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 Opportunities: Regular Research Grants
• Start date: December 01, 2012
• End date: March 31, 2015
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Maria Aparecida Shikanai Yasuda
• Grantee: Maria Aparecida Shikanai Yasuda
• Host 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

(8)

(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)

BUCCHERI, RENATA; KASSAB, MARIA JOSE; TEIXEIRA DE FREITAS, VERA LUCIA; VICENTE DA SILVA, SHEILA CRISTINA; BEZERRA, RITA C.; KHOURY, ZARIFA; SHIKANAI-YASUDA, MARIA APARECIDA; VIDAL, JOSE E.. Meningoencefalite chagásica em paciente infectada pelo HIV com imunodepressão moderada: desafios na era HAART e sobrevida prolongada. Revista do Instituto de Medicina Tropical de São Paulo, v. 57, n. 6, p. 531-535, NOV-DEC 2015. (12/50273-0)

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; et al. COVID-19: Implications for People with Chagas Disease. GLOBAL HEART, v. 15, n. 1, 2020. (12/50273-0)

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. 9-pg., 2017-11-01. (12/50273-0)

NOEMIA BARBOSA CARVALHO; VERA LÚCIA TEIXEIRA DE FREITAS; FERNANDA SALLES SEGURO; RITA CRISTINA BEZERRA; GIANCARLO FATOBENE; ÉRIKA YOSHIE SHIMODA NAKANISHI; HELENA VISNADI; GRACIA MARTINEZ; MARJORIE VIEIRA BATISTA; VANDERSON ROCHA; et al. Multiple myeloma and Chagas disease: qPCR as a marker for preemptive antiparasitic therapy: a case reports series and review. Revista do Instituto de Medicina Tropical de São Paulo, v. 66, 2024-02-05. (12/50273-0)

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. (12/50273-0)

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; et al. 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. (19/06363-4, 12/50273-0)

MARIA APARECIDA SHIKANAI YASUDA. Emerging and reemerging forms of Trypanosoma cruzi transmission. Memórias do Instituto Oswaldo Cruz, v. 117, 2022-05-16. (12/50273-0)

CARVALHO, NOEMIA BARBOSA; DE FREITAS, VERA TEIXEIRA; BEZERRA, RITA CRISTINA; NAKANISHI, ERIKA SHIMODA; VELLOSO, ELVIRA PEREIRA; HIGASHINO, HERMES RYOITI; BATISTA, MARJORIE VIEIRA; FONSECA, GUILHERME HENRIQUE; ROCHA, VANDERSON; COSTA, SILVIA FIGUEIREDO; et al. Aplastic Anemia and Chagas Disease: T. cruzi Parasitemia Monitoring by Quantitative PCR and Preemptive Antiparasitic Therapy. TROPICAL MEDICINE AND INFECTIOUS DISEASE, v. 7, n. 10, p. 11-pg., 2022-10-01. (12/50273-0)