Luquetti Alejandro O, de Oliveira Dayse Elisabeth Campos, do Nascimento Tavares Suelene Brito, de Oliveira Enio Chaves
Am J Trop Med Hyg. 2022 Mar 28;106(5):1434-41. doi: 10.4269/ajtmh.21-0620.
This study evaluated four biomarkers of inflammation or fibrosis as progression indicators for heart disease in patients with Chagas disease. We compared values of these markers at the time of the first sample collection of blood (first time point) and at the time of the last collection of blood (second time point) for 103 individuals positive for Trypanosoma cruzi antibodies. They were split into two clinical groups: 52 individuals with the indeterminate form of the disease at the first time point and 51 controls that already had either cardiac involvement (N = 25) or megaviscera (megaesophagus and/or megacolon; N = 26) at that time. All individuals had an electrocardiogram performed both at the first and second time point (mean time between time points: 11 years). All samples were blind tested for galectin-3, brain natriuretic peptide (NT-proBNP), lysyl oxidase-like protein 2 (LOXL2), and troponin. Differences in concentrations between samples were analyzed using the months between samples as the covariate. This analysis showed that values for all markers, except troponin biomarkers had a significative increase at the second time point for the 91 patients without progression. A similar result was obtained for NT-proBNP and LOXL2 with sera from 12 patients that progressed with cardiac disease. The single marker that showed a significative difference between groups (P = 0.01) was galectin-3. We concluded that galectin-3 was the only marker with a prognostic value in relation to the progression or worsening of heart disease in patients with Chagas disease.
本研究评估了四种炎症或纤维化生物标志物，作为恰加斯病患者心脏病进展的指标。我们比较了103名克鲁斯锥虫抗体呈阳性个体在首次采集血液样本时（第一个时间点）和最后一次采集血液时（第二个时间点）这些标志物的值。他们被分为两个临床组：52名在第一个时间点患有疾病不确定形式的个体和51名当时已经有心脏受累（N = 25）或巨大脏器（巨食管和/或巨结肠；N = 26）的对照组。所有个体在第一个和第二个时间点均进行了心电图检查（两个时间点之间的平均时间为11年）。所有样本均对半乳糖凝集素-3、脑钠肽（NT-proBNP）、赖氨酰氧化酶样蛋白2（LOXL2）和肌钙蛋白进行了盲法检测。使用样本之间的月份作为协变量分析样本之间浓度的差异。该分析表明，对于91名无病情进展的患者，除肌钙蛋白生物标志物外，所有标志物的值在第二个时间点均有显著增加。对于12名患有心脏病进展的患者的血清，NT-proBNP和LOXL2也得到了类似结果。在两组之间显示出显著差异（P = 0.01）的单一标志物是半乳糖凝集素-3。我们得出结论，半乳糖凝集素-3是与恰加斯病患者心脏病进展或恶化相关的唯一具有预后价值的标志物。
