@article{fdi:010092947,
  title = {{C}oinfection by multiple {T}rypanosoma cruzi clones : a new perspective on host-parasite relationship with consequences for pathogenesis and management of {C}hagas disease},
  author = {{C}arlier, {Y}. and {D}umonteil, {E}. and {H}errera, {C}. and {W}aleckx, {E}tienne and {T}ibayrenc, {M}ichel and {B}uekens, {P}. and {T}ruyens, {C}. and {M}uraille, {E}.},
  editor = {},
  language = {{ENG}},
  abstract = {{C}hagas disease ({CD}) is caused by the protozoan parasite {T}rypanosoma cruzi ({T}c), infecting 6-7 million people. {I}t is transmitted by insect vectors, orally, through infected tissues, or congenitally. {T}c infection can progress toward chronic cardiac and/or digestive severe and fatal {CD} in 20%-40% of patients. {T}c exhibits an important genetic and phenotypic intraspecies diversity and a preponderant clonal population structure. {T}he impact of multiclonal coinfections has been little studied in {CD} patients. {R}elationships between the currently used discrete typing unit ({DTU})-based classification of {T}c lineages and the occurrence of the different clinical forms of {CD}, its congenital transmission, as well as the efficacy of trypanocidal molecules (benznidazole and nifurtimox) could not be established. {I}n this review, we revisit the different aspects of {T}c diversity and analyze the impact of infections with multiple clones and their variants on the dynamic and pathogenesis of {CD} and its maternal-fetal transmission. {W}e propose to call "cruziome" all the {T}c clones and their variants infecting a given host and provide strong evidence that (i) multiclonal {T}c infections are likely the rule rather than the exception; (ii) each "cruziome" is associated with a unique combination of virulence factors, tissular tropisms, and host immune responses; (iii) accordingly, some particularly harmful "cruziomes" likely trigger the occurrence and progression of {CD} and might also favor the congenital transmission of parasites. {W}e propose that our concept of "cruziome" should be taken into consideration because of its practical consequences in epidemiological studies, laboratory diagnosis, clinical management, and treatment of {CD}.},
  keywords = {{C}hagas disease ; {T}rypanosoma cruzi ; host-parasite ; relationship ; immune responses ; pathogenesis ; multiclonal infection ; congenital infection},
  booktitle = {},
  journal = {{M}icrobiology and {M}olecular {B}iology {R}eviews},
  volume = {[{E}arly access]},
  numero = {},
  pages = {[30 p.]},
  ISSN = {1092-2172},
  year = {2025},
  DOI = {10.1128/mmbr.00242-24},
  URL = {https://www.documentation.ird.fr/hor/fdi:010092947},
}