We investigated whether sequestered Trypanosoma cruzi antigens found in heart interstitial dendritic cells (IDCs) contribute to the residual myocarditis found in mice following treatment with benznidazole, a specific chemotherapeutic drug. IDCs are antigen-presenting cells that are MHC-II-receptor dependent. Swiss mice were divided into two experimental groups: the 1st group was infected with the Colombian strain of T. cruzi, which is resistant to treatment with benznidazole, and the 2nd group was infected with clone 21SF-C 3, which has a medium susceptibility to the drug. Treatment of the Colombian strain group started on the 120th day post-infection and for the 21SF-C3 strain group treatment was started on the 90th day. In both groups, treatment lasted for 90 days. The animals were sacrificed either 150 or 200 days post-treatment. The myocardium was analysed by immunohistochemistry using anti-MAC3, 33D1, CD11b and CD11c monoclonal antibodies for IDCs or anti-T. cruzi purified antibodies. Parasite antigens were expressed on the IDC membranes in both treated and untreated mice. Myocarditis subsided following treatment, evidenced by both histological and morphometrical evaluation. A reduction in the number of IDCs carrying T. cruzi antigens in the treated group indicates that the elimination of parasites influences antigen presentation with concomitant decreases in inflammation. There is a correlation between the presence of T. cruzi antigens in these cells and the chronic focal, residual myocarditis seen in treated mice.

Infection of C3H/He mice with the Peruvian strain of Trypanosoma cruzi (Biodeme type I, Z2b), a macrophagotropic strain, determined severe parasitism of macrophages, necrosis of the spleen, and high host mortality. In the present study, pentoxifylline (PTX), an inhibitor of TNF-alpha was investigated on its action upon splenic necrosis, parasitemia and host survival. Immunohistochemical data suggested the importance of this cytokine in parasite destruction and decreasing of parasitemia, although paradoxically contributing to the high mortality of infected mice. Necrotic lesions involving several organs, specially the heart, in acute Chagas disease, are important aggravating factors, increasing cardiac morbidity. Advantage of inhibiting TNF-alpha action was herein investigated. Infected mice were divided into two groups: untreated (n = 24), and PTX treated mice (n = 25). PTX was administered in two daily doses of 30 mg/kg/bw, by intraperitoneal route. Normal controls either treated with PTX or saline were also included. Histopathology of the spleen and in situ immunolabeling of TNF-alpha, using anti-TNF-alpha monoclonal antibody, were performed. Necrotic areas were evaluated by morphometry. Mice treated with PTX showed a significant decrease of necrotic areas and diminution of TNF-alpha expression in spleen tissue, suggesting that PTX treatment could control TNF-alpha effects, and thus be used as an adjuvant in the treatment of acute Chagas' disease.

Colombian strain of Trypanosoma cruzi, biodeme Type III (T. cruzi I), has been cloned by micromanipulation at two phases of the acute infection: early (10 days ) and advanced (30 days). Twelve clones were obtained therefrom. Characterization by their biological and biochemical behavior showed an identity among the several clones and their parental strain, albeit with different degrees of virulence. Molecular characterization of the kinetoplast DNA (kDNA) after amplification by polymerase chain reaction revealed identical profiles of the bands from the kDNA minicircle by the analysis of restriction fragment lenght polymorphism for the isolated clones, their parental strain, and to the clones isolated at two different phases of the infection. Results suggest the predominance of a "principal clone", in the composition of the Colombian strain, responsible for the biological and biochemical behavior. However, no relationship was detected between the molecular profile of kDNA and the degree of virulence presented by the several clones.

