Assessment of cross-reactive host-pathogen antibodies in patients with different stages of chronic Chagas disease

Rev Esp Cardiol (Engl Ed). 2013 Oct;66(10):791-6. doi: 10.1016/j.rec.2013.05.028. Epub 2013 Aug 22.

Abstract

Introduction and objectives: Trypanosoma cruzi infection has been shown to induce humoral autoimmune responses against host antigens tissues. Particularly, antibodies cross-reacting with myocardial antigens may play a role in the development of the severe forms of chronic Chagas disease. The aim of this study was to determine the association between clinical stage of the disease and the presence of autoantibodies in patients with chronic Chagasic disease.

Methods: We performed a cross-sectional study in T. cruzi-seropositive patients divided into 3 groups according to the classic classification of chronic Chagas heart of Storino et al. All participants underwent complete clinical examination and their sera were used to measure autoantibody levels.

Results: All patients had detectable levels of anti-p2β and anti-B13 autoantibodies but none had anti-Na-K-ATPase antibodies. No association was observed between electrocardiographic conduction disturbances and autoantibody levels. Patients with chronic Chagas disease stage III had the highest levels of anti-B13 antibodies and a high risk of mortality score, showing a clear association between disease stage and this score.

Conclusions: Anti-B13 antibodies were significantly higher in chronic Chagas disease stage III patients, suggesting that these antibodies may be involved in disease progression and that they might be a useful marker of poor prognosis in terms of heart compromise. Our results also reveal an important correlation between the level of anti-B13 autoantibodies and symptomatic heart failure and/or dilated cardiomyopathy.

Keywords: Anti-B13 autoantibodies; Autoanticuerpos anti-B13; CCD; Chagas disease; Enfermedad de Chagas; Heart failure; IODN; Insuficiencia cardiaca; Trypanosoma cruzi; chronic Chagas disease; index of the optical density of autoantibodies in relation to the negative control.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antibodies, Protozoan / immunology
  • Autoantibodies / analysis
  • Autoantibodies / immunology*
  • Chagas Cardiomyopathy / diagnostic imaging
  • Chagas Cardiomyopathy / immunology*
  • Chagas Cardiomyopathy / mortality*
  • Chagas Cardiomyopathy / physiopathology
  • Chronic Disease
  • Cross-Sectional Studies
  • Disease Progression
  • Echocardiography, Doppler / methods
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Follow-Up Studies
  • Heart Failure / etiology
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Host-Pathogen Interactions / immunology*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Reference Values
  • Risk Assessment
  • Severity of Illness Index
  • Survival Analysis
  • Trypanosoma cruzi / immunology*

Substances

  • Antibodies, Protozoan
  • Autoantibodies