Small molecules circulating in the blood can predict which patients with Chagas disease will develop cardiac complications, potentially enabling earlier risk assessment and more targeted treatment, according to research published in Nature Communications.
Researcher found that measuring changes in blood metabolites could help clinicians distinguish patients at risk of disease progression from those likely to remain asymptomatic.
Chagas disease, caused by the parasite Trypanosoma cruzi, affects an estimated 10.5 million people worldwide. Although infection can persist for decades without symptoms, approximately 20 to 30 percent of chronically infected individuals develop clinically significant cardiac disease, including arrhythmias and heart failure.
Currently, clinicians lack reliable biomarkers to predict which patients will experience these complications. This uncertainty complicates treatment decisions because available antiparasitic medications can cause significant adverse effects.
Researchers analyzed stored serum samples from 72 patients with chronic Chagas disease in Bolivia, using liquid chromatography–mass spectrometry to identify metabolic differences associated with subsequent cardiac deterioration.
Among patients initially free of cardiac involvement, 15 developed more advanced disease during follow-up, while 48 remained stable.
The researchers identified eight individual metabolites associated with future disease progression. Combining these markers improved predictive performance, producing 45 candidate biomarker panels, including 10 that achieved at least 60 percent sensitivity and 90 percent specificity.
Several predictive molecules belonged to lipid-related groups, suggesting that changes in lipid metabolism may provide early indications of cardiac damage.
Unlike conventional molecular tests that detect the parasite, the proposed approach measures changes in the patient's metabolism associated with disease progression.
If validated in larger studies, these biomarkers could support personalized surveillance, helping laboratories and clinicians identify patients requiring closer cardiac monitoring or prioritized treatment.
They could also improve clinical trial design by identifying participants at greater risk of progression and providing potential measures of treatment benefit.
However, the relatively small study requires further validation across geographically diverse populations. Researchers must also establish standardized testing methods and demonstrate clinical utility before these biomarkers can enter routine diagnostic practice.
Newsletters
Receive the latest pathologist news, personalities, education, and career development – weekly to your inbox.
