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The cell-mediated immune reaction in the cutaneous lesion of Chromoblastomycosis and their correlation with different clinical forms of the disease

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Abstract

Chromoblastomycosis is a fungal infection caused by dematiaceous fungi inducing skin lesions of difficult treatment and of frequent recurrence. The objective of the present investigation was to characterize cell-mediated tissue reactions in the skin in cases of Chromoblastomycosis using histopathology and immunocytochemistry methods and to correlate them with different clinical forms of Chromoblastomycosis. Biopsies from 19 patients were stained with HE and Giemsa, and serial sections were immunohistochemically stained using CD45RO, CD20, CD4, CD8, CD68, CD1a, CD34, IL4, IL10, TNF-α and IFN-γ antibodies. A quantitative and semi quantitative analysis of the cell subsets and cytokines in the inflammatory infiltrates was performed by counting ten high-power fields (400×). The cutaneous lesion presented as verrucous plaque (n = 15) or erythematous atrophic plaque (n = 4). We observed two types of tissue reaction: A) a granulomatous reaction with a suppurative granuloma with several fungi cells in the cutaneous lesion presenting as verrucous plaque; B) a granulomatous reaction with a tuberculoid granuloma with few fungi cells in the cutaneous lesion presenting as atrophic plaque. The data obtained suggest that patients with lesion presented as verrucous plaque have a type Th2 immunological response, while patients with lesion presented as erythematous atrophic plaque have a type Th1 response.

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References

  1. Lacaz CS, Porto C, Martins JEC. Fungos actinomicetos e algas de interesse médico. 8ę ed. São Paulo: Sarvier, 1991; 21: 373–386.

    Google Scholar 

  2. McGinnis MR. Chromoblastomycosis and phaeohyphomycosis: new concepts, diagnosis and mycology. J Am Acad Dermatol 1983; 8(1): 1–16.

    Google Scholar 

  3. Dixon DM, Shandomy HJ, Shandomy S. Dematiaceous fungal pathogens isolated from nature. Mycopathologia 1980; 70: 153–161.

    Google Scholar 

  4. Silva ACCM, Serra Neto A, Galvão CES, Marques SG, Saldanha ACR, Silva CMP, et al. Cromoblastomicose produzida por Fonsecaea pedrosoi no Estado do Maranhão: aspectos clínicos, epidemiológicos e evolutivos. Rev Soc Bras Med Trop 1992; 25(1): 37–44.

    Google Scholar 

  5. Pastrana Fundora F, Ramírez Albajés C, Naranjo Lorenzo M, Galiano Audivert O. Cromomicosis: quince anos de incidencia. Rev Cuba Hig Epidemiol 1989; 27(3): 285–292.

    Google Scholar 

  6. Minotto R, Bernardi CD, Mallmann LF, Edelweiss MI, Scroferneker ML. Chromoblastomycosis: a review of 100 cases in the state of Rio Grande do Sul, Brasil. J Am Acad Dermatol 2001; 44(4): 585–592.

    Google Scholar 

  7. Carrión AL. Chromoblastomycosis. Ann NY Acad Sci 1950; 50: 1255–1282.

    Google Scholar 

  8. Uribe F, Zuluaga AI, Leon W, Restrepo A. Histopathology of chromoblastomycosis. Mycopathologia 1989; 105: 1–6.

    Google Scholar 

  9. Weedon D, editor. The skin. London: Churchill Livingstone; 1992.

    Google Scholar 

  10. Esterre P, Peyrol S, Sainte-Marie D, Ptadinaud R, Grimaud JA. Granulomatous reaction and tissue remodelling in the cutaneous lesion of chromomycosis. Virchows Archiv A Pathol Anat Histopathol 1993; 422: 285–291.

    Google Scholar 

  11. Hsu SM, Raine L, Fanger H. Use of avidin-biotin-peroxidase complex (ABC) in imunoperoxidase techniques. J Histochem Cytochem 1981; 29: 577–580.

    Google Scholar 

  12. Cuce LC. Cromomicosis. Estudo de 37 casos. Rev Argent Dermatol 1983; 64(1): 1–5.

    Google Scholar 

  13. Macola OS, Rodriguez Gonzalez DP, FontD'Escoubet E, Valencia Leon G, Barrios Perez A. Cromomicosis, estudio de cinco años. Rev Cuba Med Trop 1984; 36: 102–109.

    Google Scholar 

  14. Silva CMP, Rocha RM, Moreno JS, Branco MRFC, Silva RR, Marques SG, et al. O babaĞu (OrbignyaPhalerata martins) como provável fator de risco de infecĞão pelo agente da Cromoblastomicose no Estado do Maranhão, Brasil. Rev Soc Bras Med Trop 1995; 28(1): 49–52.

