Palomino S A, Aiello V D, Higuchi M L
Laboratório de Anatomia Patológica, University of São Paulo Medical School, Brazil.
Ann Trop Med Parasitol. 2000 Sep;94(6):571-9. doi: 10.1080/00034983.2000.11813580.
To investigate the role played by Trypanosoma cruzi in the pathogenesis of chronic chagasic cardiopathy, the myocardiums of 12 hearts from individuals who had this condition were mapped in detail. Attempts were made to associate the histopathological lesions observed with the presence of parasitic antigens in the affected tissue. Samples from 26 regions of each heart were submitted to histological analysis and immunostained for the presence of T. cruzi. All cases showed at least one positive region for antigens, but the quantity of antigen detected varied greatly. The regions showing the greatest pathological changes were the inferior atrial septum, the basal and apical portions of the ventricular septum, and the posterior basal and lateral pre-apical regions of the left ventricle. The posterior wall of the right atrium and the posterior basal wall of the left ventricle presented the greatest intensities of inflammation. Fibrosis was intense in the right atrium, the posterior basal and pre-apical left ventricular free walls and the apex. The regions in which T. cruzi antigens were detected showed the most intense inflammation. However, as there was no significant correlation between the intensity of the lesions and the quantity of parasitic antigen, other mechanisms, such as auto-immunity or hypersensitivity, may stimulate the inflammation.
为研究克氏锥虫在慢性恰加斯病性心肌病发病机制中所起的作用，对12例患有该病个体的心脏心肌进行了详细的图谱绘制。尝试将观察到的组织病理学病变与受影响组织中寄生虫抗原的存在联系起来。对每颗心脏26个区域的样本进行组织学分析，并对克氏锥虫的存在进行免疫染色。所有病例均显示至少有一个抗原阳性区域，但检测到的抗原量差异很大。显示出最大病理变化的区域是房间隔下部、室间隔基部和顶部，以及左心室后基部和前外侧心尖区域。右心房后壁和左心室后基部壁炎症最为强烈。右心房以及左心室后基部游离壁和心尖的纤维化程度很高。检测到克氏锥虫抗原的区域炎症最为强烈。然而，由于病变强度与寄生虫抗原量之间没有显著相关性，其他机制，如自身免疫或超敏反应，可能会刺激炎症。
