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Published on: January 27, 2019
Chagas cardiomyopathy manifestations and Trypanosoma cruzi genotypes circulating in chronic Chagasic patients
Juan David Ramírez1, Felipe Guhl, Lina María Rendón
1Centro de investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Facultad de Ciencias, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia.
Insights
In Colombia, Trypanosoma cruzi discrete taxonomic units (DTUs) TcI, TcIII, and TcIV were identified in chronic Chagas disease patients. TcI infections showed a higher prevalence of cardiac alterations compared to TcII.
Area of Science:
- Infectious Diseases
- Molecular Epidemiology
- Parasitology
Background:
- Chagas disease, caused by Trypanosoma cruzi, is a significant public health issue in Latin America.
- Trypanosoma cruzi is classified into six discrete taxonomic units (DTUs): TcI–TcVI.
- TcI exhibits genetic variability with genotypes Ia–Ie, and TcI and TcII are prevalent in Colombia, with mixed infections reported.
Purpose of the Study:
- To determine circulating T. cruzi DTUs in Colombian chronic Chagasic patients.
- To investigate the molecular epidemiology of Chagas disease in Colombia.
- To correlate T. cruzi genetic variability with cardiac disease manifestations.
Main Methods:
- Molecular characterization of T. cruzi using mini-exon gene, 24Sα and 18S rDNA, and satellite DNA.
- Analysis of electrocardiographic, radiologic, and echocardiographic data.
- Genotyping of TcI strains within the Colombian population.
Main Results:
- Detection of T. cruzi DTUs I, II, III, and IV in Colombian patients.
- Identification of mixed infections: TcI-TcII, TcI-TcIII, and TcI-TcIV.
- TcI genotypes Ia and Id were found; TcI infections were associated with a higher prevalence of cardiac alterations than TcII.
- First report of TcIII and TcIV in Colombian Chagasic patients.
Conclusions:
- TcI is predominant in Colombia, with TcIII and TcIV newly reported.
- Chagas cardiomyopathy is more correlated with TcI than TcII infections in Colombia.
- Findings contribute to understanding Chagas disease molecular epidemiology and its clinical impact in Colombia.
Abstract:
Chagas disease caused by Trypanosoma cruzi is a complex disease that is endemic and an important problem in public health in Latin America. The T. cruzi parasite is classified into six discrete taxonomic units (DTUs) based on the recently proposed nomenclature (TcI, TcII, TcIII, TcIV, TcV and TcVI). The discovery of genetic variability within TcI showed the presence of five genotypes (Ia, Ib, Ic, Id and Ie) related to the transmission cycle of Chagas disease. In Colombia, TcI is more prevalent but TcII has also been reported, as has mixed infection by both TcI and TcII in the same Chagasic patient. The objectives of this study were to determine the T. cruzi DTUs that are circulating in Colombian chronic Chagasic patients and to obtain more information about the molecular epidemiology of Chagas disease in Colombia. We also assessed the presence of electrocardiographic, radiologic and echocardiographic abnormalities with the purpose of correlating T. cruzi genetic variability and cardiac disease. Molecular characterization was performed in Colombian adult chronic Chagasic patients based on the intergenic region of the mini-exon gene, the 24Sα and 18S regions of rDNA and the variable region of satellite DNA, whereby the presence of T.cruzi I, II, III and IV was detected. In our population, mixed infections also occurred, with TcI-TcII, TcI-TcIII and TcI-TcIV, as well as the existence of the TcI genotypes showing the presence of genotypes Ia and Id. Patients infected with TcI demonstrated a higher prevalence of cardiac alterations than those infected with TcII. These results corroborate the predominance of TcI in Colombia and show the first report of TcIII and TcIV in Colombian Chagasic patients. Findings also indicate that Chagas cardiomyopathy manifestations are more correlated with TcI than with TcII in Colombia.
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