Zingales Bianca, Macedo Andréa M
Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, São Paulo 05508-900, São Paulo, Brazil.
Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil.
Life (Basel). 2023 Dec 14;13(12):2339. doi: 10.3390/life13122339.
, the protozoan causative of Chagas disease (ChD), exhibits striking genetic and phenotypic intraspecific diversity, along with ecoepidemiological complexity. Human-pathogen interactions lead to distinct clinical presentations of ChD. In 2009, an international consensus classified strains into six discrete typing units (DTUs), TcI to TcVI, later including TcBat, and proposed reproducible genotyping schemes for DTU identification. This article aims to review the impact of classifying strains into DTUs on our understanding of biological, ecoepidemiological, and pathogenic aspects of . We will explore the likely origin of DTUs and the intrinsic characteristics of each group of strains concerning genome organization, genomics, and susceptibility to drugs used in ChD treatment. We will also provide an overview of the association of DTUs with mammalian reservoirs, and summarize the geographic distribution, and the clinical implications, of prevalent specific DTUs in ChD patients. Throughout this review, we will emphasize the crucial roles of both parasite and human genetics in defining ChD pathogenesis and chemotherapy outcome.
克氏锥虫，恰加斯病（ChD）的原生动物病原体，表现出显著的种内遗传和表型多样性，以及生态流行病学复杂性。人类与病原体的相互作用导致恰加斯病有不同的临床表现。2009年，一项国际共识将克氏锥虫菌株分为六个离散型别单元（DTUs），从TcI到TcVI，后来又包括TcBat，并提出了用于DTU鉴定的可重复基因分型方案。本文旨在综述将克氏锥虫菌株分为DTUs对我们理解克氏锥虫的生物学、生态流行病学和致病方面的影响。我们将探讨DTUs的可能起源，以及每组菌株在基因组组织、基因组学和恰加斯病治疗中所用药物敏感性方面的内在特征。我们还将概述DTUs与哺乳动物宿主的关联，并总结恰加斯病患者中流行的特定DTUs的地理分布及其临床意义。在整个综述中，我们将强调寄生虫和人类遗传学在确定恰加斯病发病机制和化疗结果方面的关键作用。
