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- W2970914570 abstract "The chronic phase of Chagas disease (CD) is characterised by a low and intermittent parasitaemia. The Polymerase Chain Reaction (PCR) presents a variable sensitivity in this stage limiting its use as a diagnostic tool. Despite this, the use of PCR in untreated patients can provide information on the parasite behavior and its presence in peripheral blood.A timely real-time PCR determination was performed on a cohort of 495 untreated chronic CD patients. Also, a subcohort of 29 patients was followed-up by serial real-time PCR during a period from 8 to 12 months in which they could not have access to the treatment due to lack of supply.The positive percentage of real-time PCR in our series was 42%. Nevertheless, real-time PCR positive results were significantly higher in patients with five years or less of residence in Spain (P = .041). The detection of DNA was not related to the existence of cardiac and/or gastrointestinal abnormalities.In the follow-up subgroup, real-time PCR was consistently positive in 13.8% of patients, consistently negative in 31%, and intermittent in 55.2%.The different real-time PCR results regarding the time of residence suggests the possible relationship of external factors in the parasite presence in peripheral blood. On the other hand, specific host factors may be involved in the behavior of parasitaemia over time.La fase crónica de la Enfermedad de Chagas (EC) se caracteriza por una parasitemia baja e intermitente. En esta fase, la sensibilidad de la Reacción en Cadena de la Polimerasa (PCR) es muy variable, limitando su utilización como técnica diagnóstica. A pesar de ello, la realización de la PCR en pacientes no tratados puede aportar datos sobre el comportamiento del parásito y su presencia en sangre periférica.Se realizó PCR a tiempo real de forma puntual en una cohorte de 495 pacientes con EC crónica en ausencia de tratamiento. También se realizó seguimiento de una subcohorte de 29 pacientes mediante PCR a tiempo real seriadas, entre 8 y 12 meses en los que no tuvieron acceso al tratamiento por falta de suministro.El porcentaje de positividad de PCR a tiempo real fue de 42%. Este porcentaje fue significativamente mayor en pacientes con 5 años o menos de residencia en España (P = .041). La detección de ADN no se relacionó con la existencia de alteraciones cardíacas y/o digestivas.En el subgrupo de pacientes a los que se realizaron determinaciones seriadas, el resultado de PCR fue sostenidamente positivo en 13.8% de los pacientes, negativo en 31% e intermitente en 55.2%.Las diferencias de resultados de PCR a tiempo real en función del tiempo de residencia apuntan que existen factores externos que pueden influir en la presencia del parásito en sangre periférica. Así mismo, factores que propios del hospedador parecen influir en la dinámica parasitaria a lo largo del tiempo." @default.
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- W2970914570 date "2019-08-01" @default.
- W2970914570 modified "2023-10-06" @default.
- W2970914570 title "Metabolites of the Kyn pathway participate in the control of the T. cruzi infection in human placental explants" @default.
- W2970914570 doi "https://doi.org/10.1016/j.placenta.2019.06.284" @default.
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