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Kanashiro-Galo L, Alexandre AF, Tafuri WL, Barboza TC, Quaresma JAS, Brito ACD, Nascimento GYFDSD, Santos Filho AMD, Sotto MN, Pagliari C. Lacaziosis: immunohistochemical evaluation of elements of the humoral response in cutaneous lesions. Rev Inst Med Trop Sao Paulo 2020; 62:e75. [PMID: 33053144 PMCID: PMC7552988 DOI: 10.1590/s1678-9946202062075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/16/2020] [Indexed: 11/22/2022] Open
Abstract
Lacaziosis is a cutaneous mycosis caused by the fungus Lacazia loboi, described in different countries of Latin America and prevalent in the Amazon region. The ineffective immune response against the agent seems to be related to a Th2 pattern of cytokines. There are few reports exploring elements of the humoral response in these lesions. Our aim was to investigate some elements focusing on B cells, plasma cells and local expression of IgG and IgM antibodies. Forty skin biopsies of lower limbs were selected. The diagnosis of lacaziosis was based on direct mycological examination and histological analysis. The visualization of fungal cells was improved by using Gridley’s staining. An immunohistochemical protocol was performed to detect the expression of B cells, plasma cells, IgG and IgM. A double staining was performed to explore the presence of yeasts in the cytoplasm of keratinocytes, using an anti-AE1 AE3 antibody over Gridley’s staining. The inflammatory infiltrate consisted of macrophages, multinucleated giant cells, lymphocytes, and fibrosis. Fungal cells were frequent in the stratum corneum and in both, the dermis and, in 50% of the specimens, also in the epidermis. Cells expressing IgG were more abundant when compared to cells expressing IgM. B cells and the presence of IgG might indicate that the humoral response promotes a Th2 immune response resulting in an anti-inflammatory phenotype. Our results lead us to suggest a possible role of B cells and immunoglobulins in the mechanisms of lacaziosis pathogenesis.
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Affiliation(s)
- Luciane Kanashiro-Galo
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Patologia, São Paulo, São Paulo, Brazil
| | - Ariane Fernandes Alexandre
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Patologia, São Paulo, São Paulo, Brazil.,Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós-Graduação em Ciências da Saúde, São Paulo, São Paulo, Brazil
| | - Wagner Luiz Tafuri
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Departamento de Patologia Geral, Belo Horizonte, Minas Gerais, Brazil
| | - Tânia Cristina Barboza
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Patologia, São Paulo, São Paulo, Brazil.,Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós-Graduação em Ciências da Saúde, São Paulo, São Paulo, Brazil
| | - Juarez Antonio Simões Quaresma
- Universidade Federal do Pará, Núcleo de Medicina Tropical, Belém, Pará, Brazil.,Universidade do Estado do Pará, Centro de Ciências Biológicas e da Saúde, Belém, Pará, Brazil
| | | | - Gabriela Yasmin Francisca da Silva do Nascimento
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Patologia, São Paulo, São Paulo, Brazil.,Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós-Graduação em Ciências da Saúde, São Paulo, São Paulo, Brazil
| | - Antonio Marques Dos Santos Filho
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Clínica Dermatológica, São Paulo, São Paulo, Brazil
| | - Mirian Nacagami Sotto
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Patologia, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Dermatologia Tropical, São Paulo, São Paulo, Brazil
| | - Carla Pagliari
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Patologia, São Paulo, São Paulo, Brazil.,Instituto de Assistência Médica ao Servidor Público Estadual, Programa de Pós-Graduação em Ciências da Saúde, São Paulo, São Paulo, Brazil
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Alexandre AF, Quaresma JAS, Barboza TC, de Brito AC, Xavier MB, de Oliveira CMM, Unger DAA, Kanashiro-Galo L, Sotto MN, Duarte MIS, Pagliari C. The cytotoxic T cells may contribute to the in situ immune response in Jorge Lobo's Disease human lesions. Med Mycol 2017; 55:145-149. [PMID: 27562863 DOI: 10.1093/mmy/myw059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 04/13/2016] [Accepted: 06/10/2016] [Indexed: 11/14/2022] Open
Abstract
Jorge Lobo's Disease (JLD) is a cutaneous chronic granulomatous disease caused by the pathogenic fungus Lacazia loboi. It is characterized by a granulomatous reaction with multinucleated giant cells and high number of fungal cells. In order to contribute to the comprehension of immune mechanisms in JLD human lesions, we studied the cytotoxic immune response, focusing on TCD8+ and NK cells, and granzyme B. Forty skin biopsies of lower limbs were selected and an immunohistochemistry protocol was developed to detect CD8+ T cells, NK cells and Granzyme B. In order to compare the cellular populations, we also performed a protocol to visualize TCD4+ cells. Immunolabeled cells were quantified in nine randomized fields in the dermis. Lesions were characterized by inflammatory infiltrate of macrophages, lymphocytes, epithelioid and multinucleated giant cells with intense number of fungal forms. There was a prevalence of CD8 over CD4 cells, followed by NK cells. Our results suggest that in JLD the cytotoxic immune response could represent another important mechanism to control Lacazia loboi infection. We may suggest that, although CD4+ T cells are essential for host defense in JLD, CD8+ T cells could play a role in the elimination of the fungus.
