RESUMO
The effects of reactional episodes on the cutaneous nerve fibers of leprosy patients was assessed in six patients (three with reversal reactions and three with erythema nodosum leprosum). Cryosections of cutaneous biopsy of reactional lesions taken during the episode and of another sample during the remission period were immunostained with anti-NGFr and anti-PGP 9.5 (indirect immunofluorescence). We found no significant statistical difference in the number of NGFr- and PGP 9.5-positive fibers between the reactional and post-reactional groups. A significant difference was detected between the number of NGFr and PGP 9.5-stained fibers inside of the reactional group of biopsy cryosections but this difference was ascribed to the distinct aspects of the nerve fibers displayed whether stained with anti-NGFr or with anti-PGP 9.5; NGFr-positive branches looked larger and so interpreted as containing more fibers. In addition, a substantial number NGFr-positive fibers were PGP 9.5-negative. No differences in the number of stained fibers among the distinct cutaneous regions examined (epidermis + upper dermis, mid and deep dermis) was detected. In conclusion, the number of PGP- and NGFr-positive fibers were not significantly different in the reactional and post-reactional biopsies in the present study. NGFr-staining of the nerve fibers is different from their PGP-imunoreactivity and the evaluation of the nerve fiber status on an innervated target organ should be carried out choosing markers for both components of nerve fibers (Schwann cells and axons).
Assuntos
Eritema Nodoso/metabolismo , Hanseníase Virchowiana/metabolismo , Fibras Nervosas/química , Receptor de Fator de Crescimento Neural/análise , Pele/inervação , Tioléster Hidrolases/análise , Adolescente , Adulto , Análise de Variância , Axônios/química , Biomarcadores/análise , Biópsia , Eritema Nodoso/patologia , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Hanseníase Virchowiana/patologia , Masculino , Pessoa de Meia-Idade , Células de Schwann/química , Coloração e Rotulagem/métodos , Estatísticas não Paramétricas , Ubiquitina TiolesteraseRESUMO
Fundamentos: A integração das artes de controle da hanseníase, as estratégias dos Programas de Saúde da Família e Agentes Comunitários de Saúde, na conformidade do processo de reorganização da atenção básica, fundamentou a atualização das normas da legislação sobre o controle da doença no Brasil. A classificação operacional adotada, para aloação do paciente na polioquimioterapia, foi adaptada da sugerida pela Organização Mundial da Saúde, essencialmente clínica, baseada no número de lesões cutaneas
Assuntos
Humanos , Classificação , HanseníaseRESUMO
The immunohistochemical identification of neuropeptides (calcitonin gene-related peptide, vasoactive intestinal polypeptide, substance P, alpha-melanocyte stimulating hormone and gamma-melanocyte stimulating hormone) quantification of mast cells and their subsets (tryptase/chymase-immunoreactive mast cells = TCMC and tryptase-immunoreactive mast cells = TMC) were determined in biopsies of six patients with leprosy reactions (three patients with type I reaction and three with type II). Biopsies were compared with those taken from the same body site in the remission stage of the same patient. We found a relative increase of TMC in the inflammatory infiltrate of the reactional biopsies compared to the post-reactional biopsy. Also, the total number of mast cells and the TMC/TCMC ratio in the inflammatory infiltrate was significantly higher than in the intervening dermis of the biopsies of both periods. No significant difference was found regarding neuroptide expression in the reactional and post-reactional biopsies. The relative increase of TMC in the reactional infiltrates could implicate this mast cell subset in the reported increase of the immune response in leprosy reactions.
