Artículo

Burgos, J.M.; Diez, M.; Vigliano, C.; Bisio, M.; Risso, M.; Duffy, T.; Cura, C.; Brusses, B.; Favaloro, L.; Leguizamon, M.S.; Lucero, R.H.; Laguens, R.; Levin, M.J.; Favaloro, R.; Schijman, A.G. "Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation" (2010) Clinical Infectious Diseases. 51(5):485-495
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Abstract:

Background. One hundred years after the discovery of Chagas disease, it remains a major neglected tropical disease. Chronic Chagas heart disease (cChHD) is the most severe manifestation. Heart transplantation is the proper treatment for end-stage heart failure, although reactivation of disease may result after receipt of immunosuppressive therapy. T. cruzi strains cluster into 6 discrete typing units (DTUs; I-VI) associated with different geographical distribution, transmission cycles and varying disease symptoms. In the southern cone of South America, T. cruzi II, V, and VI populations appear to be associated with Chagas disease and T. cruzi I with sylvatic cycles. Methods. Molecular characterization of DTUs, T. cruzi I genotypes (on the basis of spliced-leader gene polymorphisms), and minicircle signatures was conducted using cardiac explant specimens and blood samples obtained from a cohort of 16 Argentinean patients with cChHD who underwent heart transplantation and from lesion samples obtained from 6 of these patients who presented with clinical reactivation of Chagas disease. Results. Parasite persistence was associated with myocarditis progression, revealing T. cruzi I (genotype Id) in 3 explant samples and T. cruzi II, V, or VI in 5 explant samples. Post-heart transplantation follow-up examination of bloodstream DTUs identified T. cruzi I in 5 patients (genotypes Ia or Id) and T. cruzi II, V, or VI in 7 patients. T. cruzi I, V, and VI were detected in skin chagoma specimens, and T. cruzi V and VI were detected in samples obtained from patients with myocarditis reactivations. Multiple DTUs or genotypes at diverse body sites and polymorphic minicircle signatures at different cardiac regions revealed parasite histotropism. T. cruzi I infections clustered in northern Argentina (latitude, 23°S-27°S), whereas T. cruzi II, V, or VI DTUs were more ubiquitous. Conclusions. Multiple DTUs coexist in patients with Chagas disease. The frequent finding of T. cruzi I associated with cardiac damage was astounding, revealing its pathogenic role in cChHD at the southern cone. © 2010 by the Infectious Diseases Society of America.

Registro:

Documento: Artículo
Título:Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation
Autor:Burgos, J.M.; Diez, M.; Vigliano, C.; Bisio, M.; Risso, M.; Duffy, T.; Cura, C.; Brusses, B.; Favaloro, L.; Leguizamon, M.S.; Lucero, R.H.; Laguens, R.; Levin, M.J.; Favaloro, R.; Schijman, A.G.
Filiación:Laboratorio de Biología Molecular de la Enfermedad de Chagas, Instituto de Ingeniería Genética y Biología Molecular, Vuelta de Obligado 2490, Zip 1428, Buenos Aires, Argentina
Hospital Universitario Fundación Favaloro, Argentina
Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
Laboratorio de Biología Molecular, Instituto de Medicina Regional-Universidad Nacional del Nordeste, Resistencia, Chaco, Argentina
Palabras clave:minicircle DNA; adolescent; adult; Argentina; article; Chagas disease; clinical article; disease course; DNA polymorphism; female; genotype; heart failure; heart transplantation; human; human tissue; immunosuppressive treatment; male; myocarditis; nonhuman; nucleotide sequence; parasite identification; parasite transmission; priority journal; recurrent disease; South America; Trypanosoma cruzi; Adolescent; Adult; Chagas Cardiomyopathy; Chronic Disease; Female; Genotype; Heart; Heart Transplantation; Humans; Immunocompromised Host; Immunosuppressive Agents; Male; Middle Aged; Myocardium; Recurrence; Trypanosoma cruzi; Young Adult
Año:2010
Volumen:51
Número:5
Página de inicio:485
Página de fin:495
DOI: http://dx.doi.org/10.1086/655680
Título revista:Clinical Infectious Diseases
Título revista abreviado:Clin. Infect. Dis.
ISSN:10584838
CODEN:CIDIE
CAS:Immunosuppressive Agents
Registro:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_10584838_v51_n5_p485_Burgos

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Citas:

---------- APA ----------
Burgos, J.M., Diez, M., Vigliano, C., Bisio, M., Risso, M., Duffy, T., Cura, C.,..., Schijman, A.G. (2010) . Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation. Clinical Infectious Diseases, 51(5), 485-495.
http://dx.doi.org/10.1086/655680
---------- CHICAGO ----------
Burgos, J.M., Diez, M., Vigliano, C., Bisio, M., Risso, M., Duffy, T., et al. "Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation" . Clinical Infectious Diseases 51, no. 5 (2010) : 485-495.
http://dx.doi.org/10.1086/655680
---------- MLA ----------
Burgos, J.M., Diez, M., Vigliano, C., Bisio, M., Risso, M., Duffy, T., et al. "Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation" . Clinical Infectious Diseases, vol. 51, no. 5, 2010, pp. 485-495.
http://dx.doi.org/10.1086/655680
---------- VANCOUVER ----------
Burgos, J.M., Diez, M., Vigliano, C., Bisio, M., Risso, M., Duffy, T., et al. Molecular identification of trypanosoma cruzi discrete typing units in end-stage chronic chagas heart disease and reactivation after heart transplantation. Clin. Infect. Dis. 2010;51(5):485-495.
http://dx.doi.org/10.1086/655680