Silva C L, Silva M F, Faccioli L H, Pietro R C, Cortez S A, Foss N T
Department of Parasitology, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
Clin Exp Immunol. 1995 Aug;101(2):314-20. doi: 10.1111/j.1365-2249.1995.tb08357.x.
In an attempt to understand better the immunoregulatory disorders in paracoccidioidomycosis (PCM), the possible correlation between interleukin pattern, lymphoproliferation, C-reactive protein (CRP) and specific antibody levels was investigated in the polarized clinical forms of this disease. We studied 16 PCM patients, eight with the disseminated disease (four under treatment and four non-treated) and eight with the chronic disease. The patients with disseminated disease exhibited high antibody titres specific to Paracoccidioides brasiliensis antigen compared with patients with the chronic form of disease. Tumour necrosis factor (TNF), IL-1, IL-6 and CRP in the serum of non-treated disseminated PCM patients were increased, which correlated positively with the low mitogenic response of peripheral blood mononuclear cells (PBMC) to phytohaemagglutinin (PHA) (P < 0.01) and with the high antibody titres (P < 0.001) of these patients. Moreover, we found in the disseminated PCM patients positive correlations between IL-1 and IL-6 (P = 0.0007); IL-1 and TNF (P = 0.0045); IL-1 and IL-6 with the high antibody titres (P = 0.0834 and P = 0.0631, respectively); IL-1, IL-6 and TNF with CRP levels. By contrast, no correlations were found with those interleukins in the treated disseminated and chronic patients or in controls. It was interesting to find an inverse correlation between IL-4 and antibody production in non-treated disseminated PCM (r = -0.4770); moreover, a significant correlation (P = 0.0820) was found in chronic PCM patients with respect to the low level of either IL-4 and antibody titres against fungus antigen. Chronic PCM patients also had IL-2 levels inversely correlated with antibody production (r = -0.6313; P = 0.0628). Inverse correlations were also observed between IL-2 and IL-6 levels in non-treated disseminated patients (P = 0.0501) and between IL-2 and IL-4 in chronic patients (P = 0.0131). The inflammatory cytokines might have a pivotal role in the genesis and in control of some aspects of the disease, such as granulomatous reaction, hypergammaglobulinaemia and depression of T cell-mediated immunity in PCM.
为了更好地理解副球孢子菌病（PCM）中的免疫调节紊乱，我们在这种疾病的不同临床类型中研究了白细胞介素模式、淋巴细胞增殖、C反应蛋白（CRP）和特异性抗体水平之间的可能相关性。我们研究了16例PCM患者，其中8例为播散型疾病患者（4例正在接受治疗，4例未接受治疗），8例为慢性疾病患者。与慢性疾病患者相比，播散型疾病患者对巴西副球孢子菌抗原的抗体滴度较高。未接受治疗的播散型PCM患者血清中的肿瘤坏死因子（TNF）、IL-1、IL-6和CRP升高，这与外周血单个核细胞（PBMC）对植物血凝素（PHA）的低促有丝分裂反应（P < 0.01）以及这些患者的高抗体滴度（P < 0.001）呈正相关。此外，我们发现播散型PCM患者中IL-1与IL-6之间呈正相关（P = 0.0007）；IL-1与TNF之间呈正相关（P = 0.0045）；IL-1和IL-6与高抗体滴度之间呈正相关（分别为P = 0.0834和P = 0.0631）；IL-1、IL-6和TNF与CRP水平呈正相关。相比之下，在接受治疗的播散型患者、慢性患者或对照组中，未发现这些白细胞介素之间存在相关性。有趣的是，在未接受治疗的播散型PCM患者中发现IL-4与抗体产生呈负相关（r = -0.4770）；此外，在慢性PCM患者中，IL-4水平与抗真菌抗原的抗体滴度低之间存在显著相关性（P = 0.0820）。慢性PCM患者的IL-2水平也与抗体产生呈负相关（r = -0.6313；P = 0.0628）。在未接受治疗的播散型患者中，还观察到IL-2与IL-6水平之间呈负相关（P = 0.0501），在慢性患者中，IL-2与IL-4之间呈负相关（P = 0.0131）。炎症细胞因子可能在该疾病的发生以及某些方面的控制中起关键作用，如肉芽肿反应、高球蛋白血症和PCM中T细胞介导的免疫抑制。
