| Author | Silva, Thayse do Espírito Santo Protásio da | |
| Author | Alvarado Arnez, Lucia Elena | |
| Author | Batista, Angelica Martins | |
| Author | Alves, Silvia Marinho Martins | |
| Author | Cavalcanti, Maria da Gloria Aureliano de Melo | |
| Author | Carrazzone, Cristina de Fátima Velloso | |
| Author | Moraes, Isabelle de Oliveira | |
| Author | Pacheco, Antonio Guilherme Fonseca | |
| Author | Sarteschi, Camila | |
| Author | Moraes, Milton Ozório | |
| Author | Oliveira Júnior, Wilson Alves de | |
| Author | Lannes-Vieira, Joseli | |
| Access date | 2024-12-19T17:56:29Z | |
| Available date | 2024-12-19T17:56:29Z | |
| Document date | 2024 | |
| Citation | SILVA, Thayse do Espírito Santo Protásio da et al. Influence of angiotensin II type 1 receptors and angiotensin-converting enzyme I/D gene polymorphisms on the progression of Chagas' heart disease in a brazilian cohort: impact of therapy on clinical outcomes. PLoS Neglected Tropical Diseases, v. 18, n. 11, p. 1-22, 26 Nov. 2024. | |
| ISSN | 1935-2727 | |
| URI | https://www.arca.fiocruz.br/handle/icict/67722 | |
| Description | Produção científica do Laboratório de Biologia das Interações. | pt_BR |
| Description | Produção científica do Laboratório de Hanseníase. | pt_BR |
| Sponsorship | This work received financial support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Brasil (CAPES - Finance Code 001), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq - Joseli Lannes-Vieira is fellow of CNPq1B (304474/2015-0, 306037/2019-0), Fundação Carlos Chagas Filho de Amparo à Pesquisa do Rio de Janeiro (FAPERJ - Scientist of the State of Rio de Janeiro (Joseli Lannes-Vieira: CNE E-26/ 210.190/2018 and E26/202.572/2019), Grants PAEF2 and PAEF3. | |
| Language | eng | en_US |
| Publisher | Public Library of Science | |
| Rights | open access | |
| Title | Influence of angiotensin II type 1 receptors and angiotensin-converting enzyme I/D gene polymorphisms on the progression of Chagas' heart disease in a brazilian cohort: impact of therapy on clinical outcomes | en_US |
| Type | Article | |
| DOI | 10.1371/journal.pntd.0012703 | |
| Abstract | Chagas disease (CD), a neglected tropical disease, is caused by infection by the protozoan Trypanosoma cruzi. One-third of CD patients develop cardiac disease (CARD), an inflammatory and fibrotic process that may progress to heart failure associated with reduced left ventricular ejection fraction (LVEF). The determinants of CD progression are still uncertain. In non-infectious conditions, the angiotensin-converting enzyme (ACE) functional insertion (I)/deletion (D) and type 1 angiotensin II receptor (AT₁R) +1166A>C gene polymorphisms have been linked to clinical outcomes. In a Brazilian cohort of 402 patients with positive serology for CD, in a case-control study we used PCR for genotyping the ACE rs4646994 I/D and AGTR1 rs5182C>T, rs275653 -119C>T, rs2131127A>G and rs5186 +1166A>C polymorphisms to evaluate association with CARD and progression to heart failure. Patients were classified as non-CARD (stage A; 109), and mild (stage B1; 161) or severe (stage C; 132) CARD. The groups were compared using unconditional logistic regression analysis and adjusted for non-genetic covariates (age, gender, and trypanocidal treatment). ACE II genotype appeared less frequent in C patients (15% in C vs 20% in B1 and 27% in A). After covariate adjustments, the ACE D allele showed a borderline association with susceptibility to severe CARD (C vs A: OR = 1.9; P = 0.08). AGTR1 +1166AC genotype showed a borderline association with protection against the progression and severity of CARD (C vs A: OR = 0.6; P = 0.09; C vs B1: OR = 0.6; P = 0.07; C vs A + B1: OR = 0.6; P = 0.05). However, adjustments for multiple comparisons showed no association of ACE I/D and AGTR1 polymorphisms with susceptibility and severity of CARD. The rs275653/rs2131127/rs5186/rs5182 T/A/C/T haplotype was protective against progression to the severe form of CARD (C vs B1: OR = 0.3; P = 0.03). Moreover, patients with ACE II and AGTR1 rs5186 +1166AC genotypes presented higher LVEF%. In C patients, TNF serum levels were higher in ACE D carriers than in II genotype. Although limited in number, a cross-sectional observation suggests that C-stage patients treated with benznidazole years prior to administration of ACE inhibitors/AT1R antagonists show reduced TNF serum levels and improved LVEF%. Therefore, variants of ACE and AGTR1 genes may influence the outcome of Chagas’ heart disease and should be explored in precision medicine. Further, pharmacotherapies may improve immunological abnormality and clinical outcome in CD patients. Altogether, these data support prospective studies of this cohort and replication in other cohorts. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia das Interações. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia das Interações. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia das Interações. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia das Interações. Rio de Janeiro, RJ, Brasil / Universidade de Pernambuco. Reitoria. Complexo Hospitalar. Pronto-Socorro Cardiológico Universitário de Pernambuco - Prof. Luiz Tavares. Ambulatório de Doença de Chagas e Insuficiência Cardíaca. Recife, PE, Brasil / Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Instituto do Coração. São Paulo, SP, Brasil. | |
| Affilliation | Universidade de Pernambuco. Reitoria. Complexo Hospitalar. Pronto-Socorro Cardiológico Universitário de Pernambuco - Prof. Luiz Tavares. Ambulatório de Doença de Chagas e Insuficiência Cardíaca. Recife, PE, Brasil. | |
| Affilliation | Universidade de Pernambuco. Reitoria. Complexo Hospitalar. Pronto-Socorro Cardiológico Universitário de Pernambuco - Prof. Luiz Tavares. Ambulatório de Doença de Chagas e Insuficiência Cardíaca. Recife, PE, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Presidência. Programa de Computação Científica. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Universidade de Pernambuco. Reitoria. Complexo Hospitalar. Pronto-Socorro Cardiológico Universitário de Pernambuco - Prof. Luiz Tavares. Ambulatório de Doença de Chagas e Insuficiência Cardíaca. Recife, PE, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil. | |
| Affilliation | Universidade de Pernambuco. Reitoria. Complexo Hospitalar. Pronto-Socorro Cardiológico Universitário de Pernambuco - Prof. Luiz Tavares. Ambulatório de Doença de Chagas e Insuficiência Cardíaca. Recife, PE, Brasil. | |
| Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia das Interações. Rio de Janeiro, RJ, Brasil. | |
| Subject | ACE inhibitor therapy | en_US |
| Subject | Cardiovascular diseases | en_US |
| Subject | Variant genotypes | en_US |
| Subject | Heart failure | en_US |
| Subject | Heredity | en_US |
| Subject | Brazil | en_US |
| Subject | Cardiovascular disease risk | en_US |
| Subject | Drug therapy | en_US |
| e-ISSN | 1935-2735 | |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |
| xmlui.metadata.dc.subject.ods | 09 Indústria, inovação e infraestrutura | |
| xmlui.metadata.dc.subject.ods | 10 Redução das desigualdades | |
