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Perspectives on Chagas Disease in Latin America and the United States

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Book cover Global Infectious Diseases

Abstract

A brief review of the life cycle of T. cruzi and the clinical manifestations and epidemiology of Chagas disease will facilitate an understanding of the public health problem caused by this organism. T. cruzi is a protozoan hemoflagellate that has a complex life cycle involving several parasite stages in hematophagous reduviid bugs and mammalian hosts (1, 2) . Epimastigotes multiply in the midgut of the insect vector and transform to infective insect-derived metacyclic trypomastigotes in the hindgut. Transmission to humans occurs when metacyclic trypomastigotes in bug feces contaminate mucous membranes, conjunctivae or breaks in the skin and enter host macrophages and other cells. There, insect-derived metacyclic trypomastigotes transform into amastigotes, the proliferating form in the mammalian host. After several cycles of intracellular multiplication, amastigotes differentiate into bloodform trypomastigotes, which are then released as the host cell ruptures. Bloodform trypomastigotes penetrate adjacent cells and also spread hematogenously to distant tissues, especially cardiac muscle. After the acute phase of the infection is controlled by immune mechanisms, the parasite persists in low numbers for the life of the host, alternating asynchronously between intracellular amastigotes and circulating bloodform trypomastigotes.

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References

  1. Brener Z (1973) Biology of Trypanosoma cruzi. Ann Rev Microbiol 27: 347–382

    Article  CAS  Google Scholar 

  2. Kirchhoff LV (1990) Trypanosoma species (American Trypanosorniasis, Chagas Disease) : Biology of trypanosomes. In: Mandell GL, Douglas RG Jr Bennett JE (eds) Principles and practice of infectious diseases. New York, John Wiley & Sons, pp 2077— 2084

    Google Scholar 

  3. Brener Z (1984) Laboratory-acquired Chagas’ disease: An endemic disease among parasitologists? In: Morel CM (ed) Genes and antigens of parasites: A laboratory manual. Rio de Janeiro, Oswaldo Cruz, pp 3–9

    Google Scholar 

  4. Hofflin JM, Sadler RH, Araujo FG (1987) Laboratory-acquired Chagas’ disease. Trans R Soc Trop Med Hyg 81: 437–440

    Article  PubMed  CAS  Google Scholar 

  5. Schmunis GA (1991) Trypanosoma cruzi, the etiologic agent of Chagas’ disease: Status in the blood supply in endemic and nonendemic countries. Transfusion 31: 547–557

    Article  PubMed  CAS  Google Scholar 

  6. Carrasco R, Miguez H, Camacho C, Echalar L, Revollo S, Ampuero T, Dedet J-P (1990) Prevalence of Trypanosoma cruzi infection in blood banks of seven departments of Bolivia. Mem Inst Oswaldo Cruz 85: 69–73

    Article  PubMed  CAS  Google Scholar 

  7. Azogue E, La Fuente C, Darras CH (1985) Congenital Chagas’ disease in Bolivia: Epidemiological aspects and pathological findings. Trans R Soc Trop Med Hyg 79: 176–180

    Article  PubMed  CAS  Google Scholar 

  8. Bettencourt AL (1976) Congenital Chagas’ disease. An J Dis Child 130: 97–103

    Google Scholar 

  9. Laranja FS, Dias E, Nobrega G, Miranda A (1956) Chagas’ disease: A clinical, epidemiologic, and pathologic study. Circulation 14: 1035–1060

    Article  PubMed  Google Scholar 

  10. Spina-Franca A, Mattosinho LC (1988) South American Trypanosomiasis (Chagas’ IDisease) In: Vinken PJ, Bruyn GW, Klawans HL (eds) Handbook of clinical neurology. New York, Elsevier Science Publishing Co, pp 345–349

    Google Scholar 

  11. Kierszenbaum F, Sztein MB (1990) Mechanisms underlying immunosuppression induced by Trypanosoma cruzi. Parasitol Today 6: 261–264

    Article  PubMed  CAS  Google Scholar 

  12. Reed SG, Inverso JA, Roters SB (1984) Heterologous antibody responscs in mice with chronic Tryanosoma cruzi infection: Depressed T helper function restored with supernatants containing interleukin 2. J Immunol 133: 1558–1563

