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Precision Health for Chagas Disease: Integrating Parasite and Host Factors to Predict Outcome of Infection and Response to Therapy

Authors
  • Martinez, Santiago J.1, 2
  • Romano, Patricia S.1
  • Engman, David M.2, 3, 4
  • 1 Laboratorio de Biología de Trypanosoma cruzi y la célula hospedadora—Instituto de Histología y Embriología “Dr. Mario H. Burgos,” (IHEM-CONICET- Universidad Nacional de Cuyo), Mendoza , (Argentina)
  • 2 Department of Pathology and Laboratory Medicine, Cedars Sinai Medical Center, Los Angeles, CA , (United States)
  • 3 Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, CA , (United States)
  • 4 Departments of Pathology and Microbiology-Immunology, Northwestern University, Chicago, IL , (United States)
Type
Published Article
Journal
Frontiers in Cellular and Infection Microbiology
Publisher
Frontiers Media SA
Publication Date
May 08, 2020
Volume
10
Identifiers
DOI: 10.3389/fcimb.2020.00210
PMID: 32457849
PMCID: PMC7225773
Source
PubMed Central
Keywords
License
Unknown

Abstract

Chagas disease, caused by the infection with the protozoan parasite Trypanosoma cruzi , is clinically manifested in approximately one-third of infected people by inflammatory heart disease (cardiomyopathy) and, to a minor degree, gastrointestinal tract disorders (megaesophagus or megacolon). Chagas disease is a zoonosis transmitted among animals and people through the contact with triatomine bugs, which are found in much of the western hemisphere, including most countries of North, Central and South America, between parallels 45° north (Minneapolis, USA) and south (Chubut Province, Argentina). Despite much research on drug discovery for T. cruzi , there remain only two related agents in widespread use. Likewise, treatment is not always indicated due to the serious side effects of these drugs. On the other hand, the epidemiology and pathogenesis of Chagas disease are both highly complex, and much is known about both. However, it is still impossible to predict what will happen in an individual person infected with T. cruzi , because of the highly variability of parasite virulence and human susceptibility to infection, with no definitive molecular predictors of outcome from either side of the host-parasite equation. In this Minireview we briefly discuss the current state of T. cruzi infection and prognosis and look forward to the day when it will be possible to employ precision health to predict disease outcome and determine whether and when treatment of infection may be necessary.

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