Calomys callosus, a sylvatic reservoir of Trypanosoma cruzi, when infected with the Colombian strain (Biodeme Type III, T. cruzi I ) develops necrotic-inflammatory lesions and intense early fibrogenesis in the heart and skeletal muscles, that spontaneously regress. Participation of pro-inflammatory and pro-fibrogenic cytokines, such as tumor necrosis factor-alpha (TNF-alpha), gamma interferon (IFN-gamma) , and tumor growth factor-beta (TGF-beta), in the pathogenesis of the lesions is herein studied. Eighty C. callosus weighing 20 to 30 g were used. Seventy of them were inoculated with the Colombian strain (10(5) blood forms) and 10 were maintained as intact non-infected controls. After infection, C. callosus were sacrificed at different time-points from 15 to 70 days. The heart and skeletal muscle were processed for histopathology and cryopreserved for immunohistochemistry. Early necrotic lesions of parasitized skeletal muscle and myocardium with intense inflammatory lesions were present. Search for the in situ presence of TNF-alpha and IFN-gamma, was performed using rat-IgG anti-mouse antibodies against these cytokines. For the in situ search of TGF-beta, rabbit IgG anti-mouse antibodies were used. Immunolabeling of the cytokines in tissues of infected C. callosus was successful. The cytokines TNF-alpha, IFN-gamma , and TGF-beta were detected in the cytoplasm of macrophages and in the necrotic material from 15 to 45 days post-infection, decreasing their intensity until complete disappearance by the 65th day, which correlated with subsiding histopathological lesions. These findings suggest the participation of these cytokines in the control of parasite multiplication, in the development of an early fibrogenesis and in the regression of fibrotic-inflammatory lesions observed in C. callosus.

A suscetibilidade à quimioterapia com o benzonidazol, de 5 clones isolados da cepa 21SF (biodema Tipo II, T. cruzi II), foi investigada. Camundongos suíços foram infectados com a cepa parental e com cada clone e submetidos à quimioterapia com benzonidazol (100mg/k/dia durante 90 dias). Os índices de cura foram avaliados pelos testes de cura parasitológicos. A sorologia foi avaliada para os animais tratados e (de negativo a 1: 640) e para os controles não tratados( 1:160 a 1:640). Os índices de cura variaram de 30% a 100% para os 5 clones sendo de 25% para a cepa parental. Os resultados sugerem que a variabilidade de resposta ao tratamento das populações clonais das cepas Trypanosoma cruzi II é responsável pela grande variação na resposta à quimioterapia com benzonidazol e nifurtimox das cepas deste biodema.

Susceptibility to chemotherapy with benznidazole was investigated of 5 clones isolated from the 21 SF strain (biodeme Type II, Trypanosoma cruzi II). Swiss mice were infected with the parental strain for each clone and submitted to chemotherapy with benznidazole (100mg/kg/day during 90 days). Treatment determined negativity of the parasitemia. Cure rates were evaluated by parasitological cure tests. Serology was evaluated for treated animals (titers from negative to 1:640) and untreated controls (1:160 to 1:640). Cure rates varied from 30 to 100% for the 5 clones, and were 25% for the parental strain. Results suggested that the variability of response to treatment of the clonal populations of Trypanosoma cruzi II strains is responsible for the high variation in the response to chemotherapy with benznidazole and nifurtimox by strains of this biodeme.

The influence of different Trypanosoma cruzi biodemes on the evolution of the infection and on the histopathological lesions of the heart and skeletal muscles, during the experimental infection of Calomys callosus, was investigated. Three groups of C. callosus were infected, respectively, with parasite strains representative of three different Biodemes: Type I (Y strain), Type II (21 SF strain), and Type III (Colombian strain). For each group, normal C. callosus were also used as controls. Marked differences have been detected in the responses of C. callosus to the infection with the three strains in this model. The strains Types I and II (Y and 21 SF) determined moderate lesions, mostly in the myocardium, with low parasitism, a rapid course, and total regression of the lesions by the 60th day of infection. Differently, Type III strain (Colombian), was more pathogenic for C. callosus and induced necrotic-inflammatory lesions in skeletal muscles and myocardium, in correspondence to intracellular parasitism. Proliferation of fibroblasts and amorphous matrix deposits, followed by interstitial fibrosis were present. Progressive regression of the inflammatory changes and collagen deposits occurred spontaneously. The progression and regression of both inflammation and fibrosis induced by the Colombian strain were further submitted to quantitative evaluation by morphometry. Results of the morphometric studies presented good correlation with the histopathological findings. The results confirm the importance of the different biodemes in the determination of tissue lesions and the peculiarities of response of C. callosus to infection with T. cruzi.

