دورية أكاديمية
أعرض في EDS

Early polymerase chain reaction detection of Chagas disease reactivation in heart transplant patients.

التفاصيل البيبلوغرافية
العنوان: Early polymerase chain reaction detection of Chagas disease reactivation in heart transplant patients.
المؤلفون: da Costa PA; Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. Electronic address: andrea@ufmg.br., Segatto M; Departamento de Genética, Instituto de Biociências, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil., Durso DF; Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., de Carvalho Moreira WJ; Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., Junqueira LL; Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., de Castilho FM; Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., de Andrade SA; Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., Gelape CL; Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., Chiari E; Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., Teixeira-Carvalho A; Centro de Pesquisas René Rachou, Fiocruz-Minas, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, Minas Gerais, Brazil., Junho Pena SD; Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., Machado CR; Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., Franco GR; Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., Filho GB; Departamento de Patologia da Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., Vieira Moreira MDC; Departamento de Clinica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., Mara Macedo A; Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
المصدر: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation [J Heart Lung Transplant] 2017 Jul; Vol. 36 (7), pp. 797-805. Date of Electronic Publication: 2017 Feb 24.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 9102703 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-3117 (Electronic) Linking ISSN: 10532498 NLM ISO Abbreviation: J Heart Lung Transplant Subsets: MEDLINE
أسماء مطبوعة: Publication: 1999- : New York, NY : Elsevier
Original Publication: St. Louis, Mo. : Mosby-Year Book, Inc., c1991-
مواضيع طبية MeSH: Heart Transplantation*, Chagas Cardiomyopathy/*diagnosis , Chagas Cardiomyopathy/*surgery , Endocardium/*parasitology , Trypanosoma cruzi/*isolation & purification, Adult ; DNA, Protozoan ; Female ; Humans ; Male ; Predictive Value of Tests ; ROC Curve ; Real-Time Polymerase Chain Reaction
مستخلص: Background: Heart transplantation is a valuable therapeutic option for Chagas disease patients with severe cardiomyopathy. During patient follow-up, the differential diagnosis between cardiac transplant rejection and Chagas disease infection reactivation remains a challenging task, which hinders rapid implementation of the appropriate treatment. Herein we investigate whether polymerase chain reaction (PCR) strategies could facilitate early detection of Trypanosoma cruzi (T cruzi) in transplanted endomyocardial biopsies (EMBs).
Methods: In this study we analyzed 500 EMB specimens obtained from 58 chagasic cardiac transplant patients, using PCR approaches targeted to nuclear (rDNA 24Sα) and kinetoplastid (kDNA) markers, and compared the efficiency of these approaches with that of other tests routinely used.
Results: T cruzi DNA was detected in 112 EMB specimens derived from 39 patients (67.2%). The first positive result occurred at a median 1.0 month post-transplant. Conventional histopathologic, blood smear and hemoculture analyses showed lower sensitivity and higher median time to the first positive result. Patient follow-up revealed that 31 of 39 PCR-positive cases presented clinical reactivation of Chagas disease at different time-points after transplantation. PCR techniques showed considerable sensitivity (0.82) and specificity (0.60), with area under the receiver operating characteristic (ROC) curves of 0.708 (p = 0.001). Moreover, PCR techniques anticipated the clinical signs of Chagas disease reactivation by up to 36 months, with a median time of 6 months and an average of 9.1 months.
Conclusions: We found a good association between the PCR diagnosis and the clinical signs of the disease, indicating that the PCR approaches used herein are suitable for early diagnosis of Chagas disease reactivation, with high potential to assist physicians in treatment decisions. For this purpose, an algorithm is proposed for surveillance based on the molecular tests.
(Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)
التعليقات: Comment in: J Heart Lung Transplant. 2017 Dec;36(12):1360-1361. (PMID: 28869079)
فهرسة مساهمة: Keywords: Chagas disease reactivation; endomyocardial biopsy; heart transplantation; molecular diagnostics; polymerase chain reaction
المشرفين على المادة: 0 (DNA, Protozoan)
تواريخ الأحداث: Date Created: 20170322 Date Completed: 20180508 Latest Revision: 20220331
رمز التحديث: 20231215
DOI: 10.1016/j.healun.2017.02.018
PMID: 28320630
قاعدة البيانات: MEDLINE
الوصف
تدمد:1557-3117
DOI:10.1016/j.healun.2017.02.018