Acute Chagas' disease:: immunohistochemical characteristics of T cell infiltrate and its relationship with T-cruzi parasitic antigens.

Objective -The present work analysed endomyocardial biopsies of patients with acute Chagas' disease in order to evaluate the frequency and intensity of T cruzi antigens, CD4+ and CD8+ T cells to determine the characteristics of this recurrent disease in Venezuela. Material and methods -Twelve endomyocardial biopsies of patients with Chagas' disease, 12 to 51 years old, (7M and 5F) were analysed. T cruzi antigens and CD4+ (helper) and CD8+ (cytotoxic-suppressor) T cells were detected by the immunoperoxidase technique. The presence and intensity of lymphocytic myocarditis was evaluated according to the degree of myocardial fibre injury caused by inflammatory infiltrate. Results - Myocarditis was present in 100% of the cases. The mean numbers of CD4+ T cell and CD8+ T cell were 11.00 (+/- 10.29); 14.69 (+/- 13.08) and the CD4/CD8 T cell ratio was 0.75. T cruzi antigens were detected in 58%. There was a good correlation between the numbers of CD4 and CD8+ T cells of each case and a lack of correlation with the amount of T cruzi antigens. Conclusion -All patients with acute Chagas' disease show some degree of myocarditis that seems to be directly related to the presence of parasitic antigens. Both CD4 and CD8 T cells participate in this process. We are following these patients to see if patients with severe myocarditis and more parasite antigens in the acute phase will develop chronic heart failure.