O benzonidazol é recomendado no Brasil para o tratamento da infecção pelo Trypanosoma cruzi na fase aguda e na fase crônica precoce da doença de Chagas. Observações de outros autores mostraram uma elevação na incidência de neoplasias em pacientes imunossuprimidos, com reativação da doença de Chagas, submetidos a tratamento com o benzonidazol. No presente estudo foi investigado em camundongos cronicamente infectados, tratados com drogas imunossupressoras e com benzonidazol se há uma potencialização de desenvolvimento de linfomas por esta combinação. Para isso foram usados 142 camundongos suiços crônicamente infectados pela cepa 21SF do T.cruzi e 72 camundongos suiços normais. Tanto os camundongos infectados como os normais foram divididos em grupos experimentais submetidos respectivamente a diferentes esquemas de tratamento: com benzonidazol apenas; com drogas imunossupressoras (azatioprina, betametasona e ciclosporina); com drogas imunossupressoras mais benzonidazol; e controles não tratados. no grupo infectado e tratado com benzonidazol, um camundongo desenvolveu um linfoma não-Hodgkin. Este achado foi interpretado como um tumor espontâneo do camundongo. O estudo de camundongos crônicamente infectados e tratados com uma combinação de drogas imunossupressoras e benzonidazol demonstrou ausência de linfomas ou de outras neoplasias. Estes achados reforçam a indicação do tratamento com benzonidazol como droga de escolha em pacientes imunossuprimidos que desenvolvem reativação da doença de Chagas.

Benznidazole is recommended in Brazil for the treatment of Trypanosoma cruzi infection in acute and early chronic phases of Chagas' disease. Observations by others have indicated a higher incidence of neoplasias in immunosuppressed patients, presenting Chagas' disease reactivation, submitted to treatment with benznidazole. In the present study, we investigated whether there is a potentiation in the generation of lymphomas in chronically infected mice, treated with immunosuppressive drugs and benznidazole. For this, 142 Swiss mice chronically infected with the 21 SF strain of T. cruzi and 72 normal Swiss mice were used. Both infected and normal mice were divided into experimental groups and submitted to one of the following treatment regimens: benznidazole alone; immunosuppressive drugs (azathioprine, betamethasone and cyclosporin); a combination of immunosuppressive drugs and benznidazole; and untreated controls. In the infected group treated with benznidazole, one mouse developed a non-Hodgkin's lymphoma. This finding has been interpreted as a spontaneous tumor of mice. The study of the chronically infected mice treated with the combination of immunosuppressive drugs and benznidazole demonstrated an absence of lymphomas or other neoplasias. These findings support the indication of benznidazole, as the drug of choice, for immunosuppressed patients that develop a reactivation of Chagas' disease.

A presente investigação visa avaliar a suscetibilidade ao benzonidazol de sete clones isolados da cepa Colombiana do Trypanosoma cruzi, protótipo do biodema III , altamente resistente aos quimioterápicos. Os clones préviamente obtidos apresentavam homogeneidade fenotípica e alta similaridade com a cepa parental. Oito grupos de 30 camundongos foram inoculados com cada um dos sete clones e a cepa parental;20 foram tratados com benzonidazol 100mg/kg/dia e 10 foram controles não tratados. A avaliação da cura foi feita por testes parasitológicos, sorológicos e o PCR. Os índices de cura variaram de 0%(nulo) a 16,7%. Correlação entre a positividade dos testes parasitológicos e sorológicos com a da PCR alcançou 37%. Os resultados demonstraram a alta resistência dos clones, sugerindo a predominância de um clone principal, muito resistente à quimioterapia nesta cepa. Isto indica que as possibilidades de cura de pacientes infectados com este biodema são mínimas, o que poderá interferir no controle da doença através do tratamento de individuos cronicamente infectados.

The present investigation was performed to evaluate the susceptibility of seven clones isolated from the highly resistant Colombian strains, prototype of Biodeme Type III. Seven clones previously obtained, showed a phenotypic homogeneity and high similarity with the parental strain. Eight groups of 30 mice were inoculated with one of seven clones or the parental strain; 20 were treated with benznidazole (100mg/kg/day) and 10 were untreated controls. Cure evaluations were done by parasitological and serological tests and PCR. Cure rates varied from 0% (null) to 16.7%. Correlation between positivity of parasitological and serological tests with positive PCR reached 37%. The results demonstrated the high resistance of the clones, suggesting the predominance of a highly resistant principal clone in this strain. The findings apparently indicate that the possibility of cure is minimal for patients infected with this biodeme; a fact that could affect the control of Chagas' disease through treatment of chronically infected people.

