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- Title
Chagas Cardiomyopathy Manifestations and Trypanosoma cruzi Genotypes Circulating in Chronic Chagasic Patients.
- Authors
Ramírez, Juan David; Guhl, Felipe; Rendón, Lina María; Rosas, Fernando; Marin-Neto, Jose A.; Morillo, Carlos A.
- Abstract
Chagas disease caused by Trypanosoma cruzi is a complex disease that is endemic and an important problem in public health in Latin America. The T. cruzi parasite is classified into six discrete taxonomic units (DTUs) based on the recently proposed nomenclature (TcI, TcII, TcIII, TcIV, TcV and TcVI). The discovery of genetic variability within TcI showed the presence of five genotypes (Ia, Ib, Ic, Id and Ie) related to the transmission cycle of Chagas disease. In Colombia, TcI is more prevalent but TcII has also been reported, as has mixed infection by both TcI and TcII in the same Chagasic patient. The objectives of this study were to determine the T. cruzi DTUs that are circulating in Colombian chronic Chagasic patients and to obtain more information about the molecular epidemiology of Chagas disease in Colombia. We also assessed the presence of electrocardiographic, radiologic and echocardiographic abnormalities with the purpose of correlating T. cruzi genetic variability and cardiac disease. Molecular characterization was performed in Colombian adult chronic Chagasic patients based on the intergenic region of the mini-exon gene, the 24Sα and 18S regions of rDNA and the variable region of satellite DNA, whereby the presence of T.cruzi I, II, III and IV was detected. In our population, mixed infections also occurred, with TcI-TcII, TcI-TcIII and TcI-TcIV, as well as the existence of the TcI genotypes showing the presence of genotypes Ia and Id. Patients infected with TcI demonstrated a higher prevalence of cardiac alterations than those infected with TcII. These results corroborate the predominance of TcI in Colombia and show the first report of TcIII and TcIV in Colombian Chagasic patients. Findings also indicate that Chagas cardiomyopathy manifestations are more correlated with TcI than with TcII in Colombia. Author Summary: Trypanosoma cruzi the aetiological agent of Chagas disease infects over 8 million people in Latin America. Currently, six genetic groups or DTUs have been identified in this highly genetic and diverse parasite. Many authors have considered that disease installation is induced by this genetic variability in T. cruzi but few comparisons have been made to make an approach of this premise. We performed an analysis including 240 chronic ascertained Chagasic patients evaluating cardiac alterations in electrocardiogram, radiology and echocardiogram. Also, we developed molecular characterisation on samples from these patients showing that in Colombia T.cruzi I is the predominant but others such as TcII, TcIII and TcIV can be found in low proportions as mixed infections TcI/TcII-TcIV. We conclude that TcI is more related to cardiomyopathy than TcII and we show the first report of TcIII and IV in chronic Chagasic patients from Colombia. These results will help to elucidate the molecular epidemiology of T. cruzi in this country.
- Subjects
COLOMBIA; TRYPANOSOMA cruzi; CHAGAS' disease; SATELLITE DNA; GENETIC variation; GENOTYPES
- Publication
PLoS Neglected Tropical Diseases, 2010, Vol 4, Issue 11, p1
- ISSN
1935-2727
- Publication type
Article
- DOI
10.1371/journal.pntd.0000899