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. 2022 Jan 19;116(1):80-84.
doi: 10.1093/trstmh/trab089.

Congenital Chagas disease in Santa Cruz Department, Bolivia, is dominated by Trypanosoma cruzi lineage V

Leny Sanchez  1 , Louisa A Messenger  2 , Tapan Bhattacharyya  3 , Robert H Gilman  1   4 , Holger Mayta  1 , Rony Colanzi  5 , Ricardo Bozo  6 , Manuela Verástegui  1 , Michael A Miles  3 , Caryn Bern  7
Affiliations

Congenital Chagas disease in Santa Cruz Department, Bolivia, is dominated by Trypanosoma cruzi lineage V

Leny Sanchez et al. Trans R Soc Trop Med Hyg. .

Abstract

Background: This study identified Trypanosoma cruzi discrete typing units (DTUs) in maternal and infant specimens collected from two hospitals in Bolivia, using conventional genotyping and DTU-specific serotyping.

Methods: Specimens from 142 mothers were used, including 24 seronegative and 118 seropositive individuals; 29 women transmitted T. cruzi to their infants. Maternal and infant parasite loads were determined by quantitative real-time PCR. Maternal sera were tested with an in-house parasite lysate ELISA and serotyped by a lineage-specific peptide ELISA, targeting the trypomastigote small surface antigen (TSSA). Trypanosoma cruzi genotypes in infected infants were determined by a triple PCR-RFLP assay.

Results: All infant specimens were genotyped as TcV. Maternal parasite loads and absorbance values by the lysate ELISA were significantly higher for transmitters compared with non-transmitters. Among seropositive mothers, 65.3% had positive results by the TSSA II/V/VI peptide ELISA. No significant difference in reactivity to TSSA II/V/VI was observed for transmitters compared with non-transmitters (79.3% vs 60.7%, respectively).

Conclusions: Our findings reinforce the difficulty in obtaining sufficient sample numbers and parasite DNA to investigate the interaction between parasite genetics and the risk of congenital transmission and argue for the inclusion of DTU-specific serotyping in prospective studies.

Keywords: Trypanosoma cruzi; Bolivia; Chagas disease; DTUs; TSSA; congenital transmission.

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Figures

Figure 1.
Figure 1.
Recognition of maternal seropositive sera to T. cruzi in-house lysate (A) or TSSA II/V/VI lineage-specific peptide (B) between congenitally transmitting and non-transmitting mothers. Each datapoint represents the A450 of the mean reaction of duplicates of each serum sample per assay. Medians for each group are represented by solid lines. M+ B-, mother seropositive, baby uninfected; M+ B+, mother seropositive, baby infected.
Figure 2.
Figure 2.
Amplification of PCR-RFLP assays with T. cruzi reference strains (A-D): Chaco 23 col4; TcII, JR c14; TcI, A18; TcIII, ERA; TcIV, Bug2148; TcV, CL Brener; TcVI; CN: negative control and congenital specimens (E-H), alongside a 100 bp molecular ladder (M). (A) COXII reference DTUs; all bands are 375 bp. (B) COXII + AluI reference DTUs; TcII: 81 bp + 212 bp; TcI: 30 bp + 81 bp + 264 bp; TcIII: 81 bp + 294 bp; TcIV: 81 bp + 294 bp; TcV: 81 bp + 294 bp; and TcVI: 81 bp + 294 bp. (C) 24Sα rRNA reference DTUs; TcI: 110 bp; TcII: 125 bp; TcIII: 110 bp; TcIV: 120 bp; TcV: 110 bp or 110 bp + 125 bp; TcVI: 125 bp. (D) SL-IR reference DTUs; TcI: 150 bp; TcII: 150 bp; TcIII: 200 bp; TcIV: 200 bp; TcV: 150 bp; TcVI: 150 bp. (E) COXII congenital specimens #1-9 + negative control (#10). (F) COXII + AluI congenital specimens #1-9 + negative control (#10). (G) 24Sα rRNA congenital specimens #1-8 + negative control (#9). (H) SL-IR congenital specimens #1-8 + negative control (#9).
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