TGF-β plasma levels in chromoblastomycosis patients during itraconazole treatment

Abstract

Background Chromoblastomycosis (CBM) is a dermal mycosis. The disease evolves to a chronic state, presenting a suppurative granulomatous dermatitis, combined with variable dermal fibrosis. Pathogenesis of the inflammation and tissue repair in CBM are poorly understood. Aim To quantify Transforming Growth Factor-β (TGF-β) plasma levels of CBM patients during itraconazole (ITZ) treatment. Methods Blood plasma of 12 CBM patients was subjected to TGF-β titration with ELISA at 0, 3, 6 and 12 months of 200 mg per day of ITZ therapy, and correlated with the clinical aspects. Plasma of 12 healthy individuals were used for control. Results CBM patients present high plasma levels of TGF-β (7.016 ± 1988 pg/ml), decreasing after 03 months (4.625 ± 645 pg/ml) of ITZ treatment, which correlates with a rapid clinical improvement. However, after 6 (6.566 ± 777 pg/ml) and 12 months (6.908 ± 776) of treatment, TGF-β levels increase to almost the same levels observed before treatment, which is related to a slow clinical improvement, fungal persistence on the lesion, and fibrotic scars. Conclusion TGF-β plasma levels are high in CBM patients. Fungal destruction by ITZ correlates with TGF-β downregulation, but tissue remodeling and fungal persistence probably raises its levels again, interfering with cellular immune responses.