    PubMed  CAS  Google Scholar 

  13. Tarleton RL (1988) Trypanosoma cruzi-induced suppression of IL-2 production: I. Evidence for the presence of IL-2-producing cells. J Immunol 140: 2763–2768

    PubMed  CAS  Google Scholar 

  14. Beltz LA, Kierszenbaum F, Sztein MB (1990) Tryanosoma cruzi-induced suppression of human peripheral blood lymphocytes activated via the alternative (CD2) pathway. Infect Immun 58: 1114–1116

    PubMed  CAS  Google Scholar 

  15. Sztein MB, Cuna WR, Kierszenbaum F (1990) Trypanosoma cruzi inhibits the expression of CD3, CD4, CD8, and IL-2R by mitogen-activated helper and cytotoxic human lymphocytes. J Immunol 144: 3558–3562

    PubMed  CAS  Google Scholar 

  16. Beltz LA, Kierszenbaum F, Sztein MB (1989) Selective suppressive effects of T rypanosoma cruz i on activated human lymphocytes. Infect Immun 57: 2301–2305

    PubMed  CAS  Google Scholar 

  17. Amorim DS(1979) Prog Cardiol 1979; 8: 235–279

    Google Scholar 

  18. Kirchhoff LV, Neva FA (1985) Chagas’ disease in Latin American immigrants. JAMA 254: 3058–3060

    Article  PubMed  CAS  Google Scholar 

  19. Hagar JM, Rahimtoola SH (1991) Chagas’ heart disease in the United States. N Engl J Med 325: 763–768

    Article  PubMed  CAS  Google Scholar 

  20. Köberle F (1968) Chagas’ disease and Chagas’ syndromes: The pathology of American trypanosomiasis. Adv Parasitol 6: 63–116

    Article  PubMed  Google Scholar 

  21. Cossio PM, Diez C, Szarfman A (1974) Chagasic cardiopathy-demonstration of a serum gamma globulin factor which reacts with endocardium and vascular structures. Circulation 49: 13–21

    Article  PubMed  CAS  Google Scholar 

  22. Santos-Buch CA, Teixeira ARL (1974) The immunology of experimental Chagas’ disease. III. Rejection of allogeneic heart cells in vitro. J Exp Med 140: 38–53

    Article  PubMed  CAS  Google Scholar 

  23. Van Voorhis WC, Schlekewy L, Trong HL (1991) Molecular mimicry by Trypanosoma cruzi: The F1–160 epitope that mimics mammalian nerve can be mapped to a 12-amino acid peptide. Proc Natl Acad Sci USA 88: 5993–5997

    Article  PubMed  Google Scholar 

  24. Ternynck T, Bleux C, Gregoire J, Avrameas S, Kanellopoulos-Langevin C (1990) Comparison between autoantibodies arising during Trypanosoma cruzi infection in mice and natural autoantibodies. J Immunol 144: 1504–1511

    PubMed  CAS  Google Scholar 

  25. Kierszenbaum F (1985) Is there autoimmunity in Chagas’ disease? Parasitol Today 1: 4–6

    Article  PubMed  CAS  Google Scholar 

  26. Petry K, Eisen H (1989) Chagas disease: A model for the study of autoimmune diseases. Parasitol Today 5: 111–116

    Article  PubMed  CAS  Google Scholar 

  27. Davila DF, Rossell RO, Donis JH (1989) Cardiac parasympathetic abnormalities: Cause or consequence of Chagas heart disease? Parasitol Today 5: 327–329

    Article  PubMed  CAS  Google Scholar 

  28. Goble FC. South American Trypanosomes (1970) In: Jackson GJ, Herman R, Singer I (eds) Immunity to parasitic diseases in animals. New York, Appleton-Century-Crofts, pp 597–689

    Google Scholar 

  29. Beard CB, Young DG, Butler JF, Evans DA (1988) First isolation of Trypanosoma cruzi from a wild-caught Triatoma sanguisuga (LeConte) (Hemiptera: Triatominae) in Florida, U.S.A. J Parasitol 74: 343–344

    Article  PubMed  CAS  Google Scholar 

  30. Yaeger RG (1988) The prevalence of Trypanosoma cruzi infection in armadillos collected at a site near New Orleans, Louisiana. Am J Trop Med Hyg 38: 323–326

