Cardiopatía chagásica: identificación y cuantificación de las células infiltrantes, de corazones de pacientes que sufrieron muerte cardíaca a distintas edades

Abstract

The purpose of this work was to obtain new data on factors intervening in the production and progression of human chagasic
cardiopathy (HChC) with death by cardiac failure. Wc siudied cardiac samples ofpatients that died at an early mean age versus others that died at older ages. The infiltrating ce [1s were characterized and cluantified by means of specific monoclonal antibodies and inmunohisto- chemical methodology; and by classical histological and histochemical methods. We found intense cardiac infiltration by lymphocytes that reacted with the antibodies anti-CD45RO against activated T- lymphocytes (<70%). A similar number showed reactivity for C134. And, in seriate sections, showed PAS+ substances in their cytoplasms.
Macrophages were detected in a number of 25%. Few lymphocytes reacted to C138. There was a low number of B lymphocytes. Other noticeable infiltrated eclI were intramiocardial mast cells. Qualitatively, such findings were similar in the two groups of patients. However, the number of T-lymphocytes and of the mast celis was significatively higher in the cases that underwent early cardiac death (p< 0.001). .1 cruzi was not found. In cardiomyocytes, damages were found, with T-lymphocytes and macrophages adhered to their sarcolemma, as weU as mast cells. CONCLUSIONS These findings suggest the existence of an active and intense
occurrence of immunocellular mechanims in the production and evolution of severe HChC, in which T-lymphocytes CD4+ intervene, with production and secretion of PAS+ substances; Besides, macrophages, and mast cells, in that order. The quantity of infiltrated cells was positively associated with the occurrence of malignant arrithrnyas. We suggest that such facts would be involved in the poor cardiac perfomance of the chagasic heart disease that leads to cardiac death. Indeed, they seem be worthy of consideration with respect to therapeutic strategies.