. Increased levels of anti-p2B antibodies and decreased cardiac involvement in patients with progressive chronic Chagas heart disease undergoing B1 selective antagonist treatment

VICCO M; PUJATO N; BONTEMPI I; RODELES L; MARCIPAR I; BOTTASSO O

CANADIAN JOURNAL OF CARDIOLOGY

PULSUS GROUP INC

Lugar: Ontario; Año: 2014

0828-282X

Background: Studies indicate that antibodies cross-reacting with cardiac b1 adrenergic receptors are likely to play a role in the development of chronic Chagas heart disease (CCHD). In parallel, clinical trials have shown that b1 antagonist drugs exert beneficial effects in the prognosis of patients with CCHD. In a group of patients with CCHD undergoing therapy with b1-blockers, we have now evaluated the levels of anti-p2b antibodies and the severity of CCHD. Methods: We performed a cross-sectional study in Trypanosoma cruzi seropositive patients categorized according to a standard CCHD classification. All individuals were subjected to a complete clinical examination. Results: There was no association between CCHD stages, electrocardiographic conduction disturbances, and echocardiogram pathological signs with the levels of autoantibodies. However, when patients were analyzed according to selective cardio-b1-blocker therapy, those receiving treatment had higher levels of anti-p2b. Patients from CCHD stage III treated with combined therapy of cardio-b1-selective blockers, enalapril, and statins, presented decreased cardiac involvement and lower score of risk of mortality than individuals from the same group who were not treated. Conclusions: Our results suggest that selective cardio-b1-blockers might modify the autoantibody anti-p2b levels, and that combined therapy in patients with stage III CCHD might be associated with lower cardiac involvement and risk score of mortality in patients with heart failure. Longitudinal studies will help to ascertain the proper role of b1- blockers in the immunopathological processes underlying chronic Chagas disease.