Rodríguez-Angulo Héctor, Marques Juan, Mendoza Ivan, Villegas Marco, Mijares Alfredo, Gironès Núria, Fresno Manuel
Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela.
Instituto de Medicina Tropical, Caracas, Venezuela.
BMC Infect Dis. 2017 Mar 21;17(1):221. doi: 10.1186/s12879-017-2324-x.
Chagas disease is caused by the protozoan Trypanosoma cruzi and is characterized by heart failure and sudden death. Identifying which factors are involved in evolution and treatment response is actually challenging. Thus, the aim of this work was to determine the Th1/Th17 (IL-6, IL-2, TNF, IL-17 and IFN-γ) and Th2 (IL-4 and IL-10) serum profile in Venezuelan Chagasic patients stratified according amiodarone treatment, hypertension and arrhythmias.
Sera from 38 chagasic patients were analyzed to determine the level of cytokines by Multiplexed Bead-Based Immunoassays. ANOVA test was applied to determine differences for each group. Additionally, a Linear Discriminant Analysis (LDA) was applied to observe the accuracy of different cytokines to discriminate between the groups.
The levels of several cytokines were significantly higher in the high-risk of sudden death and untreated group. LDA showed that IL-2, IFN-γ and IL-10 were the best cytokines for discriminating between high-risk of sudden death and untreated patients versus low-risk of sudden death, treated and control groups.
High IL-2 levels seem to identify patients with high-risk of sudden death and seems adequate as treatment efficacy marker. To our knowledge, this is the first report about the anti-inflammatory role of the amiodarone in Chagas disease, suggesting an inmunomodulatory effect that may be exploited as coadjutant therapy in chronic Chagas disease.
恰加斯病由原生动物克氏锥虫引起,其特征为心力衰竭和猝死。确定哪些因素参与疾病进展和治疗反应颇具挑战。因此,本研究旨在确定委内瑞拉恰加斯病患者中,根据胺碘酮治疗、高血压和心律失常分层后的Th1/Th17(白细胞介素-6、白细胞介素-2、肿瘤坏死因子、白细胞介素-17和干扰素-γ)及Th2(白细胞介素-4和白细胞介素-10)血清谱。
采用基于微珠的多重免疫测定法分析38例恰加斯病患者的血清,以确定细胞因子水平。应用方差分析检验确定各组间差异。此外,应用线性判别分析(LDA)观察不同细胞因子区分各组的准确性。
在猝死高风险组和未治疗组中,几种细胞因子水平显著更高。LDA显示,白细胞介素-2、干扰素-γ和白细胞介素-10是区分猝死高风险组及未治疗患者与猝死低风险组、治疗组和对照组的最佳细胞因子。
高白细胞介素-2水平似乎可识别猝死高风险患者,且似乎足以作为治疗疗效标志物。据我们所知,这是关于胺碘酮在恰加斯病中抗炎作用的首份报告,提示其具有免疫调节作用,可作为慢性恰加斯病辅助治疗手段。