Major Depressive Disorder and Pulmonary Tuberculosis Comorbidity Exacerbates Proinflammatory Immune Response-A Preliminary Study.

BACKGROUND: Major depressive disorders (MDDs) occurs frequently in patients with tuberculosis (TB). Elevated serum pro-inflammatory cytokine levels in MDD patients is a well-established fact. Therefore, an integrated clinical practice should be considered. However, the inflammatory status of MDD-TB patients is unknown. In this study, we analyze cytokines in activated-cells and sera from MDD-TB, TB, MDD patients, and healthy controls. METHODS: Flow cytometry was used to evaluate the intracellular production of interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, interleukin (IL)-12, and IL-10 by peripheral blood mononuclear cells after a polyclonal stimulation. A Bio-Plex Luminex system was used to measure serum cytokine and chemokine levels in the study groups. RESULTS: We observed a 40.6% prevalence of MDD in TB patients. The proportion of IFN-gamma-producing cells was higher in MDD-TB patients than other pathological groups. Nevertheless, the percentage of TNF-alpha- and IL-12-producing cells was similar between MDD-TB and TB patients. Likewise, MDD-TB and TB patients showed similar serum pro-inflammatory cytokine and chemokine levels, which were significantly lower than those in MDD patients. By multiple correspondence analyses, we observed that low levels of serum IL-4, IL-10, and IL-13 were powerfully associated with TB comorbidities with MDD. CONCLUSIONS: A high frequency of IFN-γ-producing cells is associated with low levels of serum anti-inflammatory cytokines in MDD-TB patients.

Thiamine pyrophosphate diminishes nitric oxide synthesis in endothelial cells.

Although thiamine pyrophosphate (TPP) is considered a protective agent for endothelial cells, it is still unknown if this is associated with nitric oxide (NO) synthesis. Our aim was to evaluate the synthesis of NO in endothelial cells incubated with TPP and high glucose concentrations. Endothelial cells from the umbilical cord vein from newborns (n = 20), were incubated with 5, 15 or 30 mmol/L glucose, in absence or presence of 0.625 mg/ml of TPP. Our results showed a significant increase in cell proliferation (> 40%; P < 0.05), and cell viability (> 90%; P < 0.001) after 48 h in endothelial cells cultured with glucose plus TPP. Likewise, in the presence of glucose and TPP an important rise in the consumption of glucose by the endothelial cells was observed after 24 h (> 7%; P < 0.001) and 48 h (> 10%; P < 0.05). Additionally, the levels of lactate after incubation with glucose and TPP showed only slight variations after 48 h (P < 0.05). However, these changes were clearly different from those observed in the absence of TPP. Interestingly, we found that the changes mentioned were linked with reduced levels of nitrites both at 24 h (< 171 pmol/µg protein; P < 0.001), and 48 h (< 250 pmol/µg protein; P < 0.05), which was associated with a reduced expression of mRNA of eNOS in endothelial cells incubated with TPP and high glucose. In conclusion, the presence of TPP regulates the consumption of glucose and the synthesis of NO, which would explain its protective effect in the endothelium of diabetic patients.

CD3+ICOS+ T cells show differences in the synthesis of nitric oxide, IFN-γ, and IL-10 in patients with pulmonary tuberculosis or in healthy household contacts.

Evidence indicates that more than 90 % of infected individuals never develop active tuberculosis. This fact highlights the relevance of the immune response in tuberculosis control. The inducible co-stimulator (ICOS) is a regulator of the function, differentiation, proliferation, and activation of T cells. Moreover, T cells synthesise nitric oxide (NO), interferon gamma (IFN-γ), and interleukin (IL)-10, which help regulate the immune response to tuberculosis. Therefore, we assessed the synthesis of NO, IFN-γ, and IL-10 in CD3+ICOS+ T cells from healthy individuals, household contacts (HHC), and patients with active pulmonary tuberculosis (PTB), previously stimulated with the antigen H37Rv. Our results indicated a significant increase in both the percentage of ICOS+ cells and CD3+ICOS+ T cells producing NO, IFN-γ, and IL-10 in cells obtained from patients with PTB (p < 0.01). In addition, a high mitochondrial membrane potential (ΔΨ m) in CD3+ICOS+ T cells was observed in the cells from HHC and from PTB patients, and is associated with the activation of T cells. In conclusion, results show that the CD3+ICOS+ T cells obtained from PTB patients are the main producers of NO, IFN-γ, and IL-10. In addition, our results imply that NO is a modulator of ICOS expression of T cells from PTB patients.