A sensibilidade da reação em cadeia da polimerase (PCR) para revelar a presença de números conhecidos de tripomastigotas no sangue de camundongos, foi investigada em três experimentos separados. No primeiro, foram adicionados 1, 2, 3, 4, 5, 10, 20 e 50 tripomastigotas respectivamente, em oito amostras de 500mil de sangue de camundongo. No 2º e 3º experimentos: foram feitas 10 amostras contendo 1, e 10 amostras contendo 2 tripomastigotas/500mil de sangue. Controle positivo: 500mil de sangue contendo 100.000 trypomastigotas. Para amplificação dos minicirculos do kDNA pela PCR foram usados os iniciadores S35 e S36. A PCR revelou produtos de 330 p.b nos controles positivos e nas amostras contendo de 3 a 50 tripomastigotas. Quando apenas uma amostra contendo 1 ou 2 tripomastigotas foi examinada, os resultados foram negativos, porém no 2º e 3º experimentos 9/10 amostras contendo 1 e 2 tripomastigotas foram PCR positivas, revelando alta sensibilidade da reação. Em conclusão, a presença de um só parasito em 500mil de sangue é suficiente para uma PCR positiva e este método pode ser usado como complementação dos demais testes parasitológicos de cura, em camundongos tratados, quando pequenos volumes de sangue são individualmente examinados.

To evaluate the sensitivity of polymerase chain reaction (PCR) to reveal known number of trypomastigote in the blood of mice, three separate experiments were done. First: To eight samples of 500mul of normal mice blood, one aliquot of 1, 2, 3, 4, 5, 10, and 50 trypomastigotes respectively, were added. Second and third: 10 aliquots with 1 and 10 with 2 trypomastigotes were added to samples of 500mul of normal mice blood. Positive control: 500mul of blood containing 100,000 trypomastigotes. For kDNA minicircles amplification by PCR the primers:S35 and S36 were used. PCR revealed products of 330 b.p in the positive controls. When only one sample with the aliquots of 1 or 2 trypomastigotes was examined, results were negative; results were positive with aliquots of 3 to 50 trypomastigotes. In the 2nd and 3rd experiments, 9/10 aliquots with one parasite and 9/10 with 2 trypomastigotes were positive revealing a high sensitivity of this reaction. In conclusion, the presence of one single parasite in 500mul of blood, is enough for a positive PCR. This method could be used as a complement to the various parasitological cure tests in treated mice, when low volumes of blood are individually examined.

Intense inflammatory lesions and early development of interstitial fibrosis of the myocardium and skeletal muscle with spontaneous regression, have been described in Calomys callosus infected with Trypanosoma cruzi. The genetic types of collagen present in this model were investigated through immunohistochemistry using specific antibodies, combined with histopathology and Picro-Sirius staining of collagen. Thirty-five calomys were infected with the Colombian strain of T. cruzi and sacrificed at 24, 30, 40, 60 and 90 days post-infection. Inflammatory lesions and fibrogenesis were prominent at the early phase of infection and significantly decreased during late infection. Immunoisotyping of the matrix components was performed by indirect immunofluorescence on 5 µm thick cryostat sections using specific antibodies against laminin, fibronectin and isotypes I, III and IV of collagen. In the early phase, positive deposits of all the matrix components were present, with predominance of fibronectin, laminin and collagens types I and III in the myocardium and of types III and IV in the skeletal muscles. From the 40th day, type IV collagen predominates in the heart. At the late phase of infection (60th to 90th day), a clear fragmentation and decrease of all the matrix components were detected. Findings of the present study indicate that a modulation of the inflammatory process occurs in the model of C. callosus, leading to spontaneous regression of fibrosis independent of the genetic types of collagen involved in this process.

