Chagas disease courses with different clinical phases and has a variable clinical
presentation and progression. The acute infection phase mostly exhibits a non-specific symptomatology.
In the absence of treatment, the acute phase is followed by a chronic phase,
which is initially asymptomatic. This chronic asymptomatic phase of the disease is characterized
by a fragile balance between the host’s immune response and the parasite replication.
The loss of this balance is crucial for the progression of the sickness. The virulence and tropism
of the T. cruzi infecting strain together to the inflammation processes in the cardiac tissue
are the main factors for the establishment and severity of the cardiomyopathy. The efficacy
of treatment in chronic Chagas disease patients is controversial. However, several studies
carried out in chronic patients demonstrated that antiparasitic treatment reduces parasite
load in the bloodstream and leads to an improvement in the immune response against the Trypanosoma
cruzi parasite. The present review is mainly focused on the cellular patterns associated
to the clinical status and the evolution of the disease in chronic patients, as well as the
effectiveness of the treatment related to T. cruzi infection control. Therefore, an emphasis is
placed on the dynamics of specific-antigens T cell subpopulations, their memory and activation
phenotypes, their functionality and their contribution to pathogenesis or disease control,
as well as their association with risk of congenital transmission of the parasite.
Keywords: Chagas disease, Trypanosoma cruzi, trypanocidal treatment, biomarker, immune response, CD8 and
CD4 T cells, CTL epitopes, vertical transmission.
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