Chagas disease reactivation in a heart transplant patient infected by domestic Trypanosoma cruzi discrete typing unit I (TcIDOM)

Costales, J.A., Kotton, C.N., Zurita-Leal, A.C., Garcia-Perez, J., Llewellyn, M.S. , Messenger, L.A., Bhattacharyya, T. and Burleigh, B.A. (2015) Chagas disease reactivation in a heart transplant patient infected by domestic Trypanosoma cruzi discrete typing unit I (TcIDOM). Parasites and Vectors, 8, 435. (doi:10.1186/s13071-015-1039-3) (PMID:26303927) (PMCID:PMC4548706)

Costales, J.A., Kotton, C.N., Zurita-Leal, A.C., Garcia-Perez, J., Llewellyn, M.S. , Messenger, L.A., Bhattacharyya, T. and Burleigh, B.A. (2015) Chagas disease reactivation in a heart transplant patient infected by domestic Trypanosoma cruzi discrete typing unit I (TcIDOM). Parasites and Vectors, 8, 435. (doi:10.1186/s13071-015-1039-3) (PMID:26303927) (PMCID:PMC4548706)

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Abstract

Background Trypanosoma cruzi, causative agent of Chagas disease, displays high intraspecific genetic diversity: six genetic lineages or discrete typing units (DTUs) are currently recognized, termed TcI through TcVI. Each DTU presents a particular distribution pattern across the Americas, and is loosely associated with different transmission cycles and hosts. Several DTUs are known to circulate in Central America. It has been previously suggested that TcI infection is benign and does not lead to chronic chagasic cardiomyopathy (CCC). Findings In this study, we genotyped T. cruzi parasites circulating in the blood and from explanted cardiac tissue of an El Salvadorian patient who developed reactivation Chagas disease while on immunosuppressive medications after undergoing heart transplant in the U.S. as treatment for end-stage CCC. Parasite typing was performed through molecular methods (restriction fragment length polymorphism of polymerase reaction chain amplified products, microsatellite typing, maxicircle sequence typing and low-stringency single primer PCR, [LSSP-PCR]) as well as lineage-specific serology. We show that the parasites infecting the patient belong to the TcI DTU exclusively. Our data indicate that the parasites isolated from the patient belong to a genotype frequently associated with human infection throughout the Americas (TcI DOM ). Conclusions Our results constitute compelling evidence in support of TcI DTU’s ability to cause end-stage CCC and help dispel any residual bias that infection with this lineage is benign, pointing to the need for increased surveillance for dissemination of this genotype in endemic regions, the USA and globally.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Llewellyn, Dr Martin
Authors: Costales, J.A., Kotton, C.N., Zurita-Leal, A.C., Garcia-Perez, J., Llewellyn, M.S., Messenger, L.A., Bhattacharyya, T., and Burleigh, B.A.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Parasites and Vectors
Publisher:BioMed Central
ISSN:1756-3305
ISSN (Online):1756-3305
Copyright Holders:Copyright © 2015 Costales et al.
First Published:First published in Parasites and Vectors 8:435
Publisher Policy:Reproduced under a Creative Commons License

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