Abstract
Fungus of the Sporothrix schenckii complex can produce skin lesions in humans, commonly lymphocutaneous (LC) and fixed (F) forms of sporotrichosis. Some authors have suggested that clinical forms are influenced by differences in virulence and genetic profile of isolates. But little is known about the role of immune response in determining the clinical outcome of sporotrichosis. To verify the profile of systemic and in situ IFN-γ and IL-10 expression in sporotrichosis patients, and consequently to detect any difference between the two compartments and/or clinical presentation, we quantified the number of IFN-γ and IL-10 producer peripheral blood mononuclear cells stimulated with S. schenckii antigen (Ss-Ag) by Elispot, and quantified cytokines expression by in situ immunohistochemistry in the same patient. Three groups were formed: 1- LC (n = 9); 2- F (n = 10); 3- healthy individuals (n = 14). All sporotrichosis patients produced high amounts of systemic IFN- γ when compared to uninfected individuals. No differences were observed between LC and F groups. Regarding in situ IL-10 expression, a difference between LC and F groups was observed: LC lesions presented higher amounts of IL-10 than F lesions differently from systemic IL-10 which showed similarities. Our data suggests that LC lesions present higher IL-10 expression which could be related to regulatory mechanisms for compensating the tissue injury, however favoring fungal persistence in the lesions. Surprisingly, there were no differences in systemic and in situ IFN- γ expression between CL and F patients, although it was significantly higher expressed in these patients than in healthy individuals.
Highlights
Sporotrichosis is a subcutaneous mycosis caused by fungus of the Sporothrix schenckii complex [1,2,3]
Yeast cells compatible with Sporothrix schenckii complex were observed in three LC and in four F cases
We could detect a higher IL-10 in situ expression by cells in LC lesions, associated with necrotic granulomatous inflammation and a tendency of higher number of lesions, longer duration and longer treatment duration
Summary
Sporotrichosis is a subcutaneous mycosis caused by fungus of the Sporothrix schenckii complex [1,2,3]. The individual may develop different clinical forms, varying from localized skin lesions (fixed—F) or lymphocutaneous (LC) forms, to systemic disease (extracutaneous form) [4]. The F form is characterized by one lesion (verrucous, ulcerated or plaque-like) on the site of the fungus inoculation without lymphatic involvement. The most common form is the LC which is characterized by an involvement of the lymphatic system, accompanied by the occurrence of subcutaneous nodules that may progress to necrosis, liquefaction of their content and ulceration, showing the aspect known as sporotrichoid [4,5,6,7,8]. Some authors have suggested that clinical forms are influenced by differences in virulence [9] and genetic profile of isolates [10], little is known about immune response in human SP
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