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Amplification of a Trypanosoma Cruzi DNA Sequence from Inflammatory Lesions in Human Chagasic Cardiomyopathy

Elizabeth M. Jones Department of Pathology, Vanderbilt University Medical Center, Department of Veterans' Affairs Medical Center, Departments of Microbiology and Immunology, and of Medicine, Vanderbilt University School of Medicine, Faculdade de Medicina do Triangulo Mineiro, Nashville, Tennessee, Brazil

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Daniel G. Colley Department of Pathology, Vanderbilt University Medical Center, Department of Veterans' Affairs Medical Center, Departments of Microbiology and Immunology, and of Medicine, Vanderbilt University School of Medicine, Faculdade de Medicina do Triangulo Mineiro, Nashville, Tennessee, Brazil

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Sebastiao Tostes Department of Pathology, Vanderbilt University Medical Center, Department of Veterans' Affairs Medical Center, Departments of Microbiology and Immunology, and of Medicine, Vanderbilt University School of Medicine, Faculdade de Medicina do Triangulo Mineiro, Nashville, Tennessee, Brazil

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Edison Reis Lopes Department of Pathology, Vanderbilt University Medical Center, Department of Veterans' Affairs Medical Center, Departments of Microbiology and Immunology, and of Medicine, Vanderbilt University School of Medicine, Faculdade de Medicina do Triangulo Mineiro, Nashville, Tennessee, Brazil

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Cindy L. Vnencak-Jones Department of Pathology, Vanderbilt University Medical Center, Department of Veterans' Affairs Medical Center, Departments of Microbiology and Immunology, and of Medicine, Vanderbilt University School of Medicine, Faculdade de Medicina do Triangulo Mineiro, Nashville, Tennessee, Brazil

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Thomas L. McCurley Department of Pathology, Vanderbilt University Medical Center, Department of Veterans' Affairs Medical Center, Departments of Microbiology and Immunology, and of Medicine, Vanderbilt University School of Medicine, Faculdade de Medicina do Triangulo Mineiro, Nashville, Tennessee, Brazil

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DOI:
https://doi.org/10.4269/ajtmh.1993.48.348
Volume/Issue:
Volume 48: Issue 3
Page(s):
348–357
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The major cause of morbidity and mortality in Chagas' disease is a chronic inflammatory cardiomyopathy, which presents ten or more years following initial infection. Demonstration of Trypanosoma cruzi in cardiac tissue by routine microscopy or culture is difficult in these patients, which has suggested that persistent organisms are not required for chronic disease. Consequently, studies have focused on elucidating an autoimmune pathogenesis of chronic injury. To further assess the persistence of T. cruzi in host tissue, DNA extracted from formalin-fixed, paraffin-embedded autopsy specimens from seronegative or seropositive patients was amplified by the polymerase chain reaction using T. cruzi-specific primers. Trypanosoma cruzi DNA sequences were not consistently amplified from four seropositive patients who lacked evidence of fatal chronic chagasic cardiomyopathy (CCC) (0 positive of 12 heart samples, 0 positive of four gonadal samples, and 0 positive of four adrenal samples) or nine seronegative patients (0 positive of 27 heart samples, 0 positive of nine gonadal samples and 0 positive of nine adrenal samples). In seven seropositive patients with severe CCC, cardiac tissue adjacent to inflammatory infiltrates yielded amplified T. cruzi DNA sequences in 18 of 21 heart samples. Parallel testing of gonadal and adrenal tissues from these same patients produced detectable T. cruzi DNA in none of the gonadal tissue samples and one of the seven adrenals. Our studies demonstrate that T. cruzi, or a portion of its genome, is present in the inflammatory lesion of chronic cardiac Chagas' disease.

Author Notes

Copyright:
Copyright © 1993 by The American Society of Tropical Medicine and Hygiene 1993
Published Online:
Mar 1993
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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