Oliveira Z N, Leão R C, Cucé L C
Division of Dermatology, Hospital das Clinicas, University of Sao Paulo Medical School, Brazil.
Allergol Immunopathol (Madr). 1996 May-Jun;24(3):98-105.
We have evaluated clinical and laboratorial effects of immunostimulation scarification with antigen of Paracoccidioides brasiliensis in patients with paracoccidioidomycosis, who often show depressed immunity. We have studied 62 Brazilian patients with paracoccidioidomycosis, 46 with active disease and 16 cured, in a 10-year period between 1982 and 1992. Among the 46 patients with active disease: 10 had acute form, 12 chronic unifocal form and 24 the chronic multifocal form of the disease; 16 showed positive paracoccidioidin intradermal reaction and 30 negative reaction. Amongst 16 cured patients, 5 showed negative paracoccidioidin intradermal reaction and 11 positive reaction. We immunostimulated 20 patients by scarification with polysaccharide antigen of Paracoccidioides brasiliensis. All 20 immunostimulated patients had negative paracoccidioidin intradermal reaction, and 18 patients had active disease and 2 were cured. Out of 18 immunostimulated patients with active disease, 3 had active form, 10 chronic multifocal form and 5 chronic unifocal form of the disease. Before and after immunostimulation, each patients was inmunologically evaluated by in vivo and in vitro methods; in vivo methods consisted of intradermal reactions and DNCB sensitization tests; and in vitro methods consisted of total sub-set lymphocyte counting, leukocytes migration inhibition test, chemotaxix of total leukocytes and monuclear leukocyte phagocytosis. Remaining 42 patients served as a non-immunostimulated control group who has followed only clinically. We have observed significant clinical and immunological improvement in immunostimulated patients. We conclude that the immunostimulation by scarification with antigen of P. brasiliensis can be a helpful adjuvant therapy for paracoccidioidomycosis.
我们评估了用巴西副球孢子菌抗原进行免疫刺激划痕法对副球孢子菌病患者的临床和实验室效果，这类患者常表现出免疫功能低下。在1982年至1992年的10年期间，我们研究了62例巴西副球孢子菌病患者，其中46例患有活动性疾病，16例已治愈。在46例活动性疾病患者中：10例为急性型，12例为慢性单病灶型，24例为慢性多病灶型；16例副球孢子菌素皮内反应呈阳性，30例呈阴性反应。在16例已治愈的患者中，5例副球孢子菌素皮内反应呈阴性，11例呈阳性反应。我们用巴西副球孢子菌的多糖抗原对20例患者进行了划痕免疫刺激。所有20例接受免疫刺激的患者副球孢子菌素皮内反应均为阴性，其中18例患有活动性疾病，2例已治愈。在18例接受免疫刺激的活动性疾病患者中，3例为急性型，10例为慢性多病灶型，5例为慢性单病灶型。在免疫刺激前后，通过体内和体外方法对每位患者进行了免疫评估；体内方法包括皮内反应和二硝基氯苯致敏试验；体外方法包括总亚群淋巴细胞计数、白细胞迁移抑制试验、总白细胞趋化性和单核白细胞吞噬作用。其余42例患者作为非免疫刺激对照组，仅进行临床随访。我们观察到接受免疫刺激的患者在临床和免疫方面有显著改善。我们得出结论，用巴西副球孢子菌抗原进行划痕免疫刺激可以作为副球孢子菌病的一种有益辅助治疗方法。
