恰加斯病非流行区(ChaNoE)队列研究:目标与研究方案。

The Chagas non-endemic (ChaNoE) cohort: Aims and study protocol.

作者信息

Bosch-Nicolau Pau, Herrero-Martínez Juan María, Arsuaga Marta, Chamorro-Tojeiro Sandra, Carrillo Irene, Bea-Serrano Carlos, Llenas-García Jara, Pérez-Recio Sandra, Fernández-Pedregal Elia, Crespillo-Andújar Clara, Silgado Aroa, Pérez-Ayala Ana, de la Calle-Prieto Fernando, Prieto-Pérez Laura, Pérez-Molina José A, Molina Israel

机构信息

International Health Unit Vall d'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.

Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.

出版信息

PLoS One. 2025 Apr 15;20(4):e0320637. doi: 10.1371/journal.pone.0320637. eCollection 2025.

Abstract

Chagas disease (CD), caused by Trypanosoma cruzi, is a neglected tropical disease with significant public health implications. While its primary transmission occurs in endemic regions via triatomine vectors, migratory processes have led to an increased prevalence in non-endemic areas as in Spain where an estimated 50,000 people live with CD. Chronic Chagas cardiomyopathy (CCC) and digestive complications are the primary manifestations, yet diagnostic criteria, especially regarding organic involvement, and treatment indications are still a matter of debate. There is an urgent need for standardized approaches to improve care and identify biomarkers for progression and treatment response. The Chagas non-endemic cohort (ChaNoE) aims to recruit individuals with chronic CD across multiple centers in Spain. Inclusion criteria involve a confirmed diagnosis based on two serological tests. Participants will receive comprehensive diagnostic evaluations, including electrocardiography, echocardiography, and periodic serological and PCR assessments. Follow-up will focus on disease progression, particularly CCC and digestive involvement, using standardized protocols. The study also establishes a biobank for serum samples to facilitate biomarker research. The ChaNoE cohort addresses critical gaps in the understanding of CD in non-endemic regions. By standardizing diagnostic and treatment protocols, it seeks to harmonize care and enable comparisons with cohorts in endemic areas. The creation of a biobank supports the identification of biomarkers for disease progression and treatment efficacy, a current unmet need in CD management. This initiative also strengthens research networks and informs public health strategies to mitigate the burden of CD in non-endemic settings. Findings will be disseminated to key stakeholders to improve the clinical and epidemiological understanding of this neglected disease.

摘要

恰加斯病(CD)由克氏锥虫引起,是一种被忽视的热带病,对公共卫生具有重大影响。虽然其主要传播途径是在流行地区通过锥蝽媒介进行,但人口迁移导致非流行地区的患病率上升,比如在西班牙,估计有5万人患有恰加斯病。慢性恰加斯心肌病(CCC)和消化系统并发症是主要表现,然而诊断标准,尤其是关于器官受累情况的标准,以及治疗指征仍存在争议。迫切需要标准化方法来改善护理,并确定疾病进展和治疗反应的生物标志物。西班牙恰加斯病非流行队列(ChaNoE)旨在招募西班牙多个中心的慢性恰加斯病患者。纳入标准包括基于两项血清学检测的确诊诊断。参与者将接受全面的诊断评估,包括心电图、超声心动图以及定期的血清学和聚合酶链反应评估。随访将使用标准化方案,重点关注疾病进展,特别是CCC和消化系统受累情况。该研究还建立了一个血清样本生物银行,以促进生物标志物研究。ChaNoE队列填补了非流行地区对恰加斯病认识方面的关键空白。通过标准化诊断和治疗方案,它旨在统一护理,并能够与流行地区的队列进行比较。生物银行的建立有助于识别疾病进展和治疗效果的生物标志物,这是目前恰加斯病管理中尚未满足的需求。该倡议还加强了研究网络,并为公共卫生策略提供信息,以减轻非流行地区恰加斯病的负担。研究结果将传播给关键利益相关者,以提高对这种被忽视疾病的临床和流行病学认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9869/11999160/7fcea47076db/pone.0320637.g001.jpg

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