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Affiliation(s)
- Ariane Fernandes Alexandre
- Faculdade de Medicina, Universidade de São Paulo, Departamento de Patologia.,Programa de Pós-graduação em Ciências da Saúde/Instituto de Assistência Médica ao Servidor Público Estadual
| | | | - Tânia Cristina Barboza
- Faculdade de Medicina, Universidade de São Paulo, Departamento de Patologia.,Programa de Pós-graduação em Ciências da Saúde/Instituto de Assistência Médica ao Servidor Público Estadual
| | | | | | | | | | | | | | | | - Carla Pagliari
- Faculdade de Medicina, Universidade de São Paulo, Departamento de Patologia .,Programa de Pós-graduação em Ciências da Saúde/Instituto de Assistência Médica ao Servidor Público Estadual
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Azevedo MDCS, Rosa PS, Soares CT, Fachin LRV, Baptista IMFD, Woods WJ, Garlet GP, Trombone APF, Belone ADFF. Analysis of Immune Response Markers in Jorge Lobo's Disease Lesions Suggests the Occurrence of Mixed T Helper Responses with the Dominance of Regulatory T Cell Activity. PLoS One 2015; 10:e0145814. [PMID: 26700881 PMCID: PMC4689386 DOI: 10.1371/journal.pone.0145814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 12/09/2015] [Indexed: 01/18/2023] Open
Abstract
Jorge Lobo's disease (JLD) is a chronic infection that affects the skin and subcutaneous tissues. Its etiologic agent is the fungus Lacazia loboi. Lesions are classified as localized, multifocal, or disseminated, depending on their location. Early diagnosis and the surgical removal of lesions are the best therapeutic options currently available for JLD. The few studies that evaluate the immunological response of JLD patients show a predominance of Th2 response, as well as a high frequency of TGF-β and IL-10 positive cells in the lesions; however, the overall immunological status of the lesions in terms of their T cell phenotype has yet to be determined. Therefore, the objective of this study was to evaluate the pattern of Th1, Th2, Th17 and regulatory T cell (Treg) markers mRNA in JLD patients by means of real-time PCR. Biopsies of JLD lesions (N = 102) were classified according to their clinical and histopathological features and then analyzed using real-time PCR in order to determine the expression levels of TGF-β1, FoxP3, CTLA4, IKZF2, IL-10, T-bet, IFN-γ, GATA3, IL-4, IL-5, IL-13, IL-33, RORC, IL-17A, IL-17F, and IL-22 and to compare these levels to those of healthy control skin (N = 12). The results showed an increased expression of FoxP3, CTLA4, TGF-β1, IL-10, T-bet, IL-17F, and IL-17A in lesions, while GATA3 and IL-4 levels were found to be lower in diseased skin than in the control group. When the clinical forms were compared, TGF-β1 was found to be highly expressed in patients with a single localized lesion while IL-5 and IL-17A levels were higher in patients with multiple/disseminated lesions. These results demonstrate the occurrence of mixed T helper responses and suggest the dominance of regulatory T cell activity, which could inhibit Th-dependent protective responses to intracellular fungi such as L. loboi. Therefore, Tregs may play a key role in JLD pathogenesis.
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Affiliation(s)
- Michelle de C. S. Azevedo
- Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil
- Departamento de Patologia, Instituto Lauro de Souza Lima, Bauru, São Paulo, Brazil
| | - Patricia S. Rosa
- Departamento de Patologia, Instituto Lauro de Souza Lima, Bauru, São Paulo, Brazil
| | - Cleverson T. Soares
- Departamento de Patologia, Instituto Lauro de Souza Lima, Bauru, São Paulo, Brazil
| | - Luciana R. V. Fachin
- Departamento de Patologia, Instituto Lauro de Souza Lima, Bauru, São Paulo, Brazil
| | | | - William J. Woods
- Serviço Especializado em Dermatologia, Hospital das Clínicas do Acre, Rio Branco, São Paulo, Brazil
| | - Gustavo P. Garlet
- Departamento de Ciências Biológicas, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, São Paulo, Brazil
| | - Ana Paula F. Trombone
- Departamento de Ciências da Saúde, Universidade do Sagrado Coração, Bauru, São Paulo, Brazil
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