Machado Fabiana S, Tyler Kevin M, Brant Fatima, Esper Lisia, Teixeira Mauro M, Tanowitz Herbert B
Department of Biochemistry and Immunology, Institute of Biological Sciences, Belo Horizonte, Brazil.
Front Biosci (Elite Ed). 2012 Jan 1;4(5):1743-58. doi: 10.2741/495.
Trypanosoma cruzi is the etiologic agent of Chagas disease. The contributions of parasite and immune system for disease pathogenesis remain unresolved and controversial. The possibility that Chagas disease was an autoimmune progression triggered by T. cruzi infection led some to question the benefit of treating chronically T. cruzi-infected persons with drugs. Furthermore, it provided the rationale for not investing in research aimed at a vaccine which might carry a risk of inducing autoimmunity or exacerbating inflammation. This viewpoint was adopted by cash-strapped health systems in the developing economies where the disease is endemic and has been repeatedly challenged by researchers and clinicians in recent years and there is now a considerable body of evidence and broad consensus that parasite persistence is requisite for pathogenesis and that antiparasitic immunity can be protective against T. cruzi pathogenesis without eliciting autoimmune pathology. Thus, treatment of chronically infected patients is likely to yield positive outcomes and efforts to understand immunity and vaccine development should be recognized as a priority area of research for Chagas disease.
克氏锥虫是恰加斯病的病原体。寄生虫和免疫系统在疾病发病机制中的作用仍未得到解决且存在争议。恰加斯病是由克氏锥虫感染引发的自身免疫进展这一可能性，导致一些人质疑用药物治疗慢性克氏锥虫感染患者的益处。此外，这也为不投资于可能存在诱导自身免疫或加剧炎症风险的疫苗研究提供了理论依据。这种观点被疾病流行的发展中经济体资金紧张的卫生系统所采纳，近年来研究人员和临床医生对此提出了反复质疑，现在有大量证据和广泛共识表明，寄生虫持续存在是发病机制所必需的，并且抗寄生虫免疫可以预防克氏锥虫发病机制而不引发自身免疫病理。因此，治疗慢性感染患者可能会产生积极结果，并且理解免疫和疫苗开发的努力应被视为恰加斯病研究的优先领域。
