NEUROVASCULAR DYSFUNCTION AS A POTENTIAL PATHOGENIC AXIS IN TRYPANOSOMA CRUZI INFECTION: MECHANISMS, CLINICAL IMPLICATIONS AND THERAPEUTIC PERSPECTIVES
Abstract
Chagas disease, caused by Trypanosoma cruzi, remains a major neglected tropical disease with increasing global relevance due to migration and geographic expansion. Although cardiac and gastrointestinal manifestations have been extensively investigated, growing experimental evidence indicates that microvascular and neurovascular alterations may play an important role in disease progression. However, these mechanisms are often interpreted as inflammatory consequences rather than potential central determinants of pathogenesis. This review examines experimental and clinical studies addressing endothelial dysfunction, nitric oxide imbalance, dysregulation of VEGF signaling, and blood–brain barrier alterations during T. cruzi infection. By integrating data from vascular biology, immunopathology, and host parasite interaction research, a unifying pathogenic framework is proposed, supporting the hypothesis that neurovascular dysfunction may represent a potential pathogenic axis in Chagas disease. Evidence from in vitro, in vivo, and clinical investigations suggests that parasite-induced endothelial activation, oxidative stress, and microcirculatory impairment contribute not only to cardiac pathology but also to cerebral microvascular damage, potentially underlying neurological manifestations observed in both acute and chronic phases of the disease. Rather than viewing vascular permeability alterations as secondary phenomena, this review highlights their potential role as active contributors to systemic microvascular injury. This conceptual integration may support the identification of novel adjunctive therapeutic strategies targeting endothelial integrity and vascular signaling pathways in Chagas disease.
Author Biography
Farmacêutica, pós-graduada em Análises Clínicas pela Faculdade FaSouza EaD e em Patologia Clínica pela Uniminas EaD. Possui especialização voltada para a área laboratorial, com interesse em diagnóstico clínico, interpretação de exames laboratoriais e fisiopatologia das doenças. Sua atuação concentra-se na aplicação do conhecimento científico para apoio ao diagnóstico e à prática em saúde.
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