    PubMed  CAS  Google Scholar 

  31. Dias JCP (1987) Control of Chagas’ disease in Brazil. Parasitol Today 3: 336–341

    Article  PubMed  CAS  Google Scholar 

  32. Acquatella H, Catalioti F, Gomez-Mancebo JR, Davalos V, Villalobos L (1987) Long-term control of Chagas’ disease in Venezuela: Effects on serologic findings, electrocardiographic abnormalities, and clinical outcome. Circulation 76: 556–562

    Article  PubMed  CAS  Google Scholar 

  33. Mota EA, Guimaraes AC, Santana OO, Sherlock I, Hoff R, Weller TH (1990) A nine year prospective study of Chagas’ disease in a defined rural population in Northeast Brazil. Am J Trop Med Hyg 42: 429–440

    PubMed  CAS  Google Scholar 

  34. Kirchhoff LV, Garm AA, Gilliam FC (1987) American trypanosomiasis (Chagas’ disease) in Central American immigrants. Am J Med 82: 915–920

    Article  PubMed  CAS  Google Scholar 

  35. Kirchhoff LV (1989) Is T rypanosoma cruzi a new threat to our blood supply? Ann Intern Med 111: 773–775

    PubMed  CAS  Google Scholar 

  36. Grant IH, Go1d JWM, Wittner M, Tanowitz HB, Nathan C, Mayer K, Reich L, Wollner N, Steinherz L Ghavimi F, O’Reilly RJ, Armstrong D (1989) Transfusion-associated acute Chagas disease acquired in the United States. Ann Intern Med 111: 849–851

    PubMed  CAS  Google Scholar 

  37. Nickerson P, Orr P, Schroeder M-L, Sekla L, Johnston JB (1989) Transfusion-associated Trypanosoma cruzi infection in a non-endemic area. Ann Intern Med 111: 851–853

    PubMed  CAS  Google Scholar 

  38. Kirchhoff LV (1991) American trypanosomiasis (Chagas’ disease) — a persistent problem in Latin America now affects the United States. N Engl J Med

    Google Scholar 

  39. Rivero I, Moravenik M, Morales J, Gomez M, De Rosas JM (1974) Chagas’ disease — another hazard in acute leukemia. N En gl J Med 290: 285

    CAS  Google Scholar 

  40. Stolf NAG, Higushi L, Bocchi E, Bellotti G, Costa Auler JO, Uip D, Amato Neto V, Pileggi F, Jatene AD (1987) Heart transplantation in patients with Chagas’ disease cardiomyopathy. Heart Transplantation 6: 307–312

    CAS  Google Scholar 

  41. Libow LF, Beltrani VP, Silvers DN, Grossman ME (1991) Post-cardiac transplant reactivation of Chagas’ disease diagnosed by skin biopsy. Cutis 48: 37–40

    PubMed  CAS  Google Scholar 

  42. Camargo ME (1988) American Trypanosomiasis (Chagas’ Disease) . In: Balows A, Hausler WJ Jr, Lennette EH (eds) Laboratory diagnosis of infectious diseases — principles and practice. New York, Springer, pp 744–753

    Google Scholar 

  43. Kirchhoff LV, Gam AA, Gusrnao Rd’A, Goldsmith RS, Rezende JM, Rassi A (1987) Increased specificity of serodiagnosis of Chagas’ disease by detection of antibody to the 72-and 90-kilodalton glycoproteins of T rypanosoma cruzi. J Infect Dis 155: 561–564

    Article  PubMed  CAS  Google Scholar 

  44. Schechter M, Luquetti AO, Rezende JM, Rassi A, Miles MA (1985) Further evaluation of lectin affinity purified glycoprotein (GP90) in the enzyme linked immunosorbent assay (ELISA) for diagnosis of Trypanosoma cruzi infection. Trans R Soc Trop Med Hyg 79: 637— 640

    Article  PubMed  CAS  Google Scholar 

  45. Cotrim PC, Paranhos GS, Mortara RA, Wanderley J, Rassi A, Camargo ME, da Silveira JF (1990) Expression in Escherichia coli of a dominant immunogen of Trypanosoma C 171 Zi recognized by human chagasic sera. J Clin Microbiol 28: 519–524

    PubMed  CAS  Google Scholar 

  46. Luquetti AO (1990) Use of Trypanosoma cruzi defined proteins for diagnosis-multicentre trial: Serological and technical aspects. Mem Inst Oswaldo Cruz 85: 497–505

