Laboratory of Molecular Immunopathology, Clinical Hospital, Federal University of Paraná, Curitiba, Brazil.
Am J Trop Med Hyg. 2019 Jan;100(1):93-96. doi: 10.4269/ajtmh.17-0701.
Chagas disease (CD), caused by infection with the parasite , leads to severe cardiomyopathy in 20-30% of patients, whereas the remainder may stay asymptomatic and never develop cardiomyopathy or other clinical manifestations. The underlying cause for this variable outcome is not fully characterized, although previous studies have found high levels of circulating mannose-binding lectin (MBL) to be associated with cardiac failure echocardiographic changes. We report three indeterminate (asymptomatic) chronic Chagas patients who were followed up for 10 years. Two of these patients developed chronic chagasic cardiomyopathy (CCC) during this follow-up period and, when genotyped, were found to be carriers of the high MBL producer / genotype, suggesting that genetically determined high MBL serum might be associated with the risk of CCC development. These results suggest the use of MBL quantification and genotyping as tools for clinical assessment in patients with chronic CD.
恰加斯病(CD)由寄生虫感染引起,导致 20-30%的患者出现严重的心肌病,而其余患者可能无症状,且从不发展为心肌病或其他临床表现。尽管先前的研究发现循环甘露聚糖结合凝集素(MBL)水平高与心力衰竭的超声心动图变化有关,但这种可变结果的根本原因尚未完全确定。我们报告了 3 例不确定(无症状)慢性恰加斯病患者,他们接受了 10 年的随访。其中 2 例患者在此随访期间发展为慢性恰加斯性心肌病(CCC),且基因分型后发现为高 MBL 产生/基因型携带者,提示遗传决定的高 MBL 血清可能与 CCC 发展的风险相关。这些结果表明,MBL 定量和基因分型可作为慢性 CD 患者临床评估的工具。