The innate immune response status correlates with a divergent clinical course in congenital Chagas disease of twins born in a non-endemic country

Acta Trop. 2014 Dec:140:84-90. doi: 10.1016/j.actatropica.2014.08.006. Epub 2014 Aug 19.

Abstract

The innate immune response from diamniotic and dichorionic twin brothers congenitally infected with Trypanosoma. cruzi (strain DTU-V) who displayed different clinical symptomatology was studied. While Brother I manifested severe cardiac and digestive disorders, the Brother II showed slight splenomegaly. The secretion level of IL-1β, TNF-α, IL-12, IL-10, IFN-α and IL-6 cytokines produced after stimulation of peripheral blood cells with TLR-2, TLR-4 and TLR-9 ligands was determined pre- and post-benznidazole treatment. Cells from 10 uninfected infants born to mothers seropositive for Chagas disease were included as control. The obtained data show that the cells of Brother I secreted lower levels of the pro-inflammatory cytokines IL-1β and TNF-α (upon TLR-2 and TLR-4 stimulation) relative to those secreted by cells from Brother II and uninfected controls. The cells from Brother II secreted high levels of the IL-1β cytokine following TLR-2 stimulation relative to uninfected controls. The cells from both brothers secreted a higher level of IL-6, following TLR-4 stimulation, than that secreted by uninfected infant cells. After treatments, the cytokine secretion levels were similar in both children and comparable to those of uninfected donors. Treatment success in Brother I and treatment interruption in Brother II was detected by the use of serological biomarkers (KMP11, HSP70, PFR2, Tgp63) as well as follow-up done by PCR. Therefore, the Brother II required a second treatment. The data presented suggest that benznidazol treatment allows the innate immune system to reach a fully functional status similar to that of uninfected subjects.

Keywords: Chagas disease; Congenital transmission; Innate immune response; PCR; Serological biomarker; Trypanosoma cruzi.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chagas Disease / congenital
  • Chagas Disease / drug therapy
  • Chagas Disease / immunology*
  • Chagas Disease / transmission
  • Cytokines / immunology
  • Cytokines / metabolism
  • Diseases in Twins / congenital
  • Diseases in Twins / drug therapy
  • Diseases in Twins / immunology*
  • Female
  • HSP70 Heat-Shock Proteins / immunology
  • Humans
  • Immunity, Innate
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Male
  • Nitroimidazoles / administration & dosage*
  • Pregnancy
  • Pregnancy Complications, Parasitic / immunology
  • Spain
  • Trypanocidal Agents / administration & dosage*
  • Twins, Dizygotic*

Substances

  • Cytokines
  • HSP70 Heat-Shock Proteins
  • Nitroimidazoles
  • Trypanocidal Agents
  • benzonidazole