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[皮肤淋巴管型孢子丝菌病患者的免疫特征]

[Immunologic profile of a patient with lymphocutaneous sporotrichosis].

作者信息

Meléndez Ruiz C E, González Mendoza A, Sotomayor J M, Ruiz Godoy V M, Ramos Zepeda R

出版信息

Mycopathologia. 1983 Nov 25;83(3):169-73. doi: 10.1007/BF00437024.

Abstract

Sporotrichosis is characterized by a wide range of clinical manifestations from mild fixed cutaneous forms to systemic dissemination of the disease, despite an apparent regular pattern of virulence of the etiological agent, S. schenckii. These facts suggest that immunological mechanisms of the host could play an important role on the pathogenesis of the mycosis. On this basis, an immunologic survey was carried out in patients with lymphocutaneous sporotrichosis. Cell-mediated immunity was evaluated by means of lymphocyte transformation stimulated with phytohaemagglutinin and the response to several intradermal reaction antigens. Lymphocyte blastic transformation was normal as compared with a control group. All patients were positive at least against one of the antigens tested. These results indicate that this group of patients did not show any cell-mediated immunity deficiency. Serum immunoglobulins (IgG, IgM, IgA), and C3 measured to evaluate humoral immunity, were also within normality. Since many cases of sporotrichosis cure with the administration of potassium iodine, whose mechanisms of therapeutic activity are unknown, a possible impairment in the management of iodine was investigated, with the premise that iodine enhances the host defenses rather than acting against the fungus. Thyroid function tests performed in all patients to support this hypothesis, gave normal results. These data permit to conclude that susceptibility to sporotrichosis in the affected patients does not depend on gross abnormal humoral and/or cell-mediated immunity, and their response to potassium iodine is not related to deficient thyroid function.

摘要

孢子丝菌病的临床表现多种多样,从轻度局限性皮肤型到疾病的全身播散,尽管病原体申克孢子丝菌的毒力模式明显有规律。这些事实表明,宿主的免疫机制可能在该真菌病的发病机制中起重要作用。在此基础上,对淋巴皮肤型孢子丝菌病患者进行了一项免疫学调查。通过植物血凝素刺激的淋巴细胞转化以及对几种皮内反应抗原的反应来评估细胞介导的免疫。与对照组相比,淋巴细胞母细胞转化正常。所有患者至少对一种测试抗原呈阳性。这些结果表明,该组患者未表现出任何细胞介导的免疫缺陷。为评估体液免疫而检测的血清免疫球蛋白(IgG、IgM、IgA)和C3也在正常范围内。由于许多孢子丝菌病病例在服用碘化钾后治愈,其治疗活性机制尚不清楚,因此在碘的代谢可能受损的前提下进行了调查,前提是碘增强宿主防御而不是对抗真菌。对所有患者进行甲状腺功能测试以支持这一假设,结果均正常。这些数据可以得出结论,受影响患者对孢子丝菌病的易感性并不取决于明显的体液和/或细胞介导免疫异常,并且他们对碘化钾的反应与甲状腺功能不足无关。

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