[Chagas cardiopathy: identification and quantification of infiltrating cells in the hearts of cardiac death patients of different ages].

Unlabelled: The purpose of this work was to obtain new data on factors intervening in the production and progression of human chagasic cardiopathy (HChC) with death by cardiac failure. We studied cardiac samples of patients that died at an early mean age versus others that died at older ages. The infiltrating cells were characterized and quantified by means of specific monoclonal antibodies and inmunohistochemical methodology; and by classical histological and histochemical methods. We found intense cardiac infiltration by lymphocytes that reacted with the antibodies anti-CD45RO against activated T-lymphocytes (< 70%). A similar number showed reactivity for CD4. And, in seriate sections, showed PAS+ substances in their cytoplasms. Macrophages were detected in a number of 25%. Few lymphocytes reacted to CD8. There was a low number of B lymphocytes. Other noticeable infiltrated cell were intramiocardial mast cells. Qualitatively, such findings were similar in the two groups of patients. However, the number of T-lymphocytes and of the mast cells was significantly higher in the cases that underwent early cardiac death (p < 0.001). T. cruzi was not found. In cardiomyocytes, damages were found, with T-lymphocytes and macrophages adhered to their sarcolemma, as well as mast cells.

Conclusions: These findings suggest the existence of an active and intense occurrence of immunocellular mechanisms in the production and evolution of severe HChC, in which T-lymphocytes CD4+ intervene, with production and secretion of PAS+ substances; Besides, macrophages, and mast cells, in that order. The quantity of infiltrated cells was positively associated with the occurrence of malignant arrythmyias. We suggest that such facts would be involved in the poor cardiac performance of the chagasic heart disease that leads to cardiac death. Indeed, they seem be worthy of consideration with respect to therapeutic strategies.