SOLUBLE CELL-ADHESION MOLECULES IN HUMAN CHAGAS-DISEASE - ASSOCIATIONWITH DISEASE SEVERITY AND STAGE OF INFECTION

Formation of inflammatory lesions, one of the pathologic consequences of infection with Trypanosoma cruzi, involves intricate cell-cell inte ractions in which cell adhesion molecules (CAMs) are involved. Sera fr om 56 Chagas' disease patients souped according to disease severity we re studied for the presence of soluble intercellular adhesion molecule -1 (s-ICAM-1), soluble endothelial selectin (s-E-selectin), soluble va scular cell adhesion molecule-1 (s-VCAM-1), soluble platelet selectin (s-P-selectin), and s-CD44 were studied to determine if they could be used alone or in different combinations as markers for specific diagno stic procedures. Comparisons were made between congenitally, acutely, and chronically infected patients and aged-matched, noninfected indivi duals, as well as between patients with chronic Chagas' disease groupe d according to the severity of their heart-related pathology No differ ences in levels of s-CAMs were detected between sera from children wit h congenital T. cruzi infection and sera from noninfected infants born from chagasic mothers. In contrast, titers of s-ICAM-1, s-VCAM-1, s-s electin, and s-CD44 but not s-P-selectin were significantly increased in sera from patients during the acute phase of infection with T. cruz i. Titers of s-VCAM-1 and s-P-selectin were increased in chronically i nfected patients. A positive association with disease severity in sera from patients with chronic disease was observed for the levels of s-P -selectin. In contrast, we found no association between clinical sympt oms and levels of s-VCAM-1. Patients with chronic disease with severe cardiopathy also showed diminished levels of s-CD44 in comparison with healthy controls or patients with mild disease. The results are discu ssed in the context of pathology of Chagas' disease.