Effect of Histoplasma capsulatum glucans on host innate immunity / Efecto de los glucanos de Histoplasma capsulatum sobre la inmunidad innata del huésped

Beta-1,3-Glucan is important for infective forms (mycelial phase) of Histoplasma capsulatum and shares many features allotted to pathogen-associated molecular patterns. These cell wall carbohydrates interact with phagocytes by binding to Toll and lectin-like receptors, present on cell surfaces of macrophages, neutrophils, and dendritic cells. This review focuses on recent findings of the major H. capsulatum and host carbohydrate-driven interactions that account for internalization of fungal infective forms into phagocytes, and its subsequent avoidance of intracellular elimination. The yeast phase of H. capsulatum possesses different modulating factors of the macrophagic-anti-fungal mechanisms, mainly alpha-1,3-glucan, which is considered relevant for virulence. This manuscript is part of the series of works presented at the "V International Workshop: Molecular genetic approaches to the study of human pathogenic fungi" (Oaxaca, Mexico, 2012) (AU)

El Beta-1,3-glucano es importante para las formas infectivas (fase micelial) de Histoplasma capsulatum y comparte varias características asignadas a los patrones moleculares asociados con patógenos. Estos hidratos de carbono de la pared celular interaccionan con los fagocitos uniéndose a receptores tipo Toll y tipo lectina, que están presentes en las superficies celulares de macrófagos, neutrófilos y células dendríticas. En esta revisión se presta atención a los hallazgos recientes sobre las principales interacciones entre H. capsulatum y las células del huésped mediadas por hidratos de carbono, que permiten la internalización de las formas infectivas del hongo por los fagocitos, así como la posterior evitación de su eliminación intracelular. Se discuten los datos experimentales relevantes publicados recientemente. La fase de levadura de H. capsulatum incluye distintos factores moduladores de los mecanismos de macrófagos y antifúngicos, sobre todo el alpha-1,3-glucano, que se considera relevante para la virulencia.Este artículo forma parte de una serie de estudios presentados en el «V International Workshop: Molecular genetic approaches to the study of human pathogenic fungi» (Oaxaca, México, 2012) (AU)

Effect of Histoplasma capsulatum glucans on host innate immunity.

ß-1,3-Glucan is important for infective forms (mycelial phase) of Histoplasma capsulatum and shares many features allotted to pathogen-associated molecular patterns. These cell wall carbohydrates interact with phagocytes by binding to Toll and lectin-like receptors, present on cell surfaces of macrophages, neutrophils, and dendritic cells. This review focuses on recent findings of the major H. capsulatum and host carbohydrate-driven interactions that account for internalization of fungal infective forms into phagocytes, and its subsequent avoidance of intracellular elimination. The yeast phase of H. capsulatum possesses different modulating factors of the macrophagic-anti-fungal mechanisms, mainly α-1,3-glucan, which is considered relevant for virulence. This manuscript is part of the series of works presented at the "V International Workshop: Molecular genetic approaches to the study of human pathogenic fungi" (Oaxaca, Mexico, 2012).

O-glycosylation of NnTreg lymphocytes recognized by the Amaranthus leucocarpus lectin.

O-glycosidically-linked glycans have been involved in development, maturation, homing, and immune regulation in T cells. Previous reports indicate that Amaranthus leucocarpus lectin (ALL), specific for glycans containing galactose-N-acetylgalactosamine and N-acetylgalactosamine, recognizes human naïve CD27(+)CD25(+)CD4(+) T cells. Our aim was to evaluate the phenotype of CD4(+) T cells recognized by ALL in peripheral blood mononuclear cells obtained from healthy volunteers. CD4(+) T cells were isolated by negative selection using magnetic beads-labeled monoclonal antibodies; the expression of T regulatory cell phenotypic markers was assessed on ALL-recognized cells. In addition, IL-4, IL-10, IFN-γ, and TGF-ß intracellular production in ALL (+) cells was also evaluated. The analyses of phenotypic markers and intracellular cytokines were performed through flow cytometry. ALL-recognized CD4(+) T cells were mainly CD45RA(+), CCR7(+) cells. Although 52 ± 10% CD25(+)Foxp3(+) cells were positive to ALL, only 34 ± 4% of ALL (+) cells corresponded to CD25(+)Foxp3(-) cells. Intracellular cytokines in freshly obtained ALL (+)CD4(+) T cells exhibited 8% of IL-4, 15% of IL-10, 2% of IFN-γ, and 15% of TGF-ß, whereas ALL (-)CD4(+) T cells depicted 1% of IL-4, 2% of IL-10, <1% of IFN-γ, and 6% of TGF-ß. Our results show that galactose-N-acetylgalactosamine and N-galactosamine-bearing CD4(+) T cells expressed phenotypic markers of NnTreg cells.

