Higher T-bet and IFN-γ expression in advanced chagasic megaesophagus indicates Th1 response in the chronic phase.

Myenteric plexus injury is responsible for the morpho-functional alterations observed in chagasic megaesophagus (CME). The inflammatory response, characterized by elevated synthesis of IFN-γ, TNF-α, and IL-4, contributes to the persistence of parasitism and inflammation. This study assessed the mRNA expression of cytokines, transcription factors, and metalloproteases in subjects with CME. From 2011 to 2017, esophageal samples were collected from 54 subjects with CME (38 advanced and 16 nonadvanced) and eight subjects with idiopathic megaesophagus (IME). The quantitative mRNA expression of TNF-α, IFN-γ, IL-4, IL-10, IL-17, IL-22, IL-23, IL-27, T-bet, ROR-γT, GATA-3, MMP-1, MMP-2, and TIMP-3 genes was analyzed using SYBR Green systems. T-bet expression was significantly higher in the CME group compared to the IME group and the GATA-3 and ROR-γT expression in the CME group, corroborating the higher IFN-γ expression observed in subjects with advanced CME. The increased T-bet and IFN-γ expression in advanced CME reflects the maintenance of a Th1 response in situ and the morpho-functional changes seen in the organ.