Plasma cytokine expression is associated with cardiac morbidity in chagas disease

PLoS One. 2014 Mar 6;9(3):e87082. doi: 10.1371/journal.pone.0087082. eCollection 2014.

Abstract

The expression of immune response appears to be associated with morbidity in Chagas disease. However, the studies in this field have usually employed small samples of patients and statistical analyses that do not consider the wide dispersion of cytokine production observed in these patients. The aim of this study was to evaluate the plasma cytokine levels in well-defined clinical polar groups of chagasic patients divided into categories that better reflect the wide cytokine profile and its relationship with morbidity. Patients infected with Trypanosoma cruzi (T. cruzi) were grouped as indeterminate (IND) and cardiac (CARD) forms ranging from 23 to 69 years of age (mean of 45.6±11.25). The IND group included 82 individuals, ranging from 24 to 66 years of age (mean of 39.6±10.3). The CARD group included 94 patients ranging from 23 to 69 years of age (mean of 48±12.52) presenting dilated cardiomyopathy. None of the patients have undergone chemotherapeutic treatment, nor had been previously treated for T. cruzi infection. Healthy non-chagasic individuals, ranging from 29 to 55 years of age (mean of 42.6±8.8) were included as a control group (NI). IND patients have a higher intensity of interleukin 10 (IL-10) expression when compared with individuals in the other groups. By contrast, inflammatory cytokine expression, such as interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), and interleukin 1 beta (IL-1β), proved to be the highest in the CARD group. Correlation analysis showed that higher IL-10 expression was associated with better cardiac function, as determined by left ventricular ejection fraction and left ventricular diastolic diameter values. Altogether, these findings reinforce the concept that a fine balance between regulatory and inflammatory cytokines represents a key element in the establishment of distinct forms of chronic Chagas disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chagas Cardiomyopathy / blood
  • Chagas Cardiomyopathy / epidemiology
  • Chagas Cardiomyopathy / immunology*
  • Chagas Disease / blood
  • Chagas Disease / epidemiology
  • Chagas Disease / immunology*
  • Cross-Sectional Studies
  • Cytokines / blood
  • Cytokines / immunology*
  • Flow Cytometry
  • Humans
  • Inflammation Mediators / blood
  • Inflammation Mediators / immunology
  • Interferon-gamma / blood
  • Interferon-gamma / immunology
  • Interleukin-10 / blood
  • Interleukin-10 / immunology
  • Interleukin-1beta / blood
  • Interleukin-1beta / immunology
  • Interleukin-6 / blood
  • Interleukin-6 / immunology
  • Middle Aged
  • Morbidity
  • Trypanosoma cruzi / immunology*
  • Young Adult

Substances

  • Cytokines
  • Inflammation Mediators
  • Interleukin-1beta
  • Interleukin-6
  • Interleukin-10
  • Interferon-gamma

Grants and funding

This study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, grant number: 478846/2009-6, http://www.cnpq.br) and Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG, grant number: APQ-02601-10, http://www.fapemig.br). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.