    Article  PubMed  CAS  Google Scholar 

  47. Moser DR, Kirchhoff LV, Donelson JE (1989) Detection of Trypanosoma cruzi by polymerase chain reaction gene amplification. J Clin Microbiol 27: 1744–1749

    Google Scholar 

  48. Sturm NR, Degrave W, Morel C, Simpson L (1989) Sensitive detection and schizodeme classification of Trypanosoma cruzi cells by amplification of kinetoplast minicircle DNA sequences: use in diagnosis of Chagas’ disease. Mol Biochem Parasitol 33: 205–214

    Article  PubMed  CAS  Google Scholar 

  49. Brener Z (1979) Present status of chemotherapy and chemoprophylaxis of hunan trypanosomes in the western hemisphere. Pharmacol Ther 7: 71–90

    Article  PubMed  CAS  Google Scholar 

  50. Marr JJ, Docampo R (1986) Chemotherapy for Chagas’ disease: A perspective of current therapy and considerations for future research. Rev Infect Dis 8: 884–903

    Article  PubMed  CAS  Google Scholar 

  51. Teixeira ARL Silva R, Cunha Neto E, Santana JM, Rizzo LV (1990) Malignant, nonHodgkin’s lymphomas in Trypanosoma cruzi-infected rabbits treated with nitroarenes. J Comp Path 103: 37–48

    Article  PubMed  CAS  Google Scholar 

  52. Teixeira ARL, Cordova JG, Souto Maior I, Solorzano E (1990) Chagas’ disease: Lymphoma growth in rabbits treated with benznidazole. Am J Trop Med Hyg 43: 146–158

    PubMed  CAS  Google Scholar 

  53. Gallerano RH, Marr JJ, Sosa RR (1990) Therapeutic efficacy of allopurinol in patients with chronic Chagas’ disease. Am J Trop Med Hyg 43: 159–166

    PubMed  CAS  Google Scholar 

  54. Avila JL, Avila A (1981) Trypanosoma cruzi: Allopurinol in the treatment of mice with experimental acute Chagas disease. Exp Parasitol 51: 204–208

    Article  PubMed  CAS  Google Scholar 

  55. Feagin JE (1990) RNA editing in kinetoplastid mitochondria. J Biol Chem 265: 19373— 19376

    PubMed  CAS  Google Scholar 

  56. Sartorius C, Franklin RM (1991) The use of antisense oligonucleotides as chemotherapeutic agents for parasites. Parasitol Today 7: 90–93

    Article  PubMed  CAS  Google Scholar 

  57. Buck GA, Lu H-Y (1991) Expression of an exogenous gene in Trypanosoma cruzi epimastigotes. Mol Biochem Parasitol 44: 109–114.

    Article  PubMed  Google Scholar 

  58. Eid J, Sollner-Webb B (1991) Stable integrative transformation of Trypanosorna brucei that occurs exclusively by homologous recombination. Proc Natl Acaci Sci USA 88: 2118–2121

    Article  CAS  Google Scholar 

  59. Smith DF (1990) Trypanosomatid transfection: stable introduction of 1)NA into protozoa. Parasitol Today 6: 245–247

    Article  PubMed  CAS  Google Scholar 

  60. Reed SG (1988) In vivo administration of recombinant IFN-gamma induces macrophage activation and prevents acute disease, immune suppression, and death in experimental T rypanosoma cruzi infections. J Immunol 140: 4342–4347

    PubMed  CAS  Google Scholar 

  61. Tarleton RL (1990) Depletion of CD8+ T cells increases susceptibility and reverses vaccine-induced immunity in mice infected with Trypanosoma cruzi. J Immunol 144: 717–724

    CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, and Department of Veterans Affairs Medical Center, University of Iowa, Iowa City, Iowa, USA

    Louis V. Kirchhoff

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  1. Department of Pathology, University of Texas Medical Branch, Galveston, USA

    David H. Walker

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Kirchhoff, L.V. (1992). Perspectives on Chagas Disease in Latin America and the United States. In: Walker, D.H. (eds) Global Infectious Diseases. Springer, Vienna. https://doi.org/10.1007/978-3-7091-3449-8_13

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  • DOI: https://doi.org/10.1007/978-3-7091-3449-8_13

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-82329-3

  • Online ISBN: 978-3-7091-3449-8

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