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2020, Número 1

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Rev Med UV 2020; 20 (1)


Diagnóstico de la infección con Trypanosoma cruzi: Avances y retos

Rubio-Ortiz M, Hernández-López LA, Pérez-Galicia A, Guzmán-Bracho C, Martínez-Calvillo S, Manning-Cela RG

Idioma: Español
Referencias bibliográficas: 73
Paginas: 7-27
Archivo PDF: 277.70 Kb.


RESUMEN

Introducción. Trypanosoma cruzi es el protozoario hemoflagelado causante de la enfermedad de Chagas (ECH), un padecimiento endémico de Latinoamérica que es altamente incapacitante e incurable. Además de su diferente distribución geográfica, las cepas de T. cruzi tienen variabilidad intraespecífica por lo que son clasificadas en siente DTUs (TcI-TcVI y Tcbat) que presentan diversidad biológica, bioquímica, molecular y antigénica, que se relaciona con el desarrollo de los distintos cuadros clínicos de la enfermedad, la eficiencia del diagnóstico y la respuesta al tratamiento. Existe una gran variabilidad en la sensibilidad y especificidad de las pruebas serodiagnósticas y hasta ahora, no existe una prueba estándar de oro para un diagnóstico completamente confiable. Objetivo. Revisar los avances obtenidos en la búsqueda de antígenos útiles para el serodiagnóstico de la ECH. Materiales y métodos. Se realizó una revisión sistemática de tipo cualitativa, de reportes relacionados al serodiagnóstico de la infección por T. cruzi encontrados en PubMed. Resultados. El serodiagnóstico convencional con antígenos del parásito completo es sensible pero no tiene alta especificidad. Por ello, se utilizan también pruebas no convencionales con antígenos recombinantes o péptidos sintéticos que aumentan la especificidad. Distintos enfoques han permitido la identificación de moléculas con potencial diagnóstico, mostrando la necesidad del uso de cócteles de antígenos re combinantes, mezclas de péptidos sintéticos o antígenos multiepitope para una mejor sensibilidad y especificidad de las pruebas y para la detección de la infección con cualquiera de los DTUs del parásito. Conclusiones. Aun cuando se han identificado diversos antígenos con potencial uso diagnóstico, continúan los esfuerzos para la identificación de nuevos y mejores antígenos. Los avances recientes de la proteómica a gran escala acoplada a inmunoensayos e inmunogenómica, ofrecen una oportunidad en la búsqueda no solo de biomarcadores para el diagnóstico, sino también para el tratamiento y pronóstico oportuno de la enfermedad de Chagas.


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