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慢性查加斯心脏病的发病原因

Jose Antonio Marin-Neto¹, Edécio Cunha-Neto, Benedito C Maciel

¹Cardiology Division, Department of Internal Medicine, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. marin_neto@yahoo.com

|March 7, 2007

概括

查加斯心脏病的发病过程涉及复杂的宿主-寄生虫相互作用,包括自主功能障碍,微血管问题,寄生虫攻击和免疫反应. 寄生虫的持久性和免疫力是慢性查加斯心肌病的关键.

科学领域:

传染性疾病传染性疾病
心脏病学心脏病学
免疫学免疫学免疫学

背景情况:

查加斯病是拉丁美洲的主要健康问题,导致严重的发病率和死亡率.
慢性查加斯心肌病变的发病因子,特别是宿主-寄生虫相互作用,仍然不太清楚.
了解查加斯病的发病因子对于开发有效的治疗方法至关重要.

研究的目的:

系统地审查和综合目前关于查加斯病的病原和病理生理学的知识.
确定导致慢性查加斯心脏病的关键机制.
突出未来研究和治疗开发的领域.

主要方法:

使用主要的生物医学数据库 (MEDLINE,EMBASE,BIREME,LILACS,SCIELO) 进行了系统的文献审查.
确定并分析了有关查加斯病的发病和病理生理学的相关研究.
来自动物模型和人类研究的证据被合成,以阐明疾病机制.

主要成果:

查加斯慢性心脏病的四个主要病原遗传机制被确定:自主神经系统障碍,微血管障碍,寄生虫依赖的心肌侵略和免疫介导的心肌损伤.
自主和微循环障碍似乎在慢性心肌损伤中起到次要作用.
慢性查加斯心脏病的发病因特征是持续的低级感染和不良免疫反应,寄生虫的持续性和免疫机制相互关联.

结论:

慢性查加斯心脏病的发病是多因素的,涉及到持续的感染和免疫反应.
寄生虫的持久性和免疫机制在疾病的慢性阶段是关键的联系.
未来的研究应该专注于这些基本病原遗传机制的临床影响和治疗潜力,解决当前研究中小患者队列的局限性.

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