Characterization of the immune response in patients with infective dermatitis associated to human T-cell lymphotropic virus type 1 (HTLV-1). / Caracterização da resposta imune em pacientes com dermatite infecciosa associada ao virus linfotropico de celulas T de humanos do tipo 1 (HTLV-1).

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Introduction and objectives: It is estimated that 20 million individuals are infected with HTLV-1 worldwide. HTLV-1 is the causal agent of the myelopathy associated to HTLV-1 (HAM/TSP) and adult T cell leukemia/lymphoma (ATLL) and infective dermatitis (IDH). The over production of pro-inflammatory cytokines as well as immunoproliferation occur even in unstimulated cultures. HTLV-1 proviral load is an important factor to predict the disease progression and HAM/TSP development. IDH is a pattern of chronic eczema in childhood, characterized by an exudative eczema of scalp, neck, retroauricular areas, axillae and groin, a generalized fine papular rash. Association with Staphylococcus aureus and Streptococcus b- hemolyticus cutaneous infection is usually observed. However, reactivation of the disease occurs and recent studies have documented that up to 30% of the patients with IDH will developed HAM/TSP. The aim of this study was to evaluate the immune response, the ability of cytokine and anti-cytokines to modulate IFN- g production and the HTLV-1 proviral load in IDH patients. Methods: Cytokines levels were measured by ELISA, cytokine mRNA expression analyzed by semiquantitative RT-PCR and the HTLV-1 proviral load was analyzed by Real Time PCR. In some cultures IL-10, anti-human IL-2, anti-human IL-15 was added. Results: Spontaneous production of IFN-g in IDH patients (n=17), HTLV-1 carries (n=40), HAM/TSP patients (n=40) and healthy controls (n=15) were 1.998 1922 pg/mL, 727 824 pg/mL, 3.184 2.788 pg/mL and 3.3 2.9 pg/mL respectively. TNF-a levels in IDH patients and HTLV-1 carries were 556 422 pg/mL and 255 315 pg/mL (p<0.05). There was no difference in TNF-a production between IDH and HAM/TSP patients. There was a tendency for higher IL-4 mRNA expression and IgE levels in IDH than in HTLV-1 carriers, but the difference did not reach statistical significance. Addition of IL-10 significantly reduced spontaneous IFN-g synthesis in cell cultures from IDH patients. Neutralization of IL-15 was more effective than neutralization of IL-2 in modulating IFN-gamma production in IDH patients. The HTLV-1 proviral load was significantly higher in IDH patients (n=17) than in HTLV-1 carriers (n=32) and similar that observed in HAM/TSP patients (n=31). Conclusion: The immunological abnormalities in IDH are similar than that observed in HAM/TSP patients, giving support to the clinical observation of high risk of IDH patients to progress for HAM/TSP.

ASSUNTO(S)

htlv-1 proviral load imunologia carga proviral dermatite infecciosa cytokines htlv-1 infective dermatitis citocinas

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