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Autoimmunity and the Paradox of Chagas Disease

  • Ester Roffe
  • Philip M. Murphy
Chapter

Abstract

Chagas disease, also known as American trypanosomiasis, is a vector-borne zoonosis endemic to Latin America that is caused by persistent infection with the protozoan Trypanosoma cruzi. Chagas disease poses a major public health burden to Latin America where it plays out as a ticking time bomb over decades in two stages: an acute stage marked by parasitemia with or without symptoms and a frequently fatal chronic stage that presents in ~one-third of infected individuals as an inflammatory dilated cardiomyopathy and/or inflammatory dilatation of the colon and esophagus. Although T. cruzi has fulfilled Koch’s postulates in Chagas disease, the pathogen burden is typically very low or even undetectable in the chronic stage despite exuberant immunopathology. This paradox has led to an autoimmune theory of pathogenesis that despite intense investigation remains inconclusive and controversial.

Keywords

Trypanosoma cruzi Cardiomyopathy Zoonosis Cytokine Th1 immunity 

Abbreviation

TNF

Tumor necrosis factor

Notes

Acknowledgments

This work was supported by the Division of Intramural Research of the National Institute of Allergy and Infectious Disease of the National Institutes of Health.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Departamento de Bioquímica e ImunologiaUniversidade Federal de Minas GeraisBelo HorizonteBrazil
  2. 2.Laboratory of Molecular ImmunologyNational Institute of Allergy and Infectious Diseases, National Institutes of HealthBethesdaUSA

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