Hospital Interzonal General de Agudos Eva Perón, Buenos Aires, Argentina.
Instituto Nacional de Parasitología Dr. M. Fatala Chaben, Buenos Aires, Argentina.
PLoS One. 2019 Jun 14;14(6):e0218260. doi: 10.1371/journal.pone.0218260. eCollection 2019.
Chronic inflammation, as a consequence of the persistent infection with Trypanosoma cruzi, leads to continuous activation of the immune system in patients with chronic Chagas disease. We have previously shown that increased sera levels of soluble P-selectin are associated with the severity of the cardiomyopathy distinctive of chronic Chagas disease. In this study, we explored the expression of biomarkers of platelet and endothelial activation, tissue remodeling, and mediators of the coagulation cascade in patients at different clinical stages of chronic Chagas heart disease. The frequencies of activated platelets, measured by the expression of CD41a and CD62P were decreased in patients with chronic Chagas disease compared with those in uninfected subjects, with an inverse association with disease severity. Platelet activation in response to adenosine diphosphate was also decreased in T. cruzi-infected subjects. A major proportion of T. cruzi infected subjects showed increased serum levels of fibrinogen. Patients with severe cardiac dysfunction showed increased levels of endothelin-1 and normal values of procollagen I. In conclusion, chronic infection with T. cruzi induced hemostatic alterations, even in those patients who do not yet present cardiac symptoms.
慢性炎症是由于持续感染克氏锥虫引起的，导致慢性恰加斯病患者的免疫系统持续激活。我们之前已经表明，可溶性 P 选择素的血清水平升高与慢性恰加斯病特有的心肌病的严重程度有关。在这项研究中，我们探讨了不同临床阶段慢性恰加斯心脏病患者血小板和内皮细胞激活、组织重构和凝血级联介质的生物标志物的表达。与未感染者相比，慢性恰加斯病患者的活化血小板（通过 CD41a 和 CD62P 的表达来测量）频率降低，与疾病严重程度呈负相关。对二磷酸腺苷的血小板激活也在感染 T. cruzi 的患者中降低。很大一部分 T. cruzi 感染者的血清纤维蛋白原水平升高。严重心功能障碍的患者表现出内皮素-1 水平升高和原胶原 I 的正常水平。总之，慢性 T. cruzi 感染诱导了止血改变，即使在那些尚未出现心脏症状的患者中也是如此。
