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A systematic review of the Trypanosoma cruzi genetic heterogeneity, host immune response and genetic factors as plausible drivers of chronic chagasic cardiomyopathy

Published online by Cambridge University Press:  13 September 2018

Paula Jiménez ,
Jesús Jaimes ,
Cristina Poveda  and
Juan David Ramírez Open the ORCID record for Juan David Ramírez [Opens in a new window]
Paula Jiménez
Affiliation:
Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
Jesús Jaimes
Affiliation:
Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
Cristina Poveda
Affiliation:
Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA
Juan David Ramírez*
Affiliation:
Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
*
Author for correspondence: Juan David Ramírez, E-mail: juand.ramirez@urosario.edu.co
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Abstract

Chagas disease is a complex tropical pathology caused by the kinetoplastid Trypanosoma cruzi. This parasite displays massive genetic diversity and has been classified by international consensus in at least six Discrete Typing Units (DTUs) that are broadly distributed in the American continent. The main clinical manifestation of the disease is the chronic chagasic cardiomyopathy (CCC) that is lethal in the infected individuals. However, one intriguing feature is that only 30–40% of the infected individuals will develop CCC. Some authors have suggested that the immune response, host genetic factors, virulence factors and even the massive genetic heterogeneity of T. cruzi are responsible of this clinical pattern. To date, no conclusive data support the reason why a few percentages of the infected individuals will develop CCC. Therefore, we decided to conduct a systematic review analysing the host genetic factors, immune response, cytokine production, virulence factors and the plausible association of the parasite DTUs and CCC. The epidemiological and clinical implications are herein discussed.

Keywords

Chagas diseasechronic chagasic cardiomyopathyDTUsgenetic factorsTrypanosoma cruzivirulence

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Type
Review Article
Information
Parasitology , Volume 146 , Issue 3 , March 2019 , pp. 269 - 283
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Copyright © Cambridge University Press 2018 

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Footnotes

*

Both authors contributed equally.

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