Differential correlation betweeninterleukin patternsindisseminated and chronic humanparacoccidioidomycosis

SUMMARY Inan attempt tounderstand better theimmunoregulatory disorders inparacoccidioidomycosis (PCM),thepossible correlation between interleukin pattern,lymphoproliferation, C-reactive protein (CRP)andspecific antibody levels was investigated inthepolarized clinical formsofthis disease. We studied 16PCM patients, eight withthedisseminated disease (four undertreatment andfournon-treated) andeight withthechronic disease. Thepatients withdisseminated disease exhibited highantibody titres specific toParacoccididoides brasiliensis antigen comparedwith patients withthechronic formofdisease. Tumournecrosis factor (TNF), IL-1, IL-6andCRP in theserum ofnon-treated disseminated PCM patients were increased, whichcorrelated positively withthelowmitogenic responseofperipheral bloodmononuclear cells (PBMC)tophytohaemagglutinin (PHA)(P<0-01) andwiththehighantibody titres (P<00001) ofthese patients. Moreover, we foundinthedisseminated PCM patients positive correlations between IL-1and IL-6(P=00007); IL-1andTNF (P=0-0045); IL-1andIL-6withthehighantibody titres (P= 0-0834 andP = 0-0631, respectively); IL-1,IL-6andTNF withCRPlevels. Bycontrast, no correlations werefoundwiththose interleukins inthetreated disseminated andchronic patients or incontrols. Itwas interesting tofind an inverse correlation between IL-4andantibody production innon-treated disseminated PCM (r = -04770); moreover,a significant correlation (P= 0-0820) was foundinchronic PCM patients withrespect tothelowlevel ofeither IL-4andantibody titres against fungus antigen. Chronic PCM patients alsohadIL-2levels inversely correlated with antibody production (r= -0-6313; P = 0-0628). Inverse correlations were alsoobserved between IL-2andIL-6levels innon-treated disseminated patients (P= 00501) andbetween IL-2andIL-4 inchronic patients (P=0-013 1).Theinflammatory cytokines mighthavea pivotal roleinthe genesis andincontrol ofsome aspectsofthedisease, suchas granulomatous reaction, hypergammaglobulinaemia anddepression ofTcell-mediated immunity inPCM.