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Changes in the immune response after treatment with benznidazole versus no treatment in patients with chronic indeterminate Chagas disease.

Abstract：

:Symptomatic chronic Chagas disease affects up to 40% of patients infected with Trypanosoma cruzi. The lack of reliable early markers of cure after therapy hinders disease management and clinical trials with new drugs. We performed a study with 18 months of follow-up to compare changes in immune parameters and T. cruzi-specific immune responses as surrogate markers of response to therapy between patients treated with benznidazole and untreated patients. This was a pilot, open-label, randomised clinical trial of treatment with benznidazole versus no treatment in patients with indeterminate chronic T. cruzi infection. In both groups we investigated changes in T-cell activation, T-cell subpopulations, regulatory T-cell counts, IL6, and sCD14 levels, and T. cruzi-specific immune responses (Th1, Th2, and Th17 responses). Fourteen patients were included in the study (seven in each group). Median age was 35 years (P25-75 31-43), 57% were female, and 93% were Bolivian. Benznidazole was administered at 5mg/kg/day for 60days. Three patients discontinued benznidazole owing to adverse reactions and were not evaluated. At the end of the follow-up period, treated patients showed significantly less immune activation and lower regulatory T-cell counts, with an increased Th17 and Th1 response. This randomised pilot clinical trial administering benznidazole to patients with indeterminate chronic Chagas disease brings about changes in the adaptive immunity, leading to a general decrease in inflammatory status. This apparently beneficial response could act as the basis for monitoring new antiparasitic drugs.

journal_name

Acta Trop

journal_title

Acta tropica

authors

Vallejo A,Monge-Maillo B,Gutiérrez C,Norman FF,López-Vélez R,Pérez-Molina JA

doi

10.1016/j.actatropica.2016.09.010

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

117-124

eissn

0001-706X

issn

1873-6254

pii

S0001-706X(16)30334-5

journal_volume

164

pub_type

杂志文章,随机对照试验

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