Molecular mechanisms of cardiac electromechanical remodeling during Chagas disease: Role of TNF and TGF-β

Trends Cardiovasc Med. 2017 Feb;27(2):81-91. doi: 10.1016/j.tcm.2016.08.003. Epub 2016 Aug 11.

Abstract

Chagas disease is caused by the trypanosomatid Trypanosoma cruzi, which chronically causes heart problems in up to 30% of infected patients. Chagas disease was initially restricted to Latin America. However, due to migratory events, this disease may become a serious worldwide health problem. During Chagas disease, many patients die of cardiac arrhythmia despite the apparent benefits of anti-arrhythmic therapy (e.g., amiodarone). Here, we assimilate the cardiac form of Chagas disease to an inflammatory cardiac disease. Evidence from the literature, mostly provided using experimental models, supports this view and argues in favor of new strategies for treating cardiac arrhythmias in Chagas disease by modulating cytokine production and/or action. But the complex nature of myocardial inflammation underlies the need to better understand the molecular mechanisms of the inflammatory response during Chagas disease. Here, particular attention has been paid to tumor necrosis factor alpha (TNF) and transforming growth factor beta (TGF-β) although other cytokines may be involved in the chagasic cardiomyopathy.

Keywords: Action potential; Cardiac electrophysiology; Chagas disease; Cytokine; Trypanosoma cruzi; Tumor necrosis factor.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Action Potentials
  • Animals
  • Anti-Inflammatory Agents / therapeutic use
  • Atrial Remodeling
  • Chagas Cardiomyopathy / drug therapy
  • Chagas Cardiomyopathy / metabolism*
  • Chagas Cardiomyopathy / parasitology
  • Chagas Cardiomyopathy / physiopathology
  • Heart Conduction System / drug effects
  • Heart Conduction System / metabolism*
  • Heart Conduction System / parasitology
  • Heart Conduction System / physiopathology
  • Heart Rate
  • Host-Pathogen Interactions
  • Humans
  • Inflammation Mediators / antagonists & inhibitors
  • Inflammation Mediators / metabolism*
  • Myocardial Contraction
  • Myocarditis / drug therapy
  • Myocarditis / metabolism*
  • Myocarditis / parasitology
  • Myocarditis / physiopathology
  • Myocytes, Cardiac / drug effects
  • Myocytes, Cardiac / metabolism*
  • Myocytes, Cardiac / parasitology
  • Signal Transduction
  • Transforming Growth Factor beta / metabolism*
  • Trypanosoma cruzi / pathogenicity*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Tumor Necrosis Factor-alpha / metabolism*
  • Ventricular Remodeling

Substances

  • Anti-Inflammatory Agents
  • Inflammation Mediators
  • Transforming Growth Factor beta
  • Tumor Necrosis Factor-alpha