Resveratrol Reverses Functional Chagas Heart Disease in Mice

PLoS Pathog. 2016 Oct 27;12(10):e1005947. doi: 10.1371/journal.ppat.1005947. eCollection 2016 Oct.

Abstract

Chronic chagasic cardiomyopathy (CCC) develops years after acute infection by Trypanosoma cruzi and does not improve after trypanocidal therapy, despite reduction of parasite burden. During disease, the heart undergoes oxidative stress, a potential causative factor for arrhythmias and contractile dysfunction. Here we tested whether antioxidants/ cardioprotective drugs could improve cardiac function in established Chagas heart disease. We chose a model that resembles B1-B2 stage of human CCC, treated mice with resveratrol and performed electrocardiography and echocardiography studies. Resveratrol reduced the prolonged PR and QTc intervals, increased heart rates and reversed sinus arrhythmia, atrial and atrioventricular conduction disorders; restored a normal left ventricular ejection fraction, improved stroke volume and cardiac output. Resveratrol activated the AMPK-pathway and reduced both ROS production and heart parasite burden, without interfering with vascularization or myocarditis intensity. Resveratrol was even capable of improving heart function of infected mice when treatment was started late after infection, while trypanocidal drug benznidazole failed. We attempted to mimic resveratrol's actions using metformin (AMPK-activator) or tempol (SOD-mimetic). Metformin and tempol mimicked the beneficial effects of resveratrol on heart function and decreased lipid peroxidation, but did not alter parasite burden. These results indicate that AMPK activation and ROS neutralization are key strategies to induce tolerance to Chagas heart disease. Despite all tissue damage observed in established Chagas heart disease, we found that a physiological dysfunction can still be reversed by treatment with resveratrol, metformin and tempol, resulting in improved heart function and representing a starting point to develop innovative therapies in CCC.

MeSH terms

  • Animals
  • Antioxidants / pharmacology*
  • Chagas Cardiomyopathy / pathology*
  • Cyclic N-Oxides / pharmacology
  • Disease Models, Animal
  • Female
  • Male
  • Metformin / pharmacology
  • Mice
  • Mice, Inbred BALB C
  • Oxidative Stress / drug effects
  • Resveratrol
  • Spin Labels
  • Stilbenes / pharmacology*

Substances

  • Antioxidants
  • Cyclic N-Oxides
  • Spin Labels
  • Stilbenes
  • Metformin
  • Resveratrol
  • tempol

Grants and funding

This work was supported by DECIT Conselho Nacional de Pesquisa (CNPq), CNPq Universal, Coordenação de Aperfeiçoamento de Pessoal (CAPES), and Fundação de Amparo à Pesquisa do Rio de Janeiro (FAPERJ), Instituto Oswaldo Cruz (IOC, Fiocruz). CNP, JLV, EM, JRMF and MTB received personal CNPq grants. All funding institutions are located in Brazil. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.