Greice M. Krautz; Micheli G. Coutinho; Lúcia M.C. Galvão; Joaquim R. Cançado; Antoniana U. Krettli
RESUMO
Dois antígenos solúveis de tripomastigotas do Trypanosoma cruzi, um obtido de sobrenadantes de culturas celulares (AgSb) e o outro excretado/secretado por essas formas em meio de cultura (AgES), foram avaliados em um teste de ELISA para o diagnóstico da infecção chagásica e controle de cura de pacientes tratados. Os pacientes tratados apresentavam testes de lise mediada pelo complemento e hemoculturas repetidamente negativos, apesar de permanecerem com a sorologia convencional positiva (pacientes dissociados). O teste de lise negativo indica que estes pacientes eliminaram a infecção. Entre os controles com infecção ativa, os AgSb e os AgES detectaram respectivamente 93 e 100% dos casos. No entanto, entre os pacientes dissociados, o teste de ELISA, utilizando os AgSb e AgES, foi positivo com 28% e 5% dos soros, respectivamente. Portanto, este teste com os AgES é indicado para o controle de curada doença de Chagas, podendo vir a substituir a reação de lise mediada pelo complemento no acompanhamento sorológico individual de pacientes tratados.
Palavras-chave: Trypanosoma cruzi. Antígenos solúveis de tripomastigotas. Pacientes chagásicos. Tratamento e cura. ELISA.
ABSTRACT
Two soluble antigens isolated from T. cruzi were evaluated by ELISA for the diagnosis of chronic infection and assessment of cure after specific chemotherapy, namely, supernatants from parasite cell-cultures (SpAg) arid trypomastigote excretory /secretory antigens (ESAg). Among the treated patients, a group defined as “dissociated ” had been monitored for 3 to 10 years and displayed negative hemocultures and tests of trypomastigote complement-mediated lysis persistently negative although positive by conventional serology (indirect fluorescence with epimastigote, mainly). A negative lysis test indicates parasite elimination by the patient. Our ELISA results showed that among the non-treated chagasic controls the SpAg e ESAg detected 93% and 100%, of the cases, respectively. However, only 28% of sera from the dissociated group, considered as cured, were positive by ELISA using SpAg whereas all of such sera were negative using ESAg. Therefore ELISA with ESAg seems to be ideal to replace the complement- mediated lysis test with the aim to define cure after treatment of the chronic infection by T. cruzi.
Keywords: Trypanosoma cruzi. Soluble antigens of trypomastigotes. Chagasic patients. Treatment and cure. ELISA.
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Endereço para correspondência:
Profa. Antoniana Ursine Krettli.
Centro de Pesquisas René Rachou/FIOCRUZ.
Caixa Postal 1743,
30161-970,
Belo Horizonte, MG.
Recebido para publicação em 30/12/93.
Centro de Pesquisas René Rachou/Fundação Oswaldo Cruz e Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG.
Financiado pela FAPEMIG e CNPq.
