Universidad Militar Nueva Granada, Bogotá-Colombia.
Parasitology. 2013 Feb;140(2):147-59. doi: 10.1017/S0031182012001394. Epub 2012 Sep 25.
Chagas disease or American trypanosomiasis is a pathology affecting about 8-11 million people in Mexico, Central America, and South America, more than 300 000 persons in the United States as well as an indeterminate number of people in other non-endemic countries such as USA, Spain, Canada and Switzerland. The aetiological agent is Trypanosoma cruzi, a protozoan transmitted by multiple routes; among them, congenital route emerges as one of the most important mechanisms of spreading Chagas disease worldwide even in non-endemic countries and the oral route as the responsible of multiple outbreaks of acute Chagas disease in regions where the vectorial route has been interrupted. The aim of this review is to illustrate the recent research and advances in host-pathogen interaction making a model of how the virulence factors of the parasite would interact with the physiology and immune system components of the placental barrier and gastrointestinal tract in order to establish a response against T. cruzi infection. This review also presents the epidemiological, clinical and diagnostic features of congenital and oral Chagas disease in order to update the reader about the emerging scenarios of Chagas disease transmission.
恰加斯病又称美洲锥虫病，是一种影响墨西哥、中美洲和南美洲约 800 万至 1100 万人、美国 30 多万人以及美国、西班牙、加拿大和瑞士等其他非流行国家不定数量人群的疾病。该病的病原体为克氏锥虫，一种通过多种途径传播的原生动物；其中，先天性传播成为全世界传播恰加斯病的最重要机制之一，甚至在非流行国家也是如此，而口腔传播则是导致传播媒介途径已被阻断地区急性恰加斯病多次暴发的原因。本文旨在阐述宿主-病原体相互作用的最新研究和进展，建立一种模式，说明寄生虫的毒力因子将如何与胎盘屏障和胃肠道的生理学和免疫系统成分相互作用，以对克氏锥虫感染产生反应。本文还介绍了先天性和口腔恰加斯病的流行病学、临床和诊断特征，以便读者了解恰加斯病传播的新情况。
