Circulating lymphocyte subpopulations and activated T and B cells in patients with chagasic and non-chagasic myocardiopathy.

Trypanosoma cruzi causes a profound immune depression in the infected host, and a small proportion of chagasic patients will develop a chronic disease characterized by myocardiopathy. There is evidence suggesting that dilated non-chagasic cardiomyopathy may be mediated by an immunological mechanism. In an attempt to distinguish abnormal immunoregulatory cell patterns in both dilated myocardiopathies, total and activated T and B lymphocyte subpopulations were measured by flow cytometry and double-labeling in whole blood samples from patients with dilated myocardiopathy, 10 with positive serological tests for T. cruzi and 9 with different non-chagasic cardiomyopathies. Several significant differences were found between both groups of patients and 13 sex- and age-matched apparently healthy controls. Chagasic patients besides showing clear decrease in absolute numbers of CD3+/CD71+ and CD8+/CD25+ cell populations also had a significant increase in CD19+, CD10+, and CD19+/HLA-DR+ cell subsets, as well as high helper/ suppressor cell ratio. These findings suggest that concurrently with T cell diminution, which involved activated T lymphocytes displaying suppressor/cytotoxic immunophenotype, chronic chagasic patients with myocardiopathy showed elevated numbers of total and activated B lymphocytes. Patients with dilated non-chagasic myocardiopathy had significantly increased numbers of activated T cells (CD3+/CD25+, CD8+/CD25+, and CD8+/HLA-DR+) and total and activated B lymphocytes (CD10+, CD19+, CD19+HLA-DR+). These data support the notion that dilated myocardiopathies other than the chagasics may be associated with immunological abnormalities.