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Evaluating Chagas disease progression and cure through blood-derived biomarkers: a systematic review
Ana Requena-Méndez1, Manuel Carlos López, Andrea Angheben
1Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), C/Rosello' 132 4°,08036; Barcelona, Spain.
Insights
Blood biomarkers show promise for predicting Chagas disease progression and treatment effectiveness. Further research is needed to validate these markers for early detection of cardiac and gastrointestinal damage.
Area of Science:
- * Parasitology and Tropical Medicine
- * Biomarker Discovery and Validation
- * Clinical Diagnostics
Background:
- * Chagas disease, caused by *Trypanosoma cruzi*, affects millions globally, often presenting with an indeterminate form.
- * Early detection of cardiac and gastrointestinal complications is crucial for effective management.
- * Current diagnostic and prognostic tools have limitations in predicting disease progression and treatment response.
Purpose of the Study:
- * To review the utility of blood-derived biomarkers for predicting Chagas disease progression in indeterminate cases.
- * To assess the efficacy of antiparasitic drugs using biomarkers.
- * To identify biomarkers for early detection of cardiac and gastrointestinal damage.
Main Methods:
- * Systematic literature search of MEDLINE, Cochrane Library, EmBase, Global Health, and LILACS databases.
- * Inclusion of 166 articles from 1716 screened records.
- * Classification of biomarkers into four groups: inflammation/cellular injury, metabolic, prothrombotic, and parasite-derived antigens.
Main Results:
- * Several blood-derived biomarkers demonstrate potential for detecting early cardiopathy in Chagas disease.
- * Biomarkers are categorized by biochemical structure and biological activity, aiding in understanding their roles.
- * No single gold standard biomarker for assessing treatment cure has been established.
Conclusions:
- * Blood biomarkers hold significant clinical potential for early Chagas disease diagnosis and monitoring.
- * Prospective studies with extended follow-up are essential to evaluate biomarkers for treatment efficacy.
- * Comparative studies of multiple biomarkers are recommended due to the absence of a definitive gold standard.
Abstract:
This article reviews the usefulness of various types of blood-derived biomarkers that are currently being studied to predict the progression of Chagas disease in patients with the indeterminate form, to assess the efficacy of antiparasitic drugs and to identify early cardiac and gastrointestinal damage. The authors used a search strategy based on MEDLINE, Cochrane Library Register for systematic review, EmBase, Global Health and LILACS databases. Out of 1716 screened articles, only 166 articles were eligible for final inclusion. The authors classified the biomarkers according to their biochemical structure and primary biological activity in four groups: i) markers of inflammation and cellular injury, ii) metabolic biomakers, iii) prothrombotic biomarkers and iv) markers derived from specific antigens of the parasite. Several potential biomarkers might have clinical potential for the detection of early cardiopathy. Such capacity is imperative in order to detect high-risk patients who require intensive monitoring and earlier therapy. Prospective studies with longer follow-ups are needed for the appraisal of biomarkers assessing clinical or microbiological cure after therapy. At the same time, studies evaluating more than one biomarker are useful to compare the efficacy among them given the lack of a recognized gold standard.