A ocorrência de microepidemias de infecção pelo Trypanosoma cruzi atribuidas à ingestão de alimentos contaminados com excreta de vetores ou de reservatórios vertebrados, em áreas rurais chamou a atenção para este tipo não vetorial de transmissão da doença de Chagas. Considerando que cepas de diferentes biodemas se distribuem diferentemente nos ciclos silvestre e domiciliar de transmissão, a ocorrência de microepidemias predominantes em áreas próximas aos ecótopos silvestres pode estar relacionada com a cepa do parasito, tendo-se em conta a predominância do Biodema Tipo III, Z1 nestas áreas. No presente estudo foi investigada a infectividade de cepas do T. cruzi de diferentes biodemas quando inoculadas por via digestiva. Foi feita inoculação por via intragástrica (VIG) em camundongos Suíços com a cepa Peruana (Biodema Tipo I, Z2b) ou com a Colombiana (Biodema Tipo III, Z1, T. cruzi I). Para controle da infecção, camundongos foram também inoculados por via intraperitoneal (VIP). A cepa Colombiana mostrou alta infectividade e patogenicidade tanto por VIP como por VIG. A cepa Peruana apresentou alta infectividade e patogenicidade pela VIP e mostrou baixa infectividade pela VIG. A mais elevada infectividade pela VIG, da cepa Colombiana, cujo biodema Tipo III, Z1 é o mais freqüentemente encontrado nos hospedeiros silvestres, está de acordo com a ocorrência dos episódios epidêmicos registrados na literatura.

Oral transmission of Trypanosoma cruzi has been suspected when epidemic episodes of acute infection were observed in areas devoid of domiciled insect vectors. Considering that the distribution of T. cruzi biodemes differs in sylvatic and domestic cycles, results of studies on biodemes can be of interest regarding oral transmission. The infectivity of T. cruzi strains of different biodemes was tested in mice subjected to infection by the digestive route (gavage). Swiss mice were infected either with the Peruvian strain (Biodeme Type I, Z2b) or the Colombian strain (Biodeme Type III, Z1, or T. cruzi I); for control, intraperitoneal inoculation was performed in a group of mice. The Colombian strain revealed a similar high infectivity and pathogenicity when either route of infection was used. However, the Peruvian strain showed contrasting levels of infectivity and pathogenicity, being high by intraperitoneal inoculation and low when the gastric route was used. The higher infectivity of the Colombian strain (Biodeme Type III) by gastric inoculation is in keeping with its role in the epidemic episodes of acute Chagas disease registered in the literature, since strains belonging to Biodeme III are most often found in sylvatic hosts.

A estrutura clonal da cepa Colombiana do Trypanosoma cruzi, biodema Tipo III e zimodema 1, foi analisada com o objetivo de caracterizar as suas populações e estabelecer a homogeneidade ou heterogeneidade das mesmas. Foram isolados sete clones, os quais apresentaram as características básicas do biodema Tipo III, com o mesmo padrão de curvas parasitêmicas, tropismo tecidual para músculo esquelético e miocárdio, alta patogenicidade, com extensas lesões necrótico-inflamatórias, do 20º ao 30º dia de infecção. A cepa parental e os clones C1, C3, C4 e C6 apresentaram os niveis mais elevados de parasitemia entre 20 e 30 dias pós-infecção e alto indice de mortalidade até 30 dias (79 a 100%); os clones C2, C5 e C7 apresentaram niveis mais baixos de parasitemia com baixa mortalidade até 30 dias (7,6 a 23%). Os padrões isoenzimáticos foram característicos do zimodema 1 (Z1) para a cepa parental e os sete clones. Os achados do presente trabalho indicam uma homogeneidade fenotípica entre os clones isolados da cepa Colombiana e sugerem a predominância de um clone principal, responsável pelo padrão de comportamento biológico da cepa parental e dos clones.

The clonal structure of the Colombian strain of Trypanosoma cruzi, biodeme Type III and zymodeme 1, was analyzed in order to characterize its populations and to establish its homogeneity or heterogeneity. Seven isolated clones presented the basic characteristics of Biodeme Type III, with the same patterns of parasitemic curves, tissue tropism to skeletal muscle and myocardium, high pathogenicity with extensive necrotic-inflammatory lesions from the 20th to 30th day of infection. The parental strain and its clones C1, C3, C4 and C6, determined the higher levels of parasitemia, 20 to 30 days of infection, with high mortality rate up to 30 days (79 to 100%); clones C2, C5 and C7 presented lower levels of parasitemia, with low mortality rates (7.6 to 23%). Isoenzymic patterns, characteristic of zymodeme 1, (Z1) were similar for the parental strain and its seven clones. Results point to a phenotypic homogeneity of the clones isolated from the Colombian strain and suggest the predominance of a principal clone, responsible for the biological behavior of the parental strain and clones.

