Soluble platelet selectin (sP-selectin) and soluble vascular cell adhesionmolecule-1 (sVCAM-1) decrease during therapy with benznidazole in childrenwith indeterminate form of Chagas' disease

The immune response against Trypanosoma cruzi infection has been associated with both protection and pathogenesis. Central events in host defence syst em- and immune-mediated damage are tightly regulated by cell adhesion molec ules (CAM). Levels of sP-selectin and sVCAM-1 were measured in sera from 41 children with the indeterminate phase of Chagas' disease. Simultaneously, levels of soluble adhesion molecule were also quantified in Chagas' disease children undergoing specific chemotherapy with benznidazole. Levels of sP- selectin and sVCAM-1 were found to be elevated in children with indetermina te Chagas' disease before aetiologic therapy was started. However, a small group of patients showed sP-selectin and sVCAM-1 levels comparable to those of non-infected children. A positive correlation between levels of sVCAM-1 and sP-selectin in sera from Chagas' disease patients was found. There was a significantly greater decrease in the titres of sP-selectin and sVCAM-1 in those children receiving benznidazole therapy compared with those childr en receiving placebo. Measurement of soluble adhesion molecules revealed di fferences in the activation of the immune system in children with the indet erminate form of Chagas' disease. The early decrease of sP-selectin and sVC AM-1 levels after anti-parasitic treatment suggests that these molecules mi ght be valuable indicators of effective parasitologic clearance.