RESUMO
Resistance to intracellular pathogens such as Mycobacterium leprae is dependent upon an effective T helper type 1 (Th1)-type immune response. On the other hand, intestinal helminths are known to subvert the host's immune response towards to either a Th2-type immune response or a regulatory T cell up-regulation, which may affect the host's ability to mount an effective response to mycobacteria. Here, we report a significant association between intestinal helminth infections and lepromatous leprosy [odds ratio (OR), 10.88; confidence interval (CI) 95%: 4.02-29.4; P<0.001]. We also observed that the frequency of intestinal helminths correlated strongly with the mycobacterial index (r=0.982, P<0.01). Corroborating with our hypothesis, intracellular levels of interferon-gamma were decreased significantly in leprosy patients co-infected with intestinal helminths when compared to leprosy patients without worms. Conversely, lepromatous leprosy patients with intestinal worms produced higher levels of both interleukin (IL)-4 and IL-10. Our results suggest that a pre-existing infection by intestinal helminths may facilitate the establishment of M. leprae infection or its progression to more severe forms of leprosy.
Assuntos
Enteropatias Parasitárias/imunologia , Hanseníase Virchowiana/imunologia , Hanseníase Tuberculoide/imunologia , Células Th1/imunologia , Adolescente , Adulto , Idoso , Antígenos de Bactérias/imunologia , Antígenos de Bactérias/farmacologia , Antígenos de Helmintos/imunologia , Antígenos de Helmintos/farmacologia , Brasil/epidemiologia , Estudos de Casos e Controles , Células Cultivadas/efeitos dos fármacos , Células Cultivadas/imunologia , Comorbidade , Progressão da Doença , Feminino , Humanos , Interferon gama/sangue , Interleucina-10/sangue , Interleucina-4/sangue , Enteropatias Parasitárias/sangue , Enteropatias Parasitárias/complicações , Enteropatias Parasitárias/epidemiologia , Hanseníase Virchowiana/sangue , Hanseníase Virchowiana/complicações , Hanseníase Virchowiana/epidemiologia , Hanseníase Tuberculoide/sangue , Hanseníase Tuberculoide/complicações , Hanseníase Tuberculoide/epidemiologia , Leucócitos Mononucleares/química , Ativação Linfocitária/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Mycobacterium leprae/imunologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Adulto JovemRESUMO
The understanding of the role of the immune response in the development of gastrointestinal and cardio-digestive (CD) forms of Chagas disease has received little attention. In this paper, the commitment of each leukocyte population of peripheral blood to the production of IFN-gamma, TNF-alpha, IL-12, IL-4, IL-5 and IL-10 was studied in patients with the CD form of Chagas disease. The data show that cells from patients with the CD form of the disease have distinct cytokine profiles when compared with the other clinical forms of Chagas disease and suggest that eosinophils are the major source of cytokine production in this clinical entity. The data presented in this paper demonstrate that patients with CD form can be distinguished from patients with gastrointestinal or cardiac forms of the disease by the distinct cytokine profile of peripheral blood cells.
