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Chagas disease is one of the most important endemic infections in Latin America affecting around 6–7 million people. About 30–50% of patients develop the cardiac form of the disease, which can lead to severe cardiac dysfunction and death. In this scenario, the identification of immunological markers of disease progression would be a valuable tool for early treatment and reduction of death rates. In this observational study, the production of anti- Trypanosoma cruzi  antibodies through a retrospective longitudinal follow-up in chronic Chagas disease patients´ cohort and its correlation with disease progression and heart commitment was evaluated. Strong inverse correlation (ρ = -0.6375,  p  = 0.0005) between anti- T .  cruzi  IgG 1  titers and left ventricular ejection fraction (LVEF) in chronic Chagas cardiomyopathy (CCC) patients were observed after disease progression. Elevated levels of anti- T .  cruzi  IgG 3  titers were detected in all  T .  cruzi -infected patients, indicating a lack of correlation of this IgG isotype with disease progression. Furthermore, low levels of anti- T .  cruzi  IgG 2 , IgG 4 , and IgA were detected in all patients through the follow-up. Although without statistical significance anti- T .  cruzi  IgE tends to be more reactive in patients with the indeterminate form (IND) of the disease ( p  = 0.0637). As this study was conducted in patients with many years of chronic disease no anti- T .  cruzi  IgM was detected. Taken together, these results indicate that the levels of anti- T .  cruzi  IgG 1  could be considered to seek for promising biomarkers to predict the severity of chronic Chagas disease cardiomyopathy.

plos neglected tropical diseases

Evolution of anti-Trypanosoma cruzi antibody production in patients with chronic Chagas disease: Correlation between antibody titers and development of cardiac disease severity