Características imuno-histoquímicas das lesões de hanseníase em pacientes com helmintos intestinais

Abstract

Introduction: Immunomodulation determined by intestinal nematodes in humans can interfere in the evolution and progression of infectious disorders, among them leprosy. Objective: This study analyses the presence of anti-CD4, anti-CD8, anti-CD20, antiCD138, anti-TIA-1 and anti-FOXP3 markers in biopsy samples of skin lesions from patients with clinical and histopathological diagnosis of leprosy, with and without helminthiasis, in order to determine their influence on the immune system. Patients and methods: The study conducted a retrospective analysis of medical records of patients diagnosed with leprosy from the Department of Dermatology at the University Hospital Cassiano Antonio Moraes (HUCAM), from january 1995 to january 2010, which, after clinical suspicion of leprosy, underwent skin biopsy with histopathological study, and also had stool tests. The following data was collected from leprosy patients: age, gender, disease’s clinical type, histopathological diagnosis, the presence or absence of intestinal helminthes and the species involved. Subsequently the paraffin blocks with the biopsy material from patient’s skin lesions were separated for immunohistochemichal study of the markers CD4, CD8, CD20, CD138, TIA-1 and FOXP3. Results: Out of the 53 leprosy patients analyzed, a small predominance of female patients and paucibacillary types was observed. Another finding was the concentration of paucibacillary types among female patients, and multibacillary types among male patients. The patient’s median age was 43 years. Although lacking statistical significance, helminthic infections were slightly predominant in multibacillary patients, most frequently caused by Ascaris lumbricoides. The presence of FOXP3+ and CD20+ cells was higher among paucibacillary patients, and CD20+ cells were significantly more frequent in multibacillaty patients with intestinal helminthes, when compared to patients without intestinal helminthes (p=0,005). Conclusion: The 17 study showed a higher frequency of female sex in paucibacillary types leprosy, as well as the small predominance, although without statistical significance, of helminthes in multibacillary patients. However, CD20+ cells were significantly more frequent among multibacillary patients with helminthic infections.