Monitoring of immunossupressed patients with Chagas Disease, response levels of parasitemia and associate with cytokines profile and polymorphism and patient survival and Trypanosoma cruzi isolate characteristics under organ transplant, immunosuppressive drugs

• Grant number: 12/50273-0
• Support type: Regular Research Grants
• Duration: December 01, 2012 - March 31, 2015
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal researcher: Maria Aparecida Shikanai Yasuda
• Grantee: Maria Aparecida Shikanai Yasuda
• Home Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Considering the high morbi-mortality of Chagas disease reactivation in immunosupressed patients, this prospective report aims: 1) to monitor transplanted or pre-transplant patients by analyzing levels of parasitemia; 2) to verify the influence of parasitemia on the survival of cardiomiopathic patients after 6 and 12 months comparing to cardiac biomarkers (troponin, natriuretic peptide type B and anexin); 3) to evaluate the relation between genetic polymorphisms of pro- and anti-inflammatory cytokines and parasitemia and the clinical forms of the disease in a cohort study of 320 chagasic individuals with or without cardiopathy and controls; 4) to define the detection limit of the number of parasite copies by Real Time PCR according to parasite lineage; 5) to verify the variability of the parasite after multiple isolations from the same patient recovered after therapeutic failure; 6) to verify the roles of biomarkers, leveis of cytokines and PCR in the post-therapeutic control; 7) to verify the frequency of negative seroconversion during immunosupression and its relation to different IgG subclasses. The finding of association between parasitemia and survival in a group with advanced cardiopathy may impact the definition of priorities for cardiac transplant and the orientation of specific therapy in this group of patients with high risk for adverse events during treatment. Also it may impact the usefulness of such inflammatory markers in the therapeutic control, considering that there are no short term reliable patterns and that success rates with serology negativation is only 20-30%. It is also expected to implement the monitoring of patients under immunosupression by Real Time PCR from the definition of factors associated to detection limit and to influence in the morbi-mortality of reactivation of Chagas disease. The analyzes of genetic polymorphisms of cytokines and their influence on levels of parasitemia are especially important to a better comprehension of the immunopathogeny of chronic Chagas cardiopathy. (AU)

Scientific publications

(4)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

MARIA APARECIDA SHIKANAI YASUDA. Emerging and reemerging forms of Trypanosoma cruzi transmission. Memórias do Instituto Oswaldo Cruz, v. 117, 2022-05-16.

GOMES DOS SANTOS, ALEXANDRA; WATANABE, ELIESER HITOSHI; FERREIRA, DAIANE TOMOMI; OLIVEIRA, JAMILLE; NAKANISHI, ERIKA SHIMODA; OLIVEIRA, CLAUDIA SILVA; BOCCHI, EDIMAR; NOVAES, CRISTINA TERRA GALLAFRIO; CRUZ, FATIMA; CARVALHO, NOEMIA BARBOSA; SATO, PAULA KEIKO; YAMASHIRO-KANASHIRO, EDITE HATSUMI; PONTILLO, ALESSANDRA; DE FREITAS, VERA LUCIA TEIXEIRA; ONUCHIC, LUIZ FERNANDO; SHIKANAI-YASUDA, MARIA APARECIDA. A Specific IL6 Polymorphic Genotype Modulates the Risk of Trypanosoma cruzi Parasitemia While IL18, IL17A, and IL1B Variant Profiles and HIV Infection Protect Against Cardiomyopathy in Chagas Disease. FRONTIERS IN IMMUNOLOGY, v. 11, OCT 22 2020. Web of Science Citations: 0.

ZAIDEL, EZEQUIEL JOSE; FORSYTH, COLIN J.; NOVICK, GABRIEL; MARCUS, RACHEL; RIBEIRO, ANTONIO LUIZ P.; PINAZO, MARIA-JESUS; MORILLO, CARLOS A.; ECHEVERRIA, LUIS EDUARDO; SHIKANAI-YASUDA, MARIA APARECIDA; BUEKENS, PIERRE; PEREL, PABLO; MEYMANDI, SHEBA K.; RALSTON, KATE; PINTO, FAUSTO; SOSA-ESTANI, SERGIO. COVID-19: Implications for People with Chagas Disease. GLOBAL HEART, v. 15, n. 1 2020. Web of Science Citations: 0.

TOZETTO-MENDOZA, TANIA REGINA; VASCONCELOS, DEWTON DE MORAES; IBRAHIM, KARIM YAQUB; CHRISTOVAM SARTORI, ANA MARLI; BEZERRA, RITA C.; TEIXEIRA DE FREITAS, VERA LUCIA; SHIKANAI-YASUDA, MARIA APARECIDA. Role of T. cruzi exposure in the pattern of T cell cytokines among chronically infected HIV and Chagas disease patients. Clinics, v. 72, n. 11, p. 652-660, NOV 2017. Web of Science Citations: 1.