Accuracy of inflammatory biomarkers in assessing outcomes in Chagas disease: a scoping review

Chagas disease (CD) is a global health issue with acute and chronic forms that cause severe complications, especially affecting the heart. Inflammatory biomarkers have been proposed as potential predictors of adverse outcomes in CD, however, their clinical utility remains uncertain. We conducted a scoping review of five databases, including observational studies evaluating the diagnostic and/or prognostic accuracy of inflammatory biomarkers in CD. Two reviewers independently screened and extracted data. Of 239 articles screened, 5 met the inclusion criteria. Adiponectin was associated with an increased risk of mortality and heart transplantation (hazard ratio 1.042 [95% confidence interval 1.013 to 1.072], area under the curve [AUC] 0.68, cut-off >38 μg/ml). Tumour necrosis factor α (TNF-α) and C-C motif chemokine ligand 2 (CCL2) were associated with left ventricular dysfunction (TNF-α: AUC 0.90; CCL2: AUC 0.69). Combined hepatocyte growth factor (HGF) and interleukin-12p40 (IL-12p40) predicted 3-y survival (accuracy 81.9%). Other biomarkers, including macrophage migration inhibitory factor, C-X-C motif chemokine ligand 12, monokine induced by interferon γ (MIG), transforming growth factor β1 and matrix metalloproteinases 2 and 9, showed limited utility. While TNF-α and HGF/IL-12p40 showed promise, most inflammatory biomarkers demonstrated limited accuracy, specifically for outcome prediction in CD; however, this does not preclude their potential usefulness for other clinical or experimental applications. Current evidence does not support the clinical use of this approach and further studies are needed.