Analysis of the cellular immune response in patients with the digestive and indeterminate forms of Chagas' disease.

The commitment of the digestive organs observed in patients during the chronic phase of Chagas' disease is mainly attributed to neuronal damage induced by immune and inflammatory processes elicited by the presence of Trypanosoma cruzi. Here we compare the cellular immune response in patients with the digestive and indeterminate forms of Chagas' disease on the basis of lymphocyte proliferation and cytokine production after antigen or mitogen stimulation. No significant differences between patients groups were observed on proliferative response or on tumor necrosis factor (TNF)-alpha and interleukin (IL)-10 levels, although IL-10 achieves higher levels than TNF-alpha after T. cruzi antigen stimulation. Interferon (IFN)-gamma basal production was significantly higher in the digestive form and IL-4 was significantly higher in patients with megaesophagus when compared with patients with megacolon. These results indicated that patients with the digestive form of Chagas' disease do not suffer immune suppression and that the cytokine balance favors a strong inflammatory reaction in patients with the digestive form, which may contribute to lesions of the mioenteric nervous system.