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Revista da Sociedade Brasileira de Medicina Tropical 46(2):258, Mar-Apr, 2013

http://dx.doi.org/10.1590/0037-8682-0002-0027-2013

Letter

The potential role of vitamins in the

management of Chagas disease

Shailendra Kapoor[1]

Dear Editor,

In their recent article, Gusmão et al. provided interesting data1. Vitamins may play a signiicant role in ameliorating

the pathological effects of Chagas disease. For example, beneits have been observed following the administration of ascorbic acid; supplementation with high doses of vitamin C have led to augmented clearance of trypanosomes, especially trypomastigotes2. Interestingly, the activity of ascorbate

peroxidase is enhanced signiicantly by vitamin B12, and vitamin C augments the anti-parasitic activity associated with vitamin B12. Another recent study suggests that the combined use of gentian violet, ascorbic acid, and light to sterilize blood infected with Trypanosoma cruzi effectively prevents transfusion-based transmission of Chagas disease3.

Other similar, recent data suggest that vitamin B12 may be of clinical value in the treatment of Chagas disease; vitamin B12 activity against trypomastigotes and epimastigotes is particularly signiicant4. Vitamin B12 mediates this anti-parasitic role by

accentuating superoxide dismutase activity, which leads to augmented intracellular production of reactive oxygen species. The above discussion points highlight that the combined use of vitamins C and B12 may play a signiicant role in the management of Chagas disease.

REFERENCES

1. Gusmão AS, Castanho RE, Andrade RF, Farsetti CM, Mathias AB, Therezo AL, et al. Vitamin C effects in mice experimentally infected with Trypanosoma cruzi QM2 strain. Rev Soc Bras Med Trop 2012; 45:51-54. 2. Marim RG, Gusmao AS, Castanho RE, Deminice R, Therezo AL, Jordão Jr AA,

et al. Effects of vitamin C supplementation on acute phase Chagas disease in experimentally infected mice with Trypanosoma cruzi QM1 strain. Rev Inst Med Trop Sao Paulo 2012;54:319-323.

3. Ramirez LE, Lages-Silva E, Pianetti GM, Rabelo RM, Bordin JO, Moraes-Souza H. Prevention of transfusion-associated Chagas' disease by sterilization of

Trypanosoma cruzi-infected blood with gentian violet, ascorbic acid, and light. Transfusion 1995; 35:226-230.

4. Ciccarelli AB, Frank FM, Puente V, Malchiodi EL, Batlle A, Lombardo ME. Antiparasitic Effect of Vitamin B12 on Trypanosoma cruzi. Antimicrob Agents Chemother 2012; 56:5315-5320.

[1]. Private Practice, Mechanicsville, Virginia, USA.

Address to: Dr. Shailendra Kappor. 2400 Cary Street Mechanicsville, Mechanicsville 23111 United States.

Phone: 1 865 4563456

e-mail: [email protected]

Received 05 January 2013

Accepted 07 March 2013

Author’s reply: Mechanisms of action of

vitamins in the pathogenesis of

Chagas disease

Alex Silva de Gusmão[1], Roberto Esteves Pires Castanho[1], Rodrigo Franzoso Almeida de Andrade[1], Clarisse Moreno Farsetti[1], Andressa Boim Mathias[1],

Altino Luiz Silva Therezo[1] and Luciamáre Perinetti Alves Martins[1]

Dear Editor,

We appreciate Dr. Shailendra Kappor interest in our research and his suggestions for future studies on the mechanisms of action of vitamins in the pathogenesis of Chagas disease. I, along with my research team, am contacting the references noted above and requesting permission to use their indings regarding the activity of vitamin B12 on Trypanosoma cruzi.

At present, we are concerned about the effects that may result from the indiscriminate use of vitamin C in the general population; about 2-3 million people in Brazil are in the chronic phase of the disease. Thus, we began by conducting a study on the isolated use of high doses of vitamin C, and we observed interesting antioxidant activity in the chronic phase of the disease (results in press).

In addition, we are studying the simultaneous action of vitamins C and E in both the acute and chronic phases of Chagas disease, and we intend to publish these results for use by other researchers.

[1]. Disciplina de Parasitologia, Faculdade de Medicina de Marília, Marília. SP. [2]. Disciplina de Patologia, Faculdade de Medicina de Marília, Marília. SP

Address to: Dra. Luciamáre Perinetti Alves Martins. Rua Dona Maria Feres 165, 17519-070 Marília, SP, Brasil.

Phone: 55 14 3402-1744

e-mail: [email protected]

Received 06 February 2013

Referências

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