Chagas disease: a role for autoimmunity?

Despite many years of investigation and discussion, the cause of disease in chronic Trypanosoma cruzi infection remains a hotly debated topic. The primary point of contention is whether Chagas disease is an autoimmune disease resulting from inappropriate immune responses to self antigens that are induced and perhaps perpetuated by T. cruzi infection, or whether this disease is a result of the inability to adequately, and without significant cumulative damage, control T cruzi infection on the part of some hosts, including the 30-40% of infected individuals who develop clinical disease. This review updates some of the data applicable to this debate with emphasis on the role of parasite persistence in Chagas disease.