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Between a bug and a hard place: Trypanosoma cruzi genetic diversity and the clinical outcomes of Chagas disease

Over the last 30 years, concomitant with successful transnational disease control programs across Latin America, Chagas disease has expanded from a neglected, endemic parasitic infection of the rural poor to an urbanized chronic disease, and now a potentially emergent global health problem. Trypanos...

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Detalles Bibliográficos
Autores principales: Messenger, Louisa A, Miles, Michael A, Bern, Caryn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Informa Healthcare 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4784490/
https://www.ncbi.nlm.nih.gov/pubmed/26162928
http://dx.doi.org/10.1586/14787210.2015.1056158
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author Messenger, Louisa A
Miles, Michael A
Bern, Caryn
author_facet Messenger, Louisa A
Miles, Michael A
Bern, Caryn
author_sort Messenger, Louisa A
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description Over the last 30 years, concomitant with successful transnational disease control programs across Latin America, Chagas disease has expanded from a neglected, endemic parasitic infection of the rural poor to an urbanized chronic disease, and now a potentially emergent global health problem. Trypanosoma cruzi infection has a highly variable clinical course, ranging from complete absence of symptoms to severe and often fatal cardiovascular and/or gastrointestinal manifestations. To date, few correlates of clinical disease progression have been identified. Elucidating a putative role for T. cruzi strain diversity in Chagas disease pathogenesis is complicated by the scarcity of parasites in clinical specimens and the limitations of our contemporary genotyping techniques. This article systematically reviews the historical literature, given our current understanding of parasite genetic diversity, to evaluate the evidence for any association between T. cruzi genotype and chronic clinical outcome, risk of congenital transmission or reactivation and orally transmitted outbreaks.
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spelling pubmed-47844902016-03-23 Between a bug and a hard place: Trypanosoma cruzi genetic diversity and the clinical outcomes of Chagas disease Messenger, Louisa A Miles, Michael A Bern, Caryn Expert Rev Anti Infect Ther Review Over the last 30 years, concomitant with successful transnational disease control programs across Latin America, Chagas disease has expanded from a neglected, endemic parasitic infection of the rural poor to an urbanized chronic disease, and now a potentially emergent global health problem. Trypanosoma cruzi infection has a highly variable clinical course, ranging from complete absence of symptoms to severe and often fatal cardiovascular and/or gastrointestinal manifestations. To date, few correlates of clinical disease progression have been identified. Elucidating a putative role for T. cruzi strain diversity in Chagas disease pathogenesis is complicated by the scarcity of parasites in clinical specimens and the limitations of our contemporary genotyping techniques. This article systematically reviews the historical literature, given our current understanding of parasite genetic diversity, to evaluate the evidence for any association between T. cruzi genotype and chronic clinical outcome, risk of congenital transmission or reactivation and orally transmitted outbreaks. Informa Healthcare 2015-08-03 2015-07-10 /pmc/articles/PMC4784490/ /pubmed/26162928 http://dx.doi.org/10.1586/14787210.2015.1056158 Text en © 2015 Taylor & Francis http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Messenger, Louisa A
Miles, Michael A
Bern, Caryn
Between a bug and a hard place: Trypanosoma cruzi genetic diversity and the clinical outcomes of Chagas disease
title Between a bug and a hard place: Trypanosoma cruzi genetic diversity and the clinical outcomes of Chagas disease
title_full Between a bug and a hard place: Trypanosoma cruzi genetic diversity and the clinical outcomes of Chagas disease
title_fullStr Between a bug and a hard place: Trypanosoma cruzi genetic diversity and the clinical outcomes of Chagas disease
title_full_unstemmed Between a bug and a hard place: Trypanosoma cruzi genetic diversity and the clinical outcomes of Chagas disease
title_short Between a bug and a hard place: Trypanosoma cruzi genetic diversity and the clinical outcomes of Chagas disease
title_sort between a bug and a hard place: trypanosoma cruzi genetic diversity and the clinical outcomes of chagas disease
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4784490/
https://www.ncbi.nlm.nih.gov/pubmed/26162928
http://dx.doi.org/10.1586/14787210.2015.1056158
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