High mortality associated with hyperglycemia, neutrophilia, and lymphopenia in critically ill patients.

A common finding in patients admitted to an Intensive Care Unit (ICU) is hyperglycemia without prior history of diabetes. This increase in blood glucose is considered a negative prognostic factor for patients in the ICU. Hence, we performed a retrospective cohort study in patients admitted at the ICU of the National Institute of Respiratory Diseases (INER) in a 7-month period; we collected data about their blood glucose concentration during their stay at the ICU. We gathered the available medical records of 30 patients out of 58 admitted to the ICU. Among the 30 patients, 21 patients survived (70%) and 9 patients with community-acquired pneumonia (CAP) died (30%). The 21 surviving patients included 17 patients with acute respiratory distress secondary to CAP and 4 patients with asthmatic crisis upon admission to the ICU. After admission, all patients progressed to sepsis and showed an increase in blood glucose. We detected higher glucose concentrations in deceased patients (147 mg/dl ± 4.23), as compared to surviving patients (129 mg/dl ± 2.17) (P < 0.001). In addition, the percentage of lymphocytes was lower in deceased patients than that in surviving patients (5.7 vs. 11.8%, P < 0.001), whereas percentage of neutrophils was elevated in the deceased patients (90.7 vs. 80.9%, P < 0.001). It is therefore important to measure continuously glucose concentrations, as well as the numbers of neutrophils and lymphocytes in critically ill patients with hyperglycemia. Such a simple monitoring plan may prevent fatal complications in patients admitted to ICU.

The interaction between Histoplasma capsulatum cell wall carbohydrates and host components: relevance in the immunomodulatory role of histoplasmosis.

Histoplasma capsulatum is an intracellular fungal pathogen that causes respiratory and systemic disease by proliferating within phagocytic cells. The binding of H. capsulatum to phagocytes may be mediated by the pathogen's cell wall carbohydrates, glucans, which consist of glucose homo and hetero-polymers and whose glycosydic linkage types differ between the yeast and mycelial phases. The alpha-1,3-glucan is considered relevant for H. capsulatum virulence, whereas the beta-1,3-glucan is antigenic and participates in the modulation of the host immune response. H. capsulatum cell wall components with lectin-like activity seem to interact with the host cell surface, while host membrane lectin-like receptors can recognize a particular fungal carbohydrate ligand. This review emphasizes the relevance of the main H. capsulatum and host carbohydrate-driven interactions that allow for binding and internalization of the fungal cell into phagocytes and its subsequent avoidance of intracellular elimination.

The interaction between Histoplasma capsulatum cell wall carbohydrates and host components: relevance in the immunomodulatory role of histoplasmosis

Histoplasma capsulatum is an intracellular fungal pathogen that causes respiratory and systemic disease by proliferating within phagocytic cells. The binding of H. capsulatum to phagocytes may be mediated by the pathogen's cell wall carbohydrates, glucans, which consist of glucose homo and hetero-polymers and whose glycosydic linkage types differ between the yeast and mycelial phases. The ±-1,3-glucan is considered relevant for H. capsulatum virulence, whereas the ²-1,3-glucan is antigenic and participates in the modulation of the host immune response. H. capsulatum cell wall components with lectin-like activity seem to interact with the host cell surface, while host membrane lectin-like receptors can recognize a particular fungal carbohydrate ligand. This review emphasizes the relevance of the main H. capsulatum and host carbohydrate-driven interactions that allow for binding and internalization of the fungal cell into phagocytes and its subsequent avoidance of intracellular elimination.

Effect of Bifidobacterium bifidum DSM 20082 cytoplasmic fraction on human immune cells.

