Low-level LASER therapy accelerates fungal lesions cicatrization by increasing the production of Th1 and Th2 cytokines.

Paracoccidioidomycosis (PCM) is a systemic mycosis with serious clinical consequences in which the use of antifungal drugs requires long-term treatment. Therefore, we studied the effect of low-level LASER therapy (LLLT) to evaluate its prospects as a complementary treatment for PCM and improve the clinical response to the disease. OBJECTIVES: Our study focused on the resolution of lesions caused by fungal infection using a subcutaneous air pouch model of infection. METHODS: We evaluated cell profile and cytokines, fungi viability, and the presence of fibroblasts and fibrocytes at the site of infection. Inoculation of P. brasiliensis (Pb) was performed using a subcutaneous air pouch model and the LLLT irradiation was performed on alternate days on the rear paws of mice for 10 days, after which the cells from the air pouch were collected and analyzed. RESULTS: In animals irradiated with LLLT, the influx of cells to the air pouch was reduced, but they were more activated and produced pro-inflammatory (IL-12, IL-17 and TNF-α) and neutrophil (PMN) activating cytokines (IL-8, GM-CSF and γ-IFN). A better resolution of the infection, evidenced by the reduction in the number of viable fungi with preserved morphology in the air pouch, and an increase in the number of fibrocytes, indicating a healing profile were also observed. CONCLUSION: LLLT decreased the influx of PMN, but those presents were highly activated, with increased fungicidal activity. LLLT irradiation also resulted in earlier cicatrization at the site of infection, leading to a better outcome of the infection. These data are favorable to the use of LLLT as a complementary therapy in PCM.

Effect of HeNe laser irradiation on extracellular matrix deposition and expression of cytokines and chemokines in paracoccidioidomycotic lesions.

Paracoccidioidomycosis is the most prevalent human mycosis in Latin America. Cutaneous lesions are extremely painful and sensitive, and current treatment with antifungal drugs is lengthy and may cause side effects to patients. In this perspective, the helium-neon (HeNe) laser emerges as a novel therapy form due to its ability to heal wounds without changing cell function. In this work, we evaluate the effects of HeNe laser irradiation on extracellular matrix deposition and expression of cytokines and chemokines in cutaneous lesions caused by experimental infection of Balb/c mice. Our results showed decreased levels of pro-inflammatory interleukin (IL)-17 and tumor necrosis factor-alpha, and of anti-inflammatory IL-10 cytokines in lesions exposed to HeNe laser irradiation. Chemokines CCL3 and CXCL10 showed decreased levels in laser-treated lesions, but no significant difference was observed in relation to CCL5 expression. We also detected decreased density of fibronectin and laminin in HeNe laser-treated lesions. Data presented herein support the validity of our previous results suggesting positive effects of HeNe laser in accelerating wound healing in this experimental model. We believe that HeNe laser is a new nonharmful strategy that may be used as adjuvant and/or alternative therapy for improving treatment of paracoccidioidomycotic lesions.

Effect of low intensity helium-neon (HeNe) laser irradiation on experimental paracoccidioidomycotic wound healing dynamics.

The effect of HeNe laser on the extracellular matrix deposition, chemokine expression and angiogenesis in experimental paracoccidioidomycotic lesions was investigated. At days 7, 8 and 9 postinfection the wound of each animal was treated with a 632.8 nm HeNe laser at a dose of 3 J cm(-2). At day 10 postinfection, the wounds were examined by using histologic and immunohistochemical methods. Results revealed that laser-treated lesions were lesser extensive than untreated ones, and composed mainly by macrophages and lymphocytes. High IL-1beta expression was shown in the untreated group whereas in laser-treated animals the expression was scarce. On the other hand, the expression of CXCL-10 was found to be reduced in untreated animals and quite intensive and well distributed in the laser-treated ones. Also, untreated lesions presented vascular endothelial growth factor (VEGF) in a small area near the center of the lesion and high immunoreactivity for hypoxia-inducible factor-1 (HIF-1), whereas laser-treated lesions expressed VEGF surrounding blood vessels and little immunoreactivity for HIF-1. Laser-treated lesions presented much more reticular fibers and collagen deposition when compared with the untreated lesion. Our results show that laser was efficient in minimizing the local effects observed in paracoccidioidomycosis and can be an efficient tool in the treatment of this infection, accelerating the healing process.

Paracoccidioidomicose com envolviemnto palpebral e conjuntival / Paracoccidioidomycosis with palpebral and conjunctival involvement-Repot of 4 cases and review of the literature

Os autores relatam quatro casos de Paracoccidioidomicose palpebral e conjuntival. Descrevem as lesöes oculares, o acometimento sistêmico quando presente e o tratamento. A literatura sobre o assunto é revisada