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| Author(s): |
Fernanda Gambogi Braga Amarante
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | Campinas, SP. |
| Institution: | Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas |
| Defense date: | 2012-07-27 |
| Examining board members: |
Maria Heloisa de Souza Lima Blotta;
Heloísa Helena de Araújo Ferreira;
Gil Bernard;
Nicola Amanda Conran Zorzetto;
Maria Letícia Cintra
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| Advisor: | Maria Heloisa de Souza Lima Blotta |
| Abstract | |
Patients with juvenile form of paracoccidioidomycosis (PCM) have a depressed cellular immune response as shown by negative delayed-type hypersensitivity, suppressed lymphocyte proliferation to P. brasiliensis antigens, and production of TH2 cytokines such as IL-4, IL-5, IL-10 and TGF-?. Furthermore, a common feature of this disease is the large number of eosinophils in the peripheral blood that returns to normal values after antifungal treatment. The role of eosinophils in PCM has never been investigated. This study aimed to evaluate the phenotypic and functional characteristics of eosinophils of 15 patients with the juvenile form of PCM. Eosinophils of patients isolated from peripheral blood (before and during the antifungal treatment) and of healthy donors (controls) were evaluated for: chemotactic response to RANTES, eotaxin and IL-5; adhesion to human lung endothelial cells (HLECs); expression of antigen recognition and presentation molecules (CD80, CD86, MHC class II, TLR2 and TLR-4), adhesion molecules (CD11a, CD11b, CD49d and CD54), IgE receptors (CD23 and FC?RI?), activation marker (CD69) and CCR3; direct fungicidal activity against P. brasiliensis yeast cells and gene expression of cytokines, chemokines and protein granules. We also assessed serum levels of granules cytotoxic molecules (MBP, EPO, ECP and EDN) and chemokines (CCL5, eotaxin, CXCL9, CXCL10) in patients before and during the antifungal treatment and controls. Lymph nodes and liver biopsies of patients were stained for RANTES, eotaxin, MBP, IL-25 and IDO. The results showed peripheral eosinophilia in 86.7% of cases, high titers of antibodies to P. brasiliensis and high concentration of C-Reactive Protein. The chemotactic response to eotaxin, adhesion to HLECs and expression of mRNA for IL-1 ?, IL-2, IL-4, CCL5 and CXCL8 was higher in eosinophils of patients than in controls. Eosinophils of patients as well as of controls were able to kill P. brasiliensis yeast cells. A higher frequency of eosinophil CD69+ and TLR2+ and lower frequency of eosinophil CD80+, MHC class-II+, TLR-4+, CD23+ and CD11a+ was found in patients compared to controls. Patient's follow-up showed a reduction in the number of eosinophils in peripheral blood, serum concentration of C-Reactive protein, anti-P. brasiliensis antibodies, serum levels of cytotoxic proteins and chemokines, in addition to increased migration capacity. Moreover, eosinophils of patients exhibited reduced expression CD80, MHC class-II, TLR-4, CD23, CD11a, CD11b, CD23, CD69 and CCR3 during the antifungal treatment. Immunohistochemistry staining showed strong expression of MBP, eotaxin, RANTES, IL-25 and IDO in liver and lymph nodes biopsies from PCM patients. In conclusion, this study demonstrated that eosinophils are strongly activated (high CD69 expression) and could contribute to the intense inflammatory response that characterize the initial phase of juvenile form of PCM response and impairs the elimination of the fungus. After antifungal treatment, there was a decrease of all parameters except the chemotactic ability of eosinophils which increased, probably due to reduction of inhibitors of chemotaxis such as CXCL9 and CXCL10 (AU) | |
| FAPESP's process: | 08/05552-3 - The role of eosinophils in P. brasiliensis infection |
| Grantee: | Fernanda Gambogi Braga Amarante |
| Support Opportunities: | Scholarships in Brazil - Doctorate |