The objective of the present study was to determine the effect of the soluble cytoplasmic fraction from Bifidobacterium bifidum DSM 20082 (Bb) lysate on peripheral blood T cells. In peripheral blood mononuclear cells of healthy subjects, cytotoxic activity, proliferation, apoptosis, and up-regulation of CD8 or CD4 molecules in T cells were examined. When peripheral blood mononuclear cells were stimulated with Bb lysate, the main effect was observed in CD8+ cells as a significant increase of CD8 molecules in a dose-dependent manner, and this behavior was observed at 24, 48, and 72 h after stimulation; in contrast, stimulation with Bb lysate showed no effect on the up-regulation of CD4 molecules in T helper cells. Further Bb lysate did not induce proliferation activity in either CD8+ or CD4+ cells. Bb lysate induced activation of CD8+ cytotoxic activity against autologous monocytes. Around 80% of the cells stimulated with Bb lysate were positive to peanut agglutinin (PNA), suggesting that the stimulated CD8+ cells corresponded to activated/effector cellular populations. When apoptosis was determined, there were no differences between stimulated and non-stimulated cells. Our results indicate that Bb lysate is able to increase cytotoxic activity of peripheral CD8+ cells, without affecting lymphocyte survival.

Incubation with DNase I inhibits tumor cell proliferation.

BACKGROUND: Deoxyribonuclease I (DNase-I) plays an important role in the elimination of damaged-, aging- or cancer cells. Various authors suggest that programmed cell death (PCD) is attenuated in cancer cells due to a reduced activity of DNase-I. MATERIAL AND METHODS: In this work, we evaluated cell viability (violet crystal stain), cell proliferation (tritiated thymidine) and DNA degradation of tumoral cells (Calu-1, SK-MES-1, HeLa, HEp-2, L-929) incubated with different concentrations of DNase I. PBMN cells and human fetal fibroblasts served as controls. RESULTS: Our results showed a >90% decrease in the viability of HeLa and HEp-2 cells, and >50%<90% decline in Calu-1, SK-MES-1 and L-929 cell viability, incubated with 9 mg/ml of DNase-I in comparison with control cells (p<0.05). The incorporation of [3H]thymidine showed a 50% decrease in tumoral cells. Control cells showed no significant differences. Tumor cell DNA degradation was observed after nuclease treatment, however the typical DNA ladder, characteristic of the apoptotic cell, was not observed. The morphology of some DNAse-I treated tumor cells suggested autoschizis CONCLUSION: Our results suggest that the use of a DNA nuclease might have some benefits in the treatment of cancer since it inhibits cell growth, probably by inducing autoschizis.

Hypertriglyceridemia is linked to reduced nitric oxide synthesis in women with hypertensive disorders of pregnancy.

BACKGROUND: Hypertensive disorders of pregnancy (HDP), which affect 8% to 15% of pregnancies, are associated with nitric oxide dysfunction and hyperlipidemia, but their precise role in HDP remains controversial. In order to gain more insight into the mechanisms underlying HDP, we evaluated some indicators common to the diseases associated with endothelial dysfunction. METHODS: Plasma samples were obtained from 47 normotensive women (control group) and from 27 women with HDP (experimental group). All women were 7 months pregnant. Body mass index as well as triglycerides, nitrite concentrations, total cholesterol, LDL-cholesterol, HDL-cholesterol, glucose, and glycated hemoglobin were determined. RESULTS: Our results showed significant differences in body mass index (30.4 +/- 1.3 vs 28.3 +/- 0.6 kg/m(2), p < 0.05), triglycerides (363 +/- 137 vs. 263 +/- 80 mg/dL, p < 0.01), nitrites (19.6 +/- 5.2 vs. 15.2 +/- 5.0 micromol/L, p < 0.01), and glucose (92 +/- 25 vs. 81 +/- 10.8 mg/dL, p < 0.05) in women from the experimental group compared with the control group. Interestingly, nitric oxide synthesis was significantly reduced when triglycerides and cholesterol concentrations were increased (p < 0.018 and p < 0.002, respectively). Moreover, there was a strong association (odds ratio, 3.5) between a family history of type 2 diabetes mellitus and the development of HDP, especially preeclampsia. CONCLUSIONS: It may be useful to screen pregnant women for plasma nitrites and serum triglycerides to identify those at risk of developing HDP, especially in women with a family history of type 2 diabetes mellitus.

Purification of the receptor for the N-acetyl-D-glucosamine specific adhesin of Mannheimia haemolytica from bovine neutrophils.

