de Carli Marina Lara, Miyazawa Marta, Nonogaki Suely, Shirata Neuza Kasumi, Oliveira Denise Tostes, Pereira Alessandro Antônio Costa, Hanemann João Adolfo Costa
Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil.
Pathology Center, Adolfo Lutz Institute, São Paulo, São Paulo, Brazil.
J Oral Pathol Med. 2016 Feb;45(2):141-7. doi: 10.1111/jop.12333. Epub 2015 Jun 3.
Paracoccidioidomycosis (PCM) is a systemic fungal infection caused by Paracoccidioides brasiliensis (Pb) and associated with deficient cellular immune response, which is modulated by inflammatory cells, mainly macrophages, and cytokines. Recently, the comprehension of the macrophage polarization mediated by Th1 and Th2 cytokines has contributed to elucidate the immune response that takes part in some diseases. Thus, the aim of this study was to assess the presence of Th1- and Th2-immune response and also Pb counting in oral lesions of chronic PCM.
Forty-eight cases of chronic PCM oral lesions were included. All cases were classified as loose or dense granulomas. S100 protein, IL-1β, IL-6, TNF-α, CD163 and CD68 immunoexpressions, and Pb localization were evaluated. The fungi present in the tissue were quantified by anti-Pb antibody.
Most patients were white men with mean age of 47 years old and showed higher incidence of multiple lesions. Loose granulomas were predominant and exhibited a great amount of M2 macrophages, which were visualized with anti-CD163 antibody. The expression for CD163 and CD68 was similar (P = 0.05), highlighting the predominance of M2 macrophages in PCM. IL-1β, IL-6, and TNF-α immunoexpression did not significantly change with CD163, CD68, and S100 protein. The number of fungi was significantly higher in cases with intense IL-1β immunoexpression (P = 0.003).
M2-activated macrophages were the majority among inflammatory cells in chronic PCM, characterizing the action of a Th2-immune response. Nevertheless, Th1 cytokines were also found; mainly IL-1β, which was associated with fungi counting in oral lesions.
副球孢子菌病（PCM）是由巴西副球孢子菌（Pb）引起的一种系统性真菌感染，与细胞免疫反应缺陷有关，该反应由炎症细胞（主要是巨噬细胞）和细胞因子调节。最近，对由Th1和Th2细胞因子介导的巨噬细胞极化的理解有助于阐明参与某些疾病的免疫反应。因此，本研究的目的是评估慢性PCM口腔病变中Th1和Th2免疫反应的存在以及Pb计数。
纳入48例慢性PCM口腔病变病例。所有病例均分为松散或致密肉芽肿。评估S100蛋白、IL-1β、IL-6、TNF-α、CD163和CD68免疫表达以及Pb定位。通过抗Pb抗体对组织中存在的真菌进行定量。
大多数患者为白人男性，平均年龄47岁，多灶性病变发生率较高。松散肉芽肿占主导，表现出大量M2巨噬细胞，可通过抗CD163抗体观察到。CD163和CD68的表达相似（P = 0.05），突出了PCM中M2巨噬细胞的优势。IL-1β、IL-6和TNF-α免疫表达与CD163、CD68和S100蛋白无显著变化。IL-1β免疫表达强烈的病例中真菌数量显著更高（P = 0.003）。
M2活化巨噬细胞是慢性PCM炎症细胞中的主要类型，表明存在Th2免疫反应。然而，也发现了Th1细胞因子；主要是IL-1β，其与口腔病变中的真菌计数有关。
