Silvestrini Marina Malheiros Araújo, Alessio Glaucia Diniz, Frias Bruna Estefânia Diniz, Sales Júnior Policarpo Ademar, Araújo Márcio Sobreira Silva, Silvestrini Carolina Malheiros Araújo, Brito Alvim de Melo Gustavo Eustáquio, Martins-Filho Olindo Assis, Teixeira-Carvalho Andréa, Martins Helen Rodrigues
Integrated Biomarker Research Group, René Rachou Institute, Fiocruz Minas, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil.
Department of Pharmacy, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil.
Front Immunol. 2024 Apr 9;15:1342431. doi: 10.3389/fimmu.2024.1342431. eCollection 2024.
Chagas disease, caused by , remains a serious public health problem worldwide. The parasite was subdivided into six distinct genetic groups, called "discrete typing units" (DTUs), from TcI to TcVI. Several studies have indicated that the heterogeneity of species directly affects the diversity of clinical manifestations of Chagas disease, control, diagnosis performance, and susceptibility to treatment. Thus, this review aims to describe how genetic diversity influences the biology of the parasite and/or clinical parameters in humans. Regarding the geographic dispersion of , evident differences were observed in the distribution of DTUs in distinct areas. For example, TcII is the main DTU detected in Brazilian patients from the central and southeastern regions, where there are also registers of TcVI as a secondary DTU. An important aspect observed in previous studies is that the genetic variability of can impact parasite infectivity, reproduction, and differentiation in the vectors. It has been proposed that DTU influences the host immune response and affects disease progression. Genetic aspects of the parasite play an important role in determining which host tissues will be infected, thus heavily influencing Chagas disease's pathogenesis. Several teams have investigated the correlation between DTU and the reactivation of Chagas disease. In agreement with these data, it is reasonable to suppose that the immunological condition of the patient, whether or not associated with the reactivation of the infection and the parasite strain, may have an important role in the pathogenesis of Chagas disease. In this context, understanding the genetics of and its biological and clinical implications will provide new knowledge that may contribute to additional strategies in the diagnosis and clinical outcome follow-up of patients with Chagas disease, in addition to the reactivation of immunocompromised patients infected with .
恰加斯病由[病原体名称未给出]引起，在全球范围内仍是一个严重的公共卫生问题。该寄生虫被细分为六个不同的基因群，称为“离散型分型单元”（DTUs），从TcI到TcVI。多项研究表明，[病原体名称未给出]物种的异质性直接影响恰加斯病临床表现的多样性、控制情况、诊断性能以及对治疗的易感性。因此，本综述旨在描述[病原体名称未给出]的基因多样性如何影响该寄生虫的生物学特性和/或人类的临床参数。关于[病原体名称未给出]的地理分布，在不同地区DTUs的分布上观察到了明显差异。例如，TcII是在巴西中部和东南部地区患者中检测到的主要DTU，在这些地区也有TcVI作为次要DTU的记录。在先前研究中观察到的一个重要方面是，[病原体名称未给出]的基因变异性可影响寄生虫在媒介中的感染力、繁殖和分化。有人提出，[病原体名称未给出]DTU会影响宿主免疫反应并影响疾病进展。该寄生虫的基因方面在决定哪些宿主组织会被感染方面起着重要作用，从而严重影响恰加斯病的发病机制。多个团队研究了[病原体名称未给出]DTU与恰加斯病再激活之间的相关性。与这些数据一致，可以合理推测患者的免疫状况，无论是否与[病原体名称未给出]感染和寄生虫菌株的再激活相关，可能在恰加斯病的发病机制中起重要作用。在这种背景下，了解[病原体名称未给出]的遗传学及其生物学和临床意义将提供新的知识，这可能有助于在恰加斯病患者的诊断和临床结果随访中制定额外的策略，此外还可用于免疫功能低下且感染[病原体名称未给出]的患者的再激活情况。
