RESUMEN
OBJECTIVES: The present study aimed to evaluate the dynamics of CD28 and CD57 expression in CD8+ T lymphocytes during cytomegalovirus viremia in bone marrow transplant recipients. METHODS: In a prospective study, blood samples were obtained once weekly once from 33 healthy volunteers and weekly from 33 patients. To evaluate the expression of CD57 and CD28 on CD8+ T lymphocytes, flow cytometry analysis was performed on blood samples for four months after bone marrow transplant, together with cytomegalovirus antigenemia assays. RESULTS: Compared to cytomegalovirus-seronegative healthy subjects, seropositive healthy subjects demonstrated a higher percentage of CD57+ and a lower percentage of CD28+ cells (p<0.05). A linear regression model demonstrated a continuous decrease in CD28+ expression and a continuous increase in CD57+ expression after bone marrow transplant. The occurrence of cytomegalovirus antigenemia was associated with a steep drop in the percentage of CD28+ cells (5.94%, p<0.01) and an increase in CD57+ lymphocytes (5.60%, p<0.01). This cytomegalovirus-dependent effect was for the most part concentrated in the allogeneic bone marrow transplant patients. The development of acute graft versus host disease, which occurred at an earlier time than antigenemia (day 26 vs. day 56 post- bone marrow transplant), also had an impact on the CD57+ subset, triggering an increase of 4.9% in CD57+ lymphocytes (p<0.05). CONCLUSION: We found continuous relative changes in the CD28+ and CD57+ subsets during the first 120 days post- bone marrow transplant, as part of immune system reconstitution and maturation. A clear correlation was observed between the expansion of the CD57+CD28-CD8+ T lymphocyte subpopulation and the occurrence of graft versus host disease and cytomegalovirus viremia.
Asunto(s)
Antígenos CD/inmunología , Trasplante de Médula Ósea/inmunología , Linfocitos T CD8-positivos/inmunología , Infecciones por Citomegalovirus/inmunología , Enfermedad Injerto contra Huésped/inmunología , Viremia/inmunología , Adulto , Antígenos CD28/inmunología , Antígenos CD57/inmunología , Antígenos CD8/inmunología , Linfocitos T CD8-positivos/virología , Infecciones por Citomegalovirus/sangre , Infecciones por Citomegalovirus/prevención & control , Femenino , Enfermedad Injerto contra Huésped/virología , Humanos , Modelos Lineales , Masculino , Estudios Prospectivos , Viremia/sangre , Viremia/prevención & control , Adulto JovenRESUMEN
OBJECTIVES: The present study aimed to evaluate the dynamics of CD28 and CD57 expression in CD8+ T lymphocytes during cytomegalovirus viremia in bone marrow transplant recipients. METHODS: In a prospective study, blood samples were obtained once weekly once from 33 healthy volunteers and weekly from 33 patients. To evaluate the expression of CD57 and CD28 on CD8+ T lymphocytes, flow cytometry analysis was performed on blood samples for four months after bone marrow transplant, together with cytomegalovirus antigenemia assays. RESULTS: Compared to cytomegalovirus-seronegative healthy subjects, seropositive healthy subjects demonstrated a higher percentage of CD57+ and a lower percentage of CD28+ cells (p<0.05). A linear regression model demonstrated a continuous decrease in CD28+ expression and a continuous increase in CD57+ expression after bone marrow transplant. The occurrence of cytomegalovirus antigenemia was associated with a steep drop in the percentage of CD28+ cells (5.94 percent, p<0.01) and an increase in CD57+ lymphocytes (5.60 percent, p<0.01). This cytomegalovirus-dependent effect was for the most part concentrated in the allogeneic bone marrow transplant patients. The development of acute graft versus host disease, which occurred at an earlier time than antigenemia (day 26 vs. day 56 post- bone marrow transplant), also had an impact on the CD57+ subset, triggering an increase of 4.9 percent in CD57+ lymphocytes (p<0.05). CONCLUSION: We found continuous relative changes in the CD28+ and CD57+ subsets during the first 120 days post- bone marrow transplant, as part of immune system reconstitution and maturation. A clear correlation was observed between the expansion of the CD57+CD28-CD8+ T lymphocyte subpopulation and the occurrence of graft versus host disease and cytomegalovirus viremia.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Adulto Joven , Antígenos CD/inmunología , Trasplante de Médula Ósea/inmunología , /inmunología , Infecciones por Citomegalovirus/inmunología , Enfermedad Injerto contra Huésped/inmunología , Viremia/inmunología , /inmunología , /inmunología , /inmunología , /virología , Infecciones por Citomegalovirus/sangre , Infecciones por Citomegalovirus/prevención & control , Enfermedad Injerto contra Huésped/virología , Modelos Lineales , Estudios Prospectivos , Viremia/sangre , Viremia/prevención & control , Adulto JovenRESUMEN
A leishmaniose visceral americana é uma doença importante entre crianças do nordeste do Brasil. Com o objetivo de caracterizar a resposta imune humoral durante o curso da doença, foram analisados soros de pacientes hospitalizados, pelos métodos ELISA e Western blot, usando-se preparaçöes de antígenos de Leishmania donovani chagasi. O teste de ELISA foi positivo (absorbância > 0,196), numa diluiçäo de 1: 1024, em todos os pacientes no início da doença, diminuindo no decorrer do ano, para os níveis dos indivíduos controles. Apenas um dos 72 controles, que tinha um irmäo com leishmaniose visceral, apresentou positividade para o teste. "Immunoblots" de soros de pacientes apresentaram bandas múltiplas, sendo as mais freqüentes de aproximadamente 116 kDa, 70 kDa. Com menor freqüência foram observadas bandas de 93 kDa, 74 kDa, 62 kDa, 46 kDa e 32 kDa. As respostas, através de ELISA e dos padröes de separaçäo por "immunoblot", foram distintas na leishmaniose visceral e podem ser usadas para diferenciar pacientes com leishmaniose visceral daqueles com doenças de Chagas ou leishmaniose cutânea. As amostras sorológicas de pacientes acompanhados durante seis semanas após o tratamento näo apresentaram nenhuma banda nova. A eletroforese em gel de poliacrilamida-sulfato de dodecil de sódio (SDS-PAGE) das proteínas iodinadas da superfície do parasita mostrou uma banda principal e quatro menores, enquanto a eletroforese de proteínas biotiniladas do parasita mostrou um padräo semelhante aquele apresentado pelos soros dos pacientes. A leishmaniose visceral parece produzir um padräo de "immunoblot" característico que pode ser usado, juntamente com um método sensível tipo ELISA, no diagnóstico de leishmaniose visceral americana