Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas, Medellín, Colombia.
PLoS Negl Trop Dis. 2011 Jul;5(7):e1232. doi: 10.1371/journal.pntd.0001232. Epub 2011 Jul 12.
Paracoccidioidomycosis (PCM), an endemic systemic mycosis caused by the fungus Paracoccidioides brasiliensis (Pb), usually results in severe lung damage in patients.
Considering the difficulties to sequentially study the infection in humans, this work was done in mice inoculated intranasally with infective Pb-conidia. Lungs of control and Pb-infected mice were studied after 2-hours, 4, 8, 12 and 16-weeks post-infection (p.i) in order to define histopathologic patterns of pulmonary lesions, multiplex-cytokine profiles and their dynamics during the course of this mycosis. Besides the nodular/granulomatous lesions previously informed, results revealed additional non-formerly described lung abnormalities, such as periarterial sheath inflammation and pseudotumoral masses. The following chronologic stages occurring during the course of the experimental infection were defined: Stage one (2-hours p.i): mild septal infiltration composed by neutrophils and macrophages accompanied by an intense "cytokine burst" represented by significant increases in IL-1α, IL-1β, IL-4, IL-5, IL-6, IL-10, IL12p70, IL-13, IL-17, Eotaxin, G-CSF, MCP1, MIP1α, GM-CSF, IFN-γ, MIP1β and TNFα levels. Stage two (4-weeks p.i): presence of nodules, evidence of incipient periarterial- and intense but disperse parenchymal- inflammation, abnormalities that continued to be accompanied by hyper-secretion of those cytokines and chemokines mentioned in the first stage of infection. Stages three and four (8 and 12-weeks p.i.): fungal proliferation, inflammation and collagenesis reached their highest intensity with particular involvement of the periarterial space. Paradoxically, lung cytokines and chemokines were down-regulated with significant decreases in IL-2,IL-3,IL-5,IL-9,IL-13,IL-15,GM-CSF,IFN-γ,MIP1β and TNFα. Stage five (16-weeks p.i.): inflammation decreased becoming limited to the pseudotumoral masses and was accompanied by a "silent" cytokine response, except for PDGF, MIG, RANTES and IL12p40 which remained up-regulated for the duration of the experiment.
Results of this study identified both classic and novel patterns corresponding to histopathologic and immunologic responses occurring during the course of experimental PCM.
巴西副球孢子菌(Pb)引起的地方性系统性真菌病——副球孢子菌病(PCM),通常会导致患者肺部严重受损。
考虑到连续研究人类感染的困难,本工作在经鼻接种感染性 Pb 分生孢子的小鼠中进行。在感染后 2 小时、4、8、12 和 16 周,研究对照组和 Pb 感染组小鼠的肺部,以确定肺病变的组织病理学模式、多重细胞因子谱及其在真菌病过程中的动态变化。除了先前报道的结节/肉芽肿病变外,结果还揭示了其他以前未描述的肺部异常,如动脉周围鞘炎症和假肿瘤肿块。在实验感染过程中定义了以下时间顺序发生的阶段:阶段一(感染后 2 小时):轻度间隔浸润由中性粒细胞和巨噬细胞组成,并伴有强烈的“细胞因子爆发”,表现为 IL-1α、IL-1β、IL-4、IL-5、IL-6、IL-10、IL12p70、IL-13、IL-17、Eotaxin、G-CSF、MCP1、MIP1α、GM-CSF、IFN-γ、MIP1β和 TNFα 水平显著增加。阶段二(感染后 4 周):出现结节,有动脉周围和强烈但弥散的实质炎症的早期证据,这些异常继续伴随着感染第一阶段提到的这些细胞因子和趋化因子的过度分泌。阶段三和四(感染后 8 周和 12 周):真菌增殖、炎症和胶原形成达到最高强度,特别是动脉周围空间受累。矛盾的是,肺细胞因子和趋化因子下调,IL-2、IL-3、IL-5、IL-9、IL-13、IL-15、GM-CSF、IFN-γ、MIP1β 和 TNFα 水平显著降低。阶段五(感染后 16 周):炎症减少,仅限于假肿瘤肿块,并伴有“沉默”的细胞因子反应,除了 PDGF、MIG、RANTES 和 IL12p40 外,它们在整个实验过程中仍保持上调。
本研究结果确定了在实验性 PCM 过程中发生的组织病理学和免疫学反应的经典和新型模式。