Key result
Acute Chagas' disease is associated with myocarditis in 100% of cases involving T cell inflammation.
Observational (n=12)
In acute Chagas' disease, myocarditis is universally present and involves both CD4+ and CD8+ T cells, which appears directly related to the presence of parasitic antigens.
Findings support cardiac evaluation in acute Chagas; leaves open whether antigen-driven T-cell responses predict progression.
OBJECTIVE: The present work analysed endomyocardial biopsies of patients with acute Chagas' disease in order to evaluate the frequency and intensity of T. cruzi antigens, CD4+ and CD8+ T cells to determine the characteristics of this recurrent disease in Venezuela. MATERIAL AND METHODS: Twelve endomyocardial biopsies of patients with Chagas' disease, 12 to 51 years old, (7M and 5F) were analysed. T. cruzi antigens and CD4+ (helper) and CD8+ (cytotoxic-suppressor) T cells were detected by the immunoperoxidase technique. The presence and intensity of lymphocytic myocarditis was evaluated according to the degree of myocardial fibre injury caused by inflammatory infiltrate. RESULTS: Myocarditis was present in 100% of the cases. The mean numbers of CD4+ T cell and CD8+ T cell were 11.00 (+/- 10.29); 14.69 (+/- 13.08) and the CD4/CD8 T cell ratio was 0.75. T. cruzi antigens were detected in 58%. There was a good correlation between the numbers of CD4 and CD8 T cells of each case and a lack of correlation with the amount of T. cruzi antigens. CONCLUSION: All patients with acute Chagas' disease show some degree of myocarditis that seems to be directly related to the presence of parasitic antigens. Both CD4 and CD8 T cells participate in this process. We are following these patients to see if patients with severe myocarditis and more parasite antigens in the acute phase will develop chronic heart failure.
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Fuenmayor et al. (2005) conducted an observational in Acute Chagas' disease (n=12). Acute Chagas' disease was evaluated on Presence of myocarditis. Acute Chagas' disease was associated with myocarditis in 100% of cases and detectable T. cruzi antigens in 58%, with both CD4+ and CD8+ T cells participating in the inflammatory process.
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