Chromoblastomycosis (CBM) is a chronic fungal disease witch affects the skin, characterized for slowing development of polymorphic skin, that present infiltrated inflammatory granulomatous in the presence of sclerotics cells, characteristic of this illness. One of the objectives of this study was to evaluate the induction of scleroticts cells for natural mediums, with biomasses of Bactris gasipaes and Theobroma grandiflorum, whose respective species had induced in vitro similar sclerotics cells to those found in tissue of patients, in 10 and 2 days, respectively, what it made possible
the production of a powder medium inductor, already donated to other groups that study the CBM. Another objective was to evaluate the histopathology of the CBM in
the patients, before and during the use of itraconazole (ITZ). For this, the technique of
ELISA for the cytokines was used TNF-α, circulating IL-4 and IL-10, and the
immunohistochemestry of biópsias in different times of treatment - that it allowed to analyze the quantitative and qualitative alterations of the cellular types during 12
months of the treatment with ITZ in the 200 dose of mg/dia - with antibodies anti-
CD20, anti-CD8 and anti-CD68. How much the cytokines, the circulating IL-10 did not
show significant change, while IL-4 and TNF-α had presented an increase of the levels
throughout 12 months of treatment. In relation to the immunophenotyping, it had a
significant reduction in the inflammatory process and the cellular infiltrated during 3
and 6 months of the treatment, whereas only to the 12 months had the significant
regression of the number of sclerotics cells. The immunophenotyping disclosed that the macrophages are mainly located in the areas central areas of granuloma, whereas cells TCD8+ are in the periphery and cells TCD20+, which were found throughout the tissues, with a significant increase after 6 months of the treatment, returning to the initial levels after one year. The cytotoxic macrophages and lymphocytes were having presented a significant increase after 12 months of treatment with ITZ. These results
demonstrate that the formation of granuloma in the CBM is similar to those observed in other granulomatous infectious disease, and that the presence of IL-4 and IL-10 can be related with the persistence of fungi in the injuries and with the difficulty of cure observed in these patients.
|
