Volume 84, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We investigated the relationship between potentially pathogenic antibodies against a ribosomal protein (P2β) and the evolution of Chagas disease and the effect of trypanocidal treatment on these variables. Seventy-eight patients with chronic Chagas disease who were followed-up for more than 20 years were divided into three groups: 30 asymptomatic persons undergoing specific treatment (group A), 37 asymptomatic persons not undergoing specific treatment (group B), and 11 patients with chronic chagasic cardiomyopathy (CCC) who were not treated. Five patients in group B showed evolution to myocardial abnormalities. Among persons with CCC, six showed no changes; the remaining persons showed progression of cardiac involvement. Levels of antibodies to P2β in persons in group A decreased from their initial values. This finding was not observed in persons in groups B and C. Comparisons at the end of the follow-up showed lower amounts of antibodies to P2β in groups A and C. These findings support the benefits of specific treatment during chronic infection.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Pan American Health Organization–World Health Organization, 2006. Estimación Cuantitativa de la Enfermedad de Chagas en las Américas. Washington, DC and Geneva: Pan American Health Organization–World Health Organization, OPS/HDM/CD/425-0G. [Google Scholar]
  2. Andrade ZA, , 1999. Immunopathology of Chagas disease. Mem Inst Oswaldo Cruz 94: 7180.[Crossref] [Google Scholar]
  3. Prata A, , 2001. Clinical and epidemiological aspects of Chagas disease. Lancet Infect Dis 1: 92100.[Crossref] [Google Scholar]
  4. Reis MM, Higuchi ML, Benvenuti LA, Aiello VD, Gutierrez PS, Bellotti G, Pileggi F, , 1997. An in situ quantitative immunohistochemical study of cytokines and IL-2R+ in chronic human chagasic myocarditis: correlation with the presence of myocardial Trypanosoma cruzi antigens. Clin Immunol Immunopathol 83: 165172.[Crossref] [Google Scholar]
  5. Tarleton RL, , 2001. Parasite persistence in the aetiology of Chagas disease. Int J Parasitol 31: 550554.[Crossref] [Google Scholar]
  6. Brener Z, Gazzinelli RT, , 1997. Immunological control of Trypanosoma cruzi infection and pathogenesis of Chagas' disease. Int Arch Allergy Immunol 114: 103110.[Crossref] [Google Scholar]
  7. Higuchi ML, De Morais F, Pereira-Barreto AC, Lopes EA, Stolf N, Bellotti G, Pileggi F, , 1987. The role of active myocarditis in the development of heart failure in chronic Chagas disease: a study based on endomyocardial biopsies. Clin Cardiol 10: 665670.[Crossref] [Google Scholar]
  8. Pontes-De-Carvalho L, Santana CC, Soares MB, Oliveira GG, Cunha-Neto E, Ribeiro-Dos-Santos R, , 2002. Experimental chronic Chagas' disease myocarditis is an autoimmune disease preventable by induction of immunological tolerance to myocardial antigens. J Autoimmun 18: 131138.[Crossref] [Google Scholar]
  9. Higuchi ML, Brito T, Reis M, Bellotti G, Pereira-Barreto AC, Pileggi F, , 1993. Correlation between Trypanosoma cruzi parasitism and myocardial inflammation in human chronic chagasic myocardits. Light microscopy and immunohistochemical findings. Cardiovasc Pathol 2: 101106.[Crossref] [Google Scholar]
  10. Higuchi ML, Reis M, Aiello VD, Benvenutti LA, Gutierrez PS, Bellotti G, Pileggi F, , 1997. Human chronic chagasic myocarditis is Trypanosoma cruzi antigen and CD8+ T cell dependent. Am J Trop Med Hyg 56: 485489. [Google Scholar]
  11. Jones EM, Colley DG, Tostes S, Lopes ER, Venencak-Jones C, Mc Curley TL, , 1993. Amplification of Trypanosoma cruzi DNA sequence from inflammatory lesions in human chagasic cardiomyopathy. Am J Trop Med Hyg 48: 348357. [Google Scholar]
  12. Añez N, Carrasco H, Parada H, Crisante G, Rojas A, Fuenmayor C, Gonzalez N, Percoco G, Borges R, Guevara P, Ramírez JL, , 1999. Myocardial parasite persistence in chronic chagasic patients. Am J Trop Med Hyg 60: 726732. [Google Scholar]
  13. Aznar C, Lopez-Bergami P, Brandariz S, Mariette C, Liegeard P, Alves M, Barreiro E, Carrasco R, Lafon S, Kaplan D, Miguez H, Camacho C, Levitus G, Levin M, Hontebeyrie M, , 1995. Prevalence of anti- R-13 antibodies in human Trypanosoma cruzi infection. FEMS Immunol Med Microbiol 12: 231238.[Crossref] [Google Scholar]
  14. Levitus G, Hontebeyre-Joskowicz M, Van Regenmortel M, Levin MJ, , 1991. Humoral autoimmune response to ribosomal P proteins in chronic Chagas' heart disease. Clin Exp Immunol 85: 413417.[Crossref] [Google Scholar]
