QUANTIFICATION OF ANTI M2-PIRUVATO KINASE AUTOANTIBODIES IN PATIENTS WITH DIFFERENT CLINICAL FORMS OF CHAGAS DISEASE
Chagas disease, Trypanosoma cruzi, Clinical forms, M2-PK, Autoantibodies.
Digestive and cardiodigestive forms of Chagas' disease are observed in 2% to 15% of patients and immunopathological mechanisms that induce its development remain undefined. In addition, the determination of esophagus and colon involvement in patients is due to invasive and uncomfortable tests, which in most cases are not performed, allowing the patient to evolve to a more severe form of the pathology with a worse prognosis. In this work we evaluated the involvement of the production of anti M2-pyruvate kinase autoantibodies (M2-PK) and its possible association with the development and / or diagnosis of the digestive form of Chagas' disease. The production of total IgG and isotypes (IgG1, IgG2, IgG3, IgG4) was quantified using Trypanosoma cruzi epimastigote forms antigen and human M2-PK protein by serum ELISA in patients with indeterminate forms (n = 30), cardiac (n = 30), digestive (n = 15) and cardiodigestive (n = 15) of Chagas' disease, and correlated with the degree of dilation of the esophagus and colon. Serum samples from uninfected patients (n = 30) were used as controls. Chagasic patients with indeterminate, cardiac, digestive and cardiodigestive clinical forms had higher total antiT-cruzi IgG antibody and auto M2-PK autoantibodies when compared to uninfected individuals. Patients with the digestive and cardiodigestive form of the disease had higher production of total IgG autoantibodies compared to those with an indeterminate form. These patients still had a higher production of anti M2-PK autoantibodies belonging to the IgG1 and IgG4 isotypes when compared to patients with the indeterminate and cardiac forms. There was no difference between the production of the IgG2 and IgG3 isotypes in the patients presenting the different clinical manifestations using T. cruzi antigen or the M2-PK protein. The results indicate that the increase in the production of anti M2-PK autoantibodies may be related to the development of the digestive form of Chagas' disease.