Andrade S G, Carneiro Filho A, de Souza A J, de Lima E S, Andrade Z A
Centro de Pesquisas Gonçalo Moniz, Salvador, Bahia, Brazil.
Int J Exp Pathol. 1997 Dec;78(6):391-9. doi: 10.1046/j.1365-2613.1997.390370.x.
Latent Trypanosoma cruzi infection may be reactivated in immunosuppressed individuals, with unusual clinical patterns, such as meningoencephalitis, pseudo neoplastic lesions in the central nervous system, and myocarditis with numerous parasites in the heart muscle. To investigate this problem 68 Swiss mice chronically infected with different strains of T. cruzi were treated with different combinations of immunosuppressive drugs (azathioprine, cyclosporine and betamethasone), in such a way as to imitate the situation during post transplantation treatment. Mortality varied from 6 to 25% in treated mice. There were no deaths in untreated controls. Normal mice have been submitted to the same schedules of immunosuppression as controls of treatment and no deaths were registered during treatment. Chronically infected mice showed significant elevation of total number of leukocytes and lymphocytes in comparison with intact controls; a significant decrease in blood leukocytes and lymphocytes occurred post-treatment in two of the treated experimental groups. Exacerbation of myocarditis and myositis and a high incidence of brain lesions, with focal necrosis, granulomatous lesions and glial proliferation even in the absence of parasites were present in immunosuppressed mice but not in infected controls. Although differing in some aspects from Chagas' disease in immunosuppressed humans, the murine model did show some features that resembled it, especially the peculiar pattern of central nervous system involvement.
潜伏的克氏锥虫感染在免疫抑制个体中可能会被激活,出现不寻常的临床症状,如脑膜脑炎、中枢神经系统的假性肿瘤性病变以及心肌中有大量寄生虫的心肌炎。为了研究这个问题,68只长期感染不同克氏锥虫菌株的瑞士小鼠用不同组合的免疫抑制药物(硫唑嘌呤、环孢素和倍他米松)进行治疗,以模拟移植后治疗期间的情况。治疗小鼠的死亡率在6%至25%之间。未治疗的对照组没有死亡。正常小鼠接受了与治疗对照组相同的免疫抑制方案,治疗期间没有死亡记录。与完整对照组相比,慢性感染小鼠的白细胞和淋巴细胞总数显著升高;两个治疗实验组治疗后血液中的白细胞和淋巴细胞显著减少。免疫抑制小鼠出现了心肌炎和肌炎的加重以及脑病变的高发生率,即使没有寄生虫也有局灶性坏死、肉芽肿性病变和胶质细胞增生,而感染对照组则没有。尽管在某些方面与免疫抑制人类的恰加斯病不同,但小鼠模型确实显示出一些与之相似的特征,特别是中枢神经系统受累的特殊模式。