Assuntos
Hanseníase/imunologia , Mastócitos/química , Neuropeptídeos/análise , Adolescente , Adulto , Biomarcadores/análise , Contagem de Células , Quimases , Feminino , Humanos , Hanseníase/patologia , Hanseníase Dimorfa/imunologia , Hanseníase Dimorfa/patologia , Masculino , Mastócitos/enzimologia , Pessoa de Meia-Idade , Serina Endopeptidases/análise , TriptasesRESUMO
The effects of reactional episodes on the cutaneous nerve fibers of leprosy patients was assessed in six patients (three with reversal reactions and three with erythema nodosum leprosum). Cryosections of cutaneous biopsy of reactional lesions taken during the episode and of another sample during the remission period were immunostained with anti-NGFr and anti-PGP 9.5 (indirect immunofluorescence). We found no significant statistical difference in the number of NGFr- and PGP 9.5-positive fibers between the reactional and post-reactional groups. A significant difference was detected between the number of NGFr and PGP 9.5-stained fibers inside of the reactional group of biopsy cryosections but this difference was ascribed to the distinct aspects of the nerve fibers displayed whether stained with anti-NGFr or with anti-PGP 9.5; NGFr-positive branches looked larger and so interpreted as containing more fibers. In addition, a substantial number NGFr-positive fibers were PGP 9.5-negative. No differences in the number of stained fibers among the distinct cutaneous regions examined (epidermis + upper dermis, mid and deep dermis) was detected. In conclusion, the number of PGP- and NGFr-positive fibers were not significantly different in the reactional and post-reactional biopsies in the present study. NGFr-staining of the nerve fibers is different from their PGP-imunoreactivity and the evaluation of the nerve fiber status on an innervated target organ should be carried out choosing markers for both components of nerve fibers (Schwann cells and axons)
Assuntos
Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Eritema Nodoso , Hanseníase Virchowiana , Fibras Nervosas , Receptor de Fator de Crescimento Neural , Pele , Análise de Variância , Axônios , Biomarcadores , Biópsia , Eritema Nodoso , Técnica Indireta de Fluorescência para Anticorpo , Hanseníase Virchowiana , Células de Schwann , Coloração e Rotulagem , Estatísticas não ParamétricasRESUMO
The immunohistochemical identification of neuropeptides (calcitonin gene-related peptide, vasoactive intestinal polypeptide, substance P, alpha-melanocyte stimulating hormone and gamma-melanocyte stimulating hormone) quantification of mast cells and their subsets (tryptase/chymase-immunoreactive mast cells = TCMC and tryptase-immunoreactive mast cells = TMC) were determined in biopsies of six patients with leprosy reactions (three patients with type I reaction and three with type II). Biopsies were compared with those taken from the same body site in the remission stage of the same patient. We found a relative increase of TMC in the inflammatory infiltrate of the reactional biopsies compared to the post-reactional biopsy. Also, the total number of mast cells and the TMC/TCMC ratio in the inflammatory infiltrate was significantly higher than in the intervening dermis of the biopsies of both periods. No significant difference was found regarding neuroptide expression in the reactional and post-reactional biopsies. The relative increase of TMC in the reactional infiltrates could implicate this mast cell subset in the reported increase of the immune response in leprosy reactions
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Hanseníase , Mastócitos , Neuropeptídeos , Biomarcadores , Contagem de Células , Hanseníase , Hanseníase Dimorfa , Mastócitos , Serina EndopeptidasesRESUMO
The immunohistochemical identification of neuropeptides (calcitonin gene-related peptide, vasoactive intestinal polypeptide, substance P, alpha-melanocyte stimulating hormone and gamma-melanocyte stimulating hormone) quantification of mast cells and their subsets (tryptase/chymase-immunoreactive mast cells = TCMC and tryptase-immunoreactive mast cells = TMC) were determined in biopsies of six patients with leprosy reactions (three patients with type I reaction and three with type II). Biopsies were compared with those taken from the same body site in the remission stage of the same patient. We found a relative increase of TMC in the inflammatory infiltrate of the reactional biopsies compared to the post-reactional biopsy. Also, the total number of mast cells and the TMC/TCMC ratio in the inflammatory infiltrate was significantly higher than in the intervening dermis of the biopsies of both periods. No significant difference was found regarding neuroptide expression in the reactional and post-reactional biopsies. The relative increase of TMC in the reactional infiltrates could implicate this mast cell subset in the reported increase of the immune response in leprosy reactions.