The GlcNAc-specific adhesin from Mannheimia haemolytica (MhA) has been shown to participate in pathogenicity of mannheimiosis due to its capacity to adhere to tracheal epithelial cells and activate the oxidative burst of bovine neutrophils. In this work, we purified the MhA receptor from bovine neutrophils (MhAr) by affinity chromatography on MhA-Sepharose. The MhAr, which corresponded to approximately 2% of the protein from cell lysate, is a glycoprotein mainly composed of Glu, Ala, Ser, Gly, and Asp, without cysteine. The glycan portion, which corresponds to 20% by weight, is composed of GalNAc, GlcNAc, Man, Gal, and NeuAc. The receptor is a 165-kDa glycoprotein, as determined by molecular sieve chromatography under native conditions; SDS-PAGE analysis shows a heterodimer of 83 and 80 kDa subunits. This work suggests that the GlcNAc-containing receptor plays a relevant role by activating bovine neutrophils through non-opsonic mechanisms.

Increased expression of CD30 and CD57 molecules on CD4(+) T cells from children with atopic asthma: a preliminary report.

T helper type 2 (Th2) cells play an important role in the onset and persistence of allergic airway inflammation. Consequently, many authors have attempted to identify cell surface markers associated with a Th2 phenotype. This work was aimed at correlating CD30 and CD57 expression on CD4(+) T cells with interleukin (IL)-4 production in peripheral blood mononuclear cells (PBMCs) from allergic patients. PBMCs from 17 children with atopic asthma and 12 nonatopic healthy control children were analyzed. The CD28, CD30, CD40L, CD57, CD62L, CD69, IL-4, and IFN-gamma expressions on CD4(+) T cells were determined by double immunofluorescence and flow cytometry in PBMCs ex vivo and after phorbol-12-myristate-13-acetate plus ionomycin (PMA/I) stimulation. An increased percentage of peripheral CD4(+)CD30(+) T cells was observed in asthmatic patients (p < 0.001). In addition, the percentage of CD4(+) T cells expressing IL-4, IFN-gamma, CD30, CD40L, CD57, or CD69 significantly increased (p < 0.01) after PMA/I stimulation, in asthmatic patients. The CD30 expression on CD4(+) T cells from asthmatic patients, after stimulation, correlated with both IL-4 and IFN-gamma production, whereas CD57 expression only correlated with IL-4 production. These data suggest that the expression of CD30 and CD57 cell markers on T cells could reflect circulating effector T cell early activation in the allergic airway disease.

Differential O-glycosylation in cortical and medullary thymocytes.

Differentiation of T lymphocytes is characterized by variable expression of CD8/CD4 co-receptor molecules and changes in the glycosylation pattern. In this work, O-glycosylation was analyzed in microsomes from murine thymocytes purified with the PNA and Amaranthus leucocarpus (ALL) lectins, specific for the T antigen (Gal beta1,3GalNAc1,0 Ser/Thr) in cortical and medullary thymocytes, respectively. Three peptides were used as acceptors for UDP-N-acetylgalactosamine: polypeptide N-acetylgalactosaminyl-transferase (GalNAc transferase); the peptide motif TTSAPTTS was the best glycosylated one. Cortical ALL-PNA+ thymocytes showed two-fold higher GalNAc transferase activity than ALL+PNA- thymocytes; however, capillary electrophoresis showed a higher proportion of di- versus mono-glycosylated peptides for ALL+PNA- than for ALL-PNA+. We compared the GalNAc transferase activity of thymocytes from dexamethasone-treated mice versus control mice. GalNAc transferase activity was six-fold higher in thymocytes from control mice than from dexamethasone-treated mice; the rate of di-glycosylated peptides for dexamethosone-resistant ALL+ was two-fold higher than for ALL- thymocytes. Our results confirm an upregulated biosynthesis of O-glycosidically linked glycans on T cell surface glycoproteins, and suggest that the modification of GalNAc transferase activity plays a relevant role during the maturation process of thymic cells.

Componentes glicosilados de la envoltura de Mycobacterium tuberculosis que intervienen en la patogénesis de la tuberculosis / Structural components of the envelope of Mycobacterium tuberculosis that intervene in the pathogenesis of tuberculosis

Los componentes glicosilados de la envoltura de Mycobacterium tuberculosis tienen un papel importante en la inmunopatogénesis de la tuberculosis. Permiten la adhesión, penetración y persistencia de la micobacteria en el macrófago; de igual manera, participan en los mecanismos de activación de estas células y la producción de citocinas relevantes durante la respuesta inmune. En esta revisión, examinamos las características de las principales estructuras sacarídicas de la superficie de la micobacteria y su relación con la modulación de la respuesta inmune.