    Google Scholar 

  15. Hirsh B, Johnson WC. Pathology of granulomatous diseases: mixed inflammatory granulomas. Int J Dermatol 1984; 23(9): 585–597.

    Google Scholar 

  16. Matsumoto T, Matsuda T. Chromoblastomycosis and phaeohyphomycosis. Semin Dermatol 1985; 4: 240–251.

    Google Scholar 

  17. Ganz T, Selsted ME, Szktarek D, Harwig SS, Daher K, Bainton DF, et al. Defensins: natural peptide antibiotics of human neutrophils. J Clin Invest 1985; 76: 1427–1435.

    Google Scholar 

  18. Howard DH. Mechanisms of resistance in the systemic mycoses. in: Nahmias AJ, O'Reilly RJ (eds.), Immunology of human infections. New York: Plenum Medical Book Co. 1981; 475–494.

    Google Scholar 

  19. Diamond RD. Immuno response to fungal infection. Rev Infect Dis 1989; 11(7): 1600–1604.

    Google Scholar 

  20. Waldorf AR. Host-parasite relationship in opportunistic mycosis. CRT Cri Rev Microbiol 1986; 13: 133–172.

    Google Scholar 

  21. Fromtling RA, Shandomy HJ. An overview of macrophagefungal interactions. Mycopathologia 1986; 93: 77–93.

    Google Scholar 

  22. Beaman L, Benjamini E, Pappaganis D. Activation of macrophages by lymphokines: enhancement of phagosomelysosome fusion and killing of Coccidioides immitis. Infect Immun 1983; 39: 1201–1207.

    Google Scholar 

  23. Wu-Hsieh B, Zlotnik A, Howard DH. T cell hybridoma produces lymphokines that activate macrophages to suppress intracellular growth of Histoplama capsulatum. Infect Immun 1984; 43: 380–385.

    Google Scholar 

  24. Nathan CF. Secretory products of macrophages. J Clin Invest 1987; 79: 319–326.

    Google Scholar 

  25. Murphy JW, Wu-Hsieh BA, Singer-Vermes LM, Ferrante A, Moser S, Russo M, et al. Cytokines in the host response to mycotic agents. J Med Vet Mycol 1994; 32(1): 203–210.

    Google Scholar 

  26. Calderone RA. Molecular interactions at the interface of Candida albicans and host cells. Arch Med Res 1993; 24(3): 275–279.

    Google Scholar 

  27. Forsyth CB, Plow EF, Zhang L. Interaction of the fungal pathogen Candida albicans with integrin CD11b/CD18: recognition by the I domain is modulated by the lectin-like domain and the CD18 subunit. J Immunol 1998; 161(1): 6198–6205.

    Google Scholar 

  28. Feldemesser M. Eosinophil-Cryptococcus neoformans interaction in vivo and in vitro. Infect. Immun. 1997; 65(5): 1899–1907.

    Google Scholar 

  29. Porta A, Maresca B. Host response and histoplasma capsulatum/macrophage molecular interactions. Med Mycol 2000; 38(6): 394–406.

    Google Scholar 

  30. Netea MG, Vandermeer JW, Meib JF, Kullberg BJ. Fas-fas L interactions modulate host defense against systemic Candida albicans infection. J Infect Dis 1999; 180(5): 1648–1655.

    Google Scholar 

  31. Walter P, Garin Y, Richard-Lenoble D. Chromoblastomycosis: a morphological investigation of the host-parasite interaction. Wirchows Arch (Pathol Anat) 1982; 397: 203–214.

    Google Scholar 

  32. Mosmann TR, Sad S. The expanding universe of T-cell subsets: Th1 and Th2 and more. Immunol Today 1996; 17: 138–146.

    Google Scholar 

  33. O'Garra N. Cytokines induce the development of functionally hetergeneous T helper cells subsets. Immunity 1998; 8: 275–283.

    Google Scholar 

  34. Okamura H, Tsutsi H, Komatsu T, Yutsudo M, Hakura A, Tanimoto T, et al. Cloning a new cytokine that induces IFNgamma production by T cells. Nature 1995; 378: 88–91.

    Google Scholar 

  35. Gordon JR, Burd PR, Gali SJ. Mast cells as a source of multifunctional cytokines. Immunol Today 1990; 11: 457.

    Google Scholar 

  36. Goldsby R.A, Kindt TJ, Osborne BA. Kuby immunology. 4th edn, New York: W.H. Freeman and Company, 2000.

    Google Scholar 

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Corrêa Garcia Pires d'Ávila, S., Pagliari, C. & Seixas Duarte, M.I. The cell-mediated immune reaction in the cutaneous lesion of Chromoblastomycosis and their correlation with different clinical forms of the disease. Mycopathologia 156, 51–60 (2003). https://doi.org/10.1023/A:1022948329193

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