Where do we stand on the autoimmunity hypothesis of Chagas disease?

The question posed in the title elicits as much controversy today as it did when I wrote about this subject in the first issue of Parasitology Today 20 years ago. A consensus is now emerging that Trypanosoma cruzi, the etiological agent of Chagas disease, bears primary responsibility for producing chagasic pathology. Whether one or more of the autoimmune events described in human and experimental Chagas disease can contribute to, or aggravate, this pathology is the current question.