The glycosylated compounds of Mycobacterium tuberculosis envelope play an important role in the immunopathogenesis of tuberculosis. These molecules are involved in the binding to the host cell surface followed by their internalization and persistence in macrophages; likewise they take part in the macrophage's activation and the production of cytokines that are relevant during the immune response against mycobacteria. In this review we examine the molecular characteristics of the main mycobacterial cell surface saccharide structures and their relation with the modulation of the immune response to tuberculosis.

Intracellular expression of interleukin-4 and interferon-gamma by a Mycobacterium tuberculosis antigen-stimulated CD4+ CD57+ T-cell subpopulation with memory phenotype in tuberculosis patients.

In some chronic pathological conditions, antigen persistence activates and expands the CD4+ CD57+ T-cell subset. The host immune response against tuberculosis infection is maintained through the continuous presence of antigen-stimulated effector/memory helper T cells. To determine whether CD4+ CD57+ T cells were also expanded in human tuberculosis, we analysed (by flow cytometry) the phenotype of peripheral blood CD4+ T cells from 30 tuberculosis patients and 30 healthy controls. We observed a significant increase in the CD4+ CD57+ T-cell subset in tuberculosis patients in comparison to healthy controls (P < 0.001). Most CD4+ CD57+ T cells exhibited a CD28- CD45RO+ CD62L- phenotype, which is associated with memory cells. In vitro, a higher number of antigen-stimulated CD4+ CD57+ T cells produced intracellular interferon-gamma and interleukin-4 compared with antigen-stimulated CD4+ CD57- T cells (P < 0.001). These findings suggest that the majority of CD4+ CD57+ T cells correspond to a phenotype of activated memory T cells.

Comparative analysis of mononuclear cell surface markers in atopic processes--a preliminary study.

Atopic disorders are driven by the Th2 cell subset. We have determined the expression of costimulatory molecules and cell surface markers on peripheral CD4+ T cells and antigen presenting cells, in different atopic diseases, and we have also tried to correlate the expression of these markers with the severity of the disease. Cells from patients with atopic and contact dermatitis, mild or severe asthma, and symptomatic and non-symptomatic atopic rhinitis were analyzed by flow cytometry. Our results showed that CD30, CD124, and CD152 expression on CD4+ T cells was significantly higher in atopic dermatitis than in contact dermatitis patients (p < 0.05). It was interesting to observe that the cell surface expression of CD80 in T and B cells from atopic dermatitis patients was not enhanced as opposed to the other atopic diseases we analyzed. Our results suggest that there are differences in the immune mechanisms involved in the different atopic diseases, and that expression of CD30 in CD4+ T cells might be a marker of disease activity in atopic dermatitis.

Fagocitosis no opsónica, lectinofagocitosis de Histoplasma capsulatum / Lactinophagocytosis of Histoplasma capsulatum

Objetivo: En este artículo se revisan algunos aspectos relevantes de la fagocitosis no opsónica de microorganismos intracelulares con especial énfasis en Histoplasma capsulatum, considerando que la participación de los mecanismos no opsónicos influyen en el destino final de los microorganismos dentro de los fagocitos. Introducción: Numerosos microorganismos intracelulares invaden y sobreviven en el interior de las células fagocíticas gracias a los medios utilizados para su internalización así como a la presencia de moléculas de superficie o productos metabólicos que neutralizan o inhiben los mecanismos microbicidas propios de los fagocitos del huésped. Participación de moléculas glicosiladas, de integrinas, y de otras moléculas, en la invasión de microorganismos al macrófago: La internalización de los microorganismos a través de los receptores independientes de opsoninas de los macrófagos generalmente facilita a la invasión de éstos, ya que algunos receptores no activan el metabolismo oxidativo, de ahí que el reconocimiento, entre la célula a ser infectada y el microorganismo, mediaso por carbohidratos y estructuras tipo lectinas constituye uno de los mecanismos de invasión más exitosos. Conclusión: El conocer estas alternativas de invasión favorecería entender mejor la patogénesis de muchas enfermedades intracelulares que representan importantes problemas de salud, como la histoplasmosis, la tuberculosis y la leishmaniasis, entre otras