Acta Parasitologica, Vol. 52, No. 1, 2007, 1-12. DOI: 10.2478/s11686-006-0048-y Felipe Kierszenbaum - Mechanisms of pathogenesis in Chagas disease
Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, Michigan 48824, USA
Corresponding author: kierszen@msu.edu
ABSTRACT
Chagas disease, caused by the obligate unicellular parasite Trypanosoma cruzi, presents itself in a diverse collection of clinical
manifestations, ranging from severe, fatal heart and digestive tract pathologies to unapparent or minor alterations that do not
compromise survival. Over the years, a number of mechanisms have been proposed to explain the pathogenesis of chagasic
tissue lesions, all of which have faced some criticism or been received with skepticism. This article excludes the autoimmunity
hypothesis for Chagas disease because it has been extensively reviewed elsewhere, and summarizes the various alternative
hypotheses that have been advanced over the years. For each of these hypotheses, an outline of its main tenets and key findings
that support them is presented. This is followed by the results and comments that have challenged them and the caveats that
stand on their way to wider acceptance. It is hoped that this writing will draw attention to our shortcomings in understanding the
pathogenesis of Chagas disease, which, unfortunately, continues to figure among the most serious health problems of the
American continent.
KEY WORDS: Chagas disease, Trypanosoma cruzi, pathogenesis, pathology