Alexandre Ariane Fernandes, Quaresma Juarez Antonio Simões, Barboza Tânia Cristina, de Brito Arival Cardoso, Xavier Marília Brasil, de Oliveira Clivia Maria Moraes, Unger Deborah Aben Athar, Kanashiro-Galo Luciane, Sotto Mirian Nacagami, Duarte Maria Irma Seixas, Pagliari Carla
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.
Med Mycol. 2017 Feb 1;55(2):145-149. doi: 10.1093/mmy/myw059. Epub 2016 Aug 25.
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.
若热·洛博病（JLD）是一种由致病性真菌罗博隐球菌引起的皮肤慢性肉芽肿性疾病。其特征为伴有多核巨细胞和大量真菌细胞的肉芽肿反应。为了有助于理解JLD人类病变中的免疫机制，我们研究了细胞毒性免疫反应，重点关注CD8 + T细胞、自然杀伤（NK）细胞和颗粒酶B。选取了40例下肢皮肤活检样本，并制定了免疫组织化学方案以检测CD8 + T细胞、NK细胞和颗粒酶B。为了比较细胞群体，我们还进行了一项方案以观察CD4 + T细胞。在真皮层的9个随机视野中对免疫标记细胞进行定量。病变的特征是巨噬细胞、淋巴细胞、上皮样细胞和多核巨细胞的炎性浸润，伴有大量真菌形态。CD8细胞多于CD4细胞，其次是NK细胞。我们的结果表明，在JLD中细胞毒性免疫反应可能是控制罗博隐球菌感染的另一个重要机制。我们可以推测，尽管CD4 + T细胞在JLD的宿主防御中至关重要，但CD8 + T细胞可能在真菌清除中发挥作用。
