigation in Immunology/Instituto Nacional de Ciência e Tecnologia, São Paulo, Brazil
| | - Antonio L. Ribeiro
- Hospital das Clínicas and Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Barbara Ianni
- Cardiomyopathy Unit of the Heart Institute (InCor) University of São Paulo Medical School, São Paulo, Brazil
| | - Charles Mady
- Cardiomyopathy Unit of the Heart Institute (InCor) University of São Paulo Medical School, São Paulo, Brazil
| | - Michael P. Busch
- Blood Systems Research Institute, San Francisco, California, United States of America
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Mark Seielstad
- Blood Systems Research Institute, San Francisco, California, United States of America
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, United States of America
- Institute for Human Genetics, University of California San Francisco, San Francisco, California, United States of America
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