Chagas disease: Neurology and neurobiology

Abstract

Chagas disease or American trypanosomiasis, caused by the intracellular protozoan Trypanosoma cruzi, is characterized by (1) a systemic acute phase with, in the most severe cases, myocarditis and/or meningoencephalitis that can be fatal, especially in infants; (2) a chronic phase, with an indeterminate (asymptomatic) form, a cardiac form, a digestive form (with megaesophagus and/or megacolon), and a mixed form combining the cardiac and digestive forms. Concerning nervous system damage, in the chronic phase the peripheral nervous system and especially the autonomic nervous system are involved, with denervation of the heart and gastrointestinal tract. T. cruzi brain infections, which attack glial cells, represent an increasing problem during immunosuppressive therapies and diseases, especially after the emergence of HIV-AIDS. Disease pathogenesis, and in particular mechanisms by which parasite-derived molecules and the host immune response interact with neurons that innervate the heart and the gastrointestinal tract remain to be clarifi ed and deserve an engagement of the neuroscience community.