Antezana, G.

Brenière, Simone Frédérique

Carrasco, R.

Desjeux, P.

Tibayrenc, Michel

Horizon / Pleins textes

517 
Moens, F., De Wilde, M. & Kola Ngato (1984). Essai de 
traitement au nifurtimox de la trypanosomiase humaine 
africaine. Annales de la Société Belge de Médecine Tropi- 
Aires, who kindly donated the Nifurtimox and to Dr B. M. 
Greenwood who reviewed the manuscript. This work was 
supported by the Canadian International Development 
Agency. The logistic help of Forescom was much appreci- 
ated. 
I' 
References 
Apted, F. I. C. (1980). Present status of chemotherapy and 
chemoprophylaxis of human trypanosomiasis in the 
eastern hemisphere. Pharmacology and Therapeutics, 11, 
391-413. 
DoKa, F ,  Boa, F. Y., Schechter, P. J., Miezan, T. W., 
Dia, D., Sanon, S. R., de Raadt, P., Haegele, K. D., 
Sjoerdsma, A. & Konian, K. (1987). Treatment of 
human late-stage gambiense trypanosomiasis with or- 
difluoromethylornithine (eflornithine). Efficacy and 
tolerance in 14 cases of Côte d'Ivoire. AmericanJournal of 
Tropical Medicine and Hygiene, 37, 525-533. 
Ginoux, P. Y., Lancien, P.,. Frezil, J. L. & Bissadidi, N. 
(1984). Les Echecs du tratement de la trypanosomiase à 
T. gambiense au Congo. Médecine Tropicale, 44,149-154. 
Gutteridge, W. E. (1985).Existhg chemotherapy and its 
limitations. British Medical Bulletin, 41, 162-168. 
Janssens, P. G. & De Muynck, A. (1977). Clinical trials with 
nifurtimox in African trypanosormasis. Annales de la 
Société Belge de Médecine Tropicale, 57, 475479. 
cale, 64, 37-43. 
Pepin, J., Milord, F., Guern, C. & Schechter, P. J. (1987). 
Difluoromethvlornithine for arsenoresistant TrvDanosoma 
bmcei gambihe sleeping sickness. Lancet, ìi, fd31-1433. 
Van Nieuwenhove, S., Schechter, P. J., Declerq, J., Bone, 
G., Burke, J. & Sjoerdsma, A. (1985). Treatment of 
gambiense sleeping sickness in the Sudan with oral 
DFMO (DL-or-diiluoromethylornithine), an inhibitor of 
ornithine decarboxylase; first field trial. Transactions of 
the Royal Socie& of Tropical Medicine and Hygiene, 79, 
692-698. 
WHO (1987). La prévention de la trypanosomiase et la lutte 
contre cette maladie dans le cadre des soins de santé 
primaires. Weekly Epidemiological Record, 62, 197-200. 
Received 8 December 1988; accepted for publication 1 
March 1989 
Note added in proof. Since admission of this paper, 
an additional patient has relapsed, with 262 WBClpl 
and trypanosomes in the CSF 15 months after 
nifurtimox treatment. 
TRANSACTIONS F THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE (1989) 83, 517 
I ShortReport I 
Association between Trypanosoma 
cruzizymodemes and specific 
humoral depression in chronic 
chagasic patients 
S .  F. Brenière', R. Carrasco' G .  Antezana', P. 
Desjeu'  and M. Tibayrenc' 'Laboratoire de Géné- 
tique des Parasites et des Vecteurs, O R S T O M ,  2051 ' 
Avenue du Va l  de Montferand, BP 5045, 34032 
Montpellier Cedex, France'; ' I B B A ,  Casilla 641, L a  
P a z ,  Bolivia; 3World Health Organization, 121 1 Gene- 
v a  27, Switzerland 
We previously reported four autochthonous cases 
of Chagas disease in Bolivia, presenting a particular 
pattern of negative serology with positive xenodiagno- 
sis (BRENIÈRE et a l . ,  1984). To date, we have observed 
13 similar cases (8 women and 5 men), 12 from Bolivia 
and one from Argentina. The age of these patients 
ranged from 18 to 58 years (mean 39+13). The 
clinical features exhibited were diversified: 5 patients 
presented a cardiac pathology (electrocardiogram) or a 
digestive pathology (megacolon), or both, while the 8 
other patients were asymptomatic. In the present 
preliminary study, we explored a possible association 
between the humoral depression and Ttypanosoma 
c m i  zymodemes. Eight stocks isolated from patients 
with negative serology and positive xenodiagnosis and 
52 stocks from patients with positive serology and 
positive xenodiagnosis were characterized by 11 
enzyme systems (12 genetic loci), using the genetic 
interpretation and zymodeme numbering used by 
*Address for offprints. 
TIBAYRENC et al .  (1986); definitions of positive and 
negative serology were according to BRENIÈRE et al. 
(1984). Eight different zymodemes were recorded, of 
which 3 represent more than 90% of our sample, 
namely zymodemes 19, 20 and 39. Zymodemes 19 
and 20 are closely related (only one allelic difference) 
and were plotted together in the statistical analyses. 
On the contrary, zymodeme 39 is radically different 
from 19 and 20. Twenty-nine patients (48%) were 
infected with either zymodeme 19 or 20, while 18 
patients (30%) had zymodeme 39, and 7 patients 
(11.6%) exhibited a mixture of zymodeme 39 with 
either 19 or 20. A statistically significant association 
was observed between specsc humoral depression 
and zymodeme: all  serologically negative patients had 
either zymodeme 19 or 20, aqd none had zymodeme 
39. Yate's corrected x2 was 4.19, one degree of 
freedom and P<0*05. 
These results confirm the existence of specific 
humoral depression in some chronic chagasic pat- 
ients, and shows that this phenomenon can be 
associated with typical chagasic symptomatology. The 
association between negative serology and T.  c m i  
zymodeme, although statistically sigdicant in the 
present set of patients, must be confirmed on a more 
extensive sample. 
References 
Brenière, F., Poch, O., Selats, H., Tibayrenc, M., 
Lemesre, J. L., Antezana, G. & Desjeu:, P..(1984). 
Specific humoral depression in chronic pauents infected 
with Trypanosoma mi. Revista do Instituto de Medicina 
Tropical de São Paulo, 26, 254-258. 
Tibayrenc, M., Ward, P., Moya, A. & Ayala, F. J. (1986). 
Natural populations of Trypanosoma cruzi, the agent of 
Chagas disease, have a complex multiclonal structure. 
Proceedings of ihe National Academy of Sciences of the 
Received 12 July 1988; accepted for publication 11. 
USA, 83, 115-119. 
August I988 ORSTOM Fonds Documentaire 


Association between Trypanosoma cruzi zymodemes and specific humoral depression in chronic chagasic patients

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