Molecular characterization of one stable strain of Trypanosoma cruzi, the 21 SF, representative of the pattern of strains isolated from the endemic area of São Felipe, State of Bahia, Brazil, maintained for 15 years in laboratory by serial passages in mice and classified as biodeme Type II and zymodeme 2 has been investigated. The kinetoplast DNA (kDNA) of parental strain, 5 clones and 14 subclones were analyzed. Schizodeme was established by comparative study of the fragments obtained from digestion of the 330-bp fragments amplified by polymerase chain reaction (PCR) from the variable regions of the minicicles, and digested by restriction endonucleases Rsa I and Hinf I. Our results show a high percentual of similarity between the restriction fragment lenght polymorphism (RFLP) for the parental strain and its clones and among these individual clones and their subclones at a level of 80 to 100%.This homology indicates a predominance of the same "principal clone" in the 21SF strain and confirms the homogeneity previously observed at biological and isozymic analysis. These results suggest the possibility that the T. cruzi strains with similar biological and isoenzymic patterns, circulating in this endemic area, are representative of one dominant clone. The presence of "principal clones" could be responsible for a predominant tropism of the parasites for specific organs and tissues and this could contribute to the pattern of clinico-pathological manifestations of Chagas's disease in one geographical area.

Foram estudados os caracteres biológicos e isoenzimáticos de 138 cepas do Trypanosoma cruzi de diferentes áreas geográficas, sendo 120 do Brasil e 18 de outros paises da América do Sul e Central. Camundongos recém-nascidos foram inoculados com formas metacíclicas de triatomineos ou de culturas axenicas, seguindo-se passagem em camundongo de 10 a 12g. Os caracteres biológicos e o estudo histopatológico permitiram incluir todas a cepas em três Tipos ou biodemas: I, II e III . A análise isoenzimática para PGM, GPI, ASAT e ALAT confirmou a correspondência entre os biodemas e os zimodemas: Tipo I e Z2b, Tipo II e Z2, Tipo III e Z1. Os resultados mostraram a distribuição ubíqua dos diversos Tipos de cepas, observando-se a predominância do mesmo biodema em uma mesma áreas geográfica: cepas de Tipo II de casos humanos do Leste da Bahia e Leste de Goiás; cepas de Tipo III do Norte do Brazil e da América Central e de vetores ou vertebrados silvestres em várias áreas geográficas. Os biodemas correlacionam com diferentes lesões histopatológicas na fase aguda e crônica da infecção, considerando-se o envolvimento cardíaco e as lesões neuronais. Estes achados sugerem que o comportamento biológico, os padrões isoenzimáticos e o quadro patológico podem se constituir em importantes elementos para o estabelecimento de correlações entre as cepas do parasito e as manifestações clinico-patológicas da doença de Chagas em diferentes áreas geográficas.

With the objective of establishing biological and biochemical characteristics of a significant number of Trypanosoma cruzi strains from different geographical areas, 138 strains isolated from naturally infected humans, triatomine or vertebrate hosts were studied; 120 were isolated from different areas of Brazil and 18 from other South and Central American countries. Inocula from triatomine or culture forms were injected into suckling Swiss mice, followed by passages into mice 10 to 12 g. Biological characters and histopathological study permitted the inclusion of the strains into three Types or biodemes: I, II, III. Isoenzymic analysis confirmed a correspondence between the biodemes and zymodemes : Type I and Z2b, Type II and Z2, Type III and Z1. Results showed the ubiquitary distribution of the several types of strains. The predominance of the same Type and zymodeme in one geographical area was confirmed : Type II strains among the human cases from eastern Bahia and east of Goiás; Type III strains from humans of north Brazil and Central America and from silvatic vectors or vertebrates from other geographical areas. The biological types of strains correlate with different histopathological lesions considering cardiac involvement and neuronal lesions. These findings suggest that the biological behavior together with isoenzymes patterns and pathological pictures in the vertebrate host can be an important tool for establishing correlations between strains behavior and clinico-pathological manifestations of Chagas' disease in different geographical areas.