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THE ROLE OF INTERLEUKIN 17-MEDIATED IMMUNE RESPONSE IN CHAGAS DISEASE: HIGH LEVEL IS CORRELATED WITH BETTER LEFT VENTRICULAR FUNCTION
Trypanosoma cruzi
doença de Chagas
respoosta imune
cardiopatias
deficiencia cardiaca
plasma sanguineo
Serologia
Trypanosoma cruzi
Chagas disease
Immune response
Cardiomyopathies
Heart failure
Blood plasma
Serology
Author
Affilliation
Universidade Federal de Minas Gerais. Faculdade de Medicina. Pos Graduação em Medicina Tropical. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Pos Graduação em Medicina Tropical. Belo Horizonte, MG, Brazil/Universidade Federal de Minas Gerais. Instituto de Ciências Biologicas. Departamento de Morfologia. Laboratorio de Interação Celular. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Instituto de Ciências Biologicas. Departamento de Morfologia. Laboratorio de Interação Celular. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Pos Graduação em Medicina Tropical. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Pos Graduação em Medicina Tropical. Belo Horizonte, MG, Brazil.
Fundação Oswaldo Cruz. Instituto René Rachou. Laboratório de Imunologia Molecular e Celular. Belo Horizonte, MG, Brazil.
Fundação Oswaldo Cruz. Instituto René Rachou. Laboratório de Imunologia Molecular e Celular. Belo Horizonte, MG, Brazil
Universidade Federal de Minas Gerais. Faculdade de Medicina. Pos Graduação em Medicina Tropical. Belo Horizonte, MG, Brazil.
Fundação Oswaldo Cruz. Instituto René Rachou. Laboratório de Imunologia Molecular e Celular. Belo Horizonte, MG, Brazil/National Institutes of Science and Technology Tropical Diseases. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Pos Graduação em Medicina Tropical. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Pos Graduação em Medicina Tropical. Belo Horizonte, MG, Brazil/Universidade Federal de Minas Gerais. Instituto de Ciências Biologicas. Departamento de Morfologia. Laboratorio de Interação Celular. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Instituto de Ciências Biologicas. Departamento de Morfologia. Laboratorio de Interação Celular. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Pos Graduação em Medicina Tropical. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Pos Graduação em Medicina Tropical. Belo Horizonte, MG, Brazil.
Fundação Oswaldo Cruz. Instituto René Rachou. Laboratório de Imunologia Molecular e Celular. Belo Horizonte, MG, Brazil.
Fundação Oswaldo Cruz. Instituto René Rachou. Laboratório de Imunologia Molecular e Celular. Belo Horizonte, MG, Brazil
Universidade Federal de Minas Gerais. Faculdade de Medicina. Pos Graduação em Medicina Tropical. Belo Horizonte, MG, Brazil.
Fundação Oswaldo Cruz. Instituto René Rachou. Laboratório de Imunologia Molecular e Celular. Belo Horizonte, MG, Brazil/National Institutes of Science and Technology Tropical Diseases. Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Pos Graduação em Medicina Tropical. Belo Horizonte, MG, Brazil.
Abstract
Interleukin 17A (IL-17A) has been associated with protective rather than pathogenic response in Chagas disease (ChD). However, it is not established whether or not IL-17A-mediated immune response is correlated with patient’s left ventricular (LV) function in ChD. To address this question we have gathered cardiac functional parameters from ChD patients and analysed the possible relationship between their plasma IL-17A levels and LV function. Plasma IL-17A levels were measured by BD Cytometric Bead Array (CBA) in 240 patients with positive specific serology for Trypanosoma cruzi (T. cruzi) grouped as indeterminate (IND) and Chagas cardiomyopathy (CARD) forms. The levels of IL-17A in ChD patients were compared with 32 healthy individuals, mean age of 39 years, 50% male, that were also included as a control group (non-infected [NI]). The overall mean age of ChD patients was 46 years and 52% were male. The IND group included 95 asymptomatic patients, with ages ranging from 27 to 69 years (mean of 43 years), and 42.1% of them were male. The CARD group included 145 patients, which 58.6% were male, with ages ranging from 23 to 67 years (mean of 49). The IND group presented substantially higher levels of IL-17A, median of 26.16 (3.66–48.33) as compared to both the CARD group, median of 13.89 (3.87–34.54) (P <0.0001), and the NI group, median of 10.78 (6.23–22.26) (P <0.0001). The data analysis demonstrated that the IND group comprises a significantly greater proportion (P <0.001) of high IL-17A producers (52.6%, 50 of 95 subjects) than do the other groups. A significant direct correlation was verified between IL-17A levels and cardiac function expressed by LV ejection fraction (LVEF), LV diastolic diameter (LVDd), and body surface area (BSA)-indexed LVDd as well as ratio of the early diastolic transmitral flow velocity to early diastolic mitral annular velocity (E/e’) in both groups. We demonstrated that plasma IL-17A levels has an accurate sensitivity and specificity to predict heart failure in serology-positive patients and might be a useful parameter to distinguish patients with or without cardiac impairment. This study indicates a consistent relationship between high expression of IL-17A and better LV in human chronic ChD. Our data raise the possibility that IL-17A plays an important immunomodulatory role in the chronic phase of ChD and might be involved in protection against myocardial damage.
Keywords in Portuguese
citocinasTrypanosoma cruzi
doença de Chagas
respoosta imune
cardiopatias
deficiencia cardiaca
plasma sanguineo
Serologia
Keywords
CytokinesTrypanosoma cruzi
Chagas disease
Immune response
Cardiomyopathies
Heart failure
Blood plasma
Serology
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