Amato Valdir S, Andrade Heitor F Júnior, Amato Neto Vicente, Duarte Maria Irma S
Department of Infectious and Parasitic Diseases, University of Sao Paulo, Alameda Gabriel Monteiro da Silva, 429, 01441-000, Sao Paulo, Brazil.
Am J Trop Med Hyg. 2003 May;68(5):527-8. doi: 10.4269/ajtmh.2003.68.527.
Mucosal leishmaniasis (ML) is a disease characterized by intense activation of inflammatory cells and extensive tissue destruction. Among the cytokines involved in the immune response to ML, tumor necrosis factor-alpha (TNF-alpha) has attracted strong interest because of its roles in the modulation of the immune response. We studied 20 patients with ML who provided biopsy specimens before treatment and after lesion healing obtained by specific therapy. The biopsy specimens were subjected to immunohistochemical analysis for in situ quantification of cellular and extracellular TNF-alpha. The amount of TNF-alpha was significantly lower in the healed lesions compared with pretreatment biopsy specimens, although TNF-alpha persisted at the tissue level even after lesion healing. This relevant finding demonstrates for the first time an in situ tissue reduction of TNF-alpha after treatment and shows persistence of TNF-alpha in healed lesions may be related to the maintenance of an immunopathologic background for relapses observed in ML.
黏膜利什曼病（ML）是一种以炎症细胞强烈激活和广泛组织破坏为特征的疾病。在参与对ML免疫反应的细胞因子中，肿瘤坏死因子-α（TNF-α）因其在调节免疫反应中的作用而引起了强烈关注。我们研究了20例ML患者，这些患者在治疗前以及通过特定治疗实现病变愈合后提供了活检标本。对活检标本进行免疫组织化学分析，以原位定量细胞内和细胞外的TNF-α。与治疗前活检标本相比，愈合病变中TNF-α的量显著降低，尽管即使在病变愈合后TNF-α仍在组织水平持续存在。这一相关发现首次证明了治疗后TNF-α在原位组织中的减少，并表明愈合病变中TNF-α的持续存在可能与ML中观察到的复发的免疫病理背景的维持有关。