  15. Lopez Bergami P, Scaglione J, Levin MJ, , 2001. Antibodies against the carboxylterminal end of the Trypanosoma cruzi ribosomal P proteins are pathogenic. FASEB J 15: 26022612.[Crossref] [Google Scholar]
  16. Masuda MO, Levin M, De Oliveira SF, Dos Santos Costa PC, Bergami PL, Dos Santos Almeida NA, Pedrosa RC, Ferrari I, Hoebeke J, Campos de Carvalho AC, , 1998. Functionally active cardiac antibodies in chronic Chagas' disease are specifically blocked by Trypanosoma cruzi antigens. FASEB J 12: 15511558. [Google Scholar]
  17. Laucella SA, Pérez Mazliah D, Bertocchi G, Alvarez MG, Cooley G, Viotti R, Albareda MC, Lococo B, Postan M, Armenti A, Tarleton RL, , 2009. Changes in Trypanosoma cruzi–specific immune responses after treatment: surrogate markers of treatment efficacy. Clin Infect Dis 49: 16751684.[Crossref] [Google Scholar]
  18. Diez C, Gea S, Marcipar I, Pezzotto S, Beloscar J, Pellizzon O, Marcipar A, Bottasso O, , 2006. Cardiovascular risk factors in chronic Chagas' disease are associated with a different profile of putative heart-pathogenic antibodies. FEMS Immunol Med Microbiol 48: 2633.[Crossref] [Google Scholar]
  19. Sgammini HO, , 1981. Criterio de clasificación de la miocardiopatía chagásica. Rev Fed Arg Cardiol 10: 145152. [Google Scholar]
  20. Marcipar I, Olivares ML, Robles L, Dekanty A, Marcipar A, Silber A, , 2004. The diagnostic performance of recombinant Trypanosoma cruzi ribosomal P2 protein is influenced by its expression system. Protein Expr Purif 34: 17.[Crossref] [Google Scholar]
  21. Laemmli UK, , 1970. Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature 227: 680685.[Crossref] [Google Scholar]
  22. Bradford MM, , 1976. A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal Biochem 72: 248254.[Crossref] [Google Scholar]
  23. Viotti RJ, Vigliano C, Armenti A, Segura EL, , 1994. Treatment of chronic Chagas'disease with benznidazole: clinical and serologic evolution of patients with long-term follow-up. Am Heart J 127: 151161.[Crossref] [Google Scholar]
  24. Cançado JR, , 2002. Long term evaluation of etiological treatment of Chagas disease with benznidazole. Rev Inst Med Trop Sao Paulo 44: 121.[Crossref] [Google Scholar]
  25. Viotti RJ, Vigliano C, Lococo B, Bertocchi G, Petti M, Alvarez MG, Postan M, Armenti A, , 2006. Long-term cardiac outcomes of treatment chronic Chagas disease with benznidazole versus no treatment: a nonrandomized trial. Ann Intern Med 144: 724734.[Crossref] [Google Scholar]
  26. Fabbro DL, Streiger ML, Arias ED, Bizai ML, del Barco ML, Amicone NA, , 2007. Trypanocide treatment among adults with chronic Chagas disease living in Santa Fe city (Argentina), over a mean follow-up of 21 years: parasitological, serological and clinical evolution. Rev Soc Bras Med Trop 40: 110.[Crossref] [Google Scholar]
  27. Garcia S, Ramos CO, Senra JF, Vilas-Boas F, Rodriguez MM, Campos-de-Carvalho AC, Ribeiro-Dos-Santos R, Soares MB, , 2005. Treatment with benznidazole during the chronic phase of experimental Chagas' disease decreases cardiac alterations. Antimicrob Agents Chemother 49: 15211528.[Crossref] [Google Scholar]
  28. Hyland KV, Leon JS, Daniels MD, Giafis N, Woods LM, Bahk TJ, Wang K, Engman DM, , 2007. Modulation of autoimmunity by treatment of an infectious disease. Infect Immun 75: 36413650.[Crossref] [Google Scholar]
  29. Levin MJ, Mesri W, Benarous R, Levitus G, Schijman A, Levy-Yeyati P, Chiale PA, Ruiz AM, , 1989. Identification of major Trypanosoma cruzi antigenic determinants in chronic Chagas' heart disease. Am J Trop Med Hyg 41: 530538. [Google Scholar]
  30. Milei J, Storino R, Milei J, , 1994. Patogenia. , eds. Enfermedad de Chagas. Buenos Aires: Mosby-Doyma, 103128. [Google Scholar]
  31. Bonney KM, Engman DM, , 2008. Chagas heart disease pathogenesis: one mechanism or many? Curr Mol Med 8: 510518.[Crossref] [Google Scholar]
  32. Kierszenbaum F, , 2007. Mechanism of pathogenesis in Chagas disease. Acta Parasitol 52: 112.[Crossref] [Google Scholar]
  33. Tarleton RL, , 2003. Chagas disease: a role for autoimmunity? Trends Parasitol 19: 447451.[Crossref] [Google Scholar]
  34. Schwartz D, Lellouch J, , 1967. Explanatory and pragmatic attitudes in therapeutical trials. J Chronic Dis 20: 637648.[Crossref] [Google Scholar]

Data & Media loading...


  • Received : 06 May 2010
  • Accepted : 29 Dec 2010
  • Published online : 05 Apr 2011

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error