Improving the outcome for patients with chronic Chagas disease

Is the cardiac pathology associated with chronic Chagas disease preventable with anti-parasitic drugs?

Chagas disease is caused by a small parasite species called Trypanosoma cruzi. This tiny parasite infects millions of people in Latin American regions and there are around 800,000 infected people in Europe. Chagas disease can become a chronic illness in around a third of patients, many of whom develop heart problems decades after the original infection, including heart muscle problems (cardiomyopathy), heart failure and abnormal heart rhythms, such as heart block. There are drugs that can be used to treat Chagas disease, but experts are still unsure whether patients with chronic disease should be treated with antiparasitic drugs. These drugs have toxic side effects, and their benefits in late-stage disease are not fully known. In particular, researchers do not know if the heart damage is caused by the parasite itself or the body’s own response to infection and therefore what might be the best treatment for chronic patients. It is very difficult to study this problem in people. Professor John Kelly from the London School of Hygiene and Tropical Medicine has developed a way to study chronic Chagas disease in mice. He will test whether antiparasitic drugs can prevent the development of heart disease. He will use sophisticated imaging techniques to track the drugs’ removal of the parasite in real time and any effects this has on stopping heart damage. He will also investigate whether the success of treatment depends on the particular strain of parasite causing the infection, or on the genetic profile of the mouse. This study should offer better results than the traditional approach of studying Chagas patients, and will help to define the best treatment plan for people with chronic Chagas disease.