Evaluation of bronchoalveolar cells in pulmonary paracoccidioidomycosis

Abstract

To investigate the local immune response, the cellular infiltrate and cytokine levels were analysed in bronchoalveolar lavage (BAL) from patients with pulmonary paracoccidioidomycosis. The group consisted of 19 patients aged 34-65 yrs. The diagnosis was confirmed by demonstration of the fungus in the sputum or BAL fluid and by serological tests.Cytospin preparations showed an increased number of lymphocytes and neutrophils in BAL. A higher number of CD8z lymphocytes were observed in BAL compared with peripheral blood. Alveolar macrophages (AM) expressed approximately three-fold more major histocompatibility class II, intercellular adhesion molecule-1 and B7-2 molecules on their surfaces than their circulating counterparts, indicating that they had differentiated into activated macrophages inside the lungs.Cultured AM produced higher levels of interleukin (IL)-6, tumour necrosis factor (TNF)-a and macrophage inflammatory protein (MIP)-1a than peripheral blood monocytes. BAL fluid contained low but detectable amounts of IL-6, TNF-a and MIP1a, and specific antibodies to Paracoccidioides brasiliensis, mainly of the immunoglobulin G 2 isotype.As macrophage inflammatory protein-1a was shown to selectively attract CD8z Tcells and this population was elevated in bronchoalveolar lavage, the data suggest that, besides macrophages, CD8z T-cells may have an important role in the pathogenesis of pulmonary paracoccidioidomycosis. Eur Respir J 2003; 22: 895-899.

An overview of the immunopathology of human paracoccidioidomycosis

“…Several groups addressed this question by quantifying the cytokines released in vitro from patients' cells. The results published so far were, in general, quite concordant and the picture that emerged were quite consistent, as depicted in Table 2 [19,25,[27][28][29][30][31][32][33][34]. In brief, these studies showed that the acute/subacute form of the disease is associated with down modulation of the Th-1 cytokine pattern and expression of a dominant Th-2 immunity consisting of high levels of a subset of cytokines such as IL-4, IL-5 and IL-10, specific antibodies of the IgE and IgG4 subclasses, in situ and peripheral blood eosinophilia, among other parameters.…”

Pulmonary immune responses induced in BALB/c mice by Paracoccidioides brasiliensis conidia

“…In this study, the alveolar macrophages over expressed ICAM-1, and other molecules on their surfaces, and they produced higher levels of IL-6, TNF-a and MIP-1a, indicating their participation in the pathogenesis of pulmonary PCM [91].…”

“…In human studies, Fornazim et al [91], found increased number of lymphocytes and PMNs in BALs of patients with PCM. In this study, the alveolar macrophages over expressed ICAM-1, and other molecules on their surfaces, and they produced higher levels of IL-6, TNF-a and MIP-1a, indicating their participation in the pathogenesis of pulmonary PCM [91].…”

Expression of adhesion molecules in lungs of mice infected with Paracoccidioides brasiliensis conidia

“…Along the same lines, Fornazim et al [37], found increased number of lymphocytes and neutrophils in bronchoalveolar lavages of patients with PCM. The alveolar macrophages overexpressed ICAM-1, as well as other molecules (major histocompatibility class II and B7-2) on their surfaces and they produced higher levels of IL-6, TNF-a and MIP-1a, indicating that both were activate and participated in the pathogenesis of pulmonary PCM [37].…”