RESUMO
This report describes a case of a 49-year-old man with cough, recurrent hemoptysis, and dyspnea during 18 months, presenting with radiological findings of alveolar infiltrate and cystic lesions in left upper lobe. Laboratory studies revealed normocytic hypochromic anemia and normal coagulation tests. C-reactive protein and mucoproteins were negative. Serum protein electrophoresis and complement, urinalysis, serum creatinine, creatinine clearance, and 24-hour urine protein were normal. Tests for antineutrophil cytoplasmic antibodies and anti-glomerular-basement membrane antibodies were negative. Tests for connective tissue diseases were all negative. Histological findings were consistent with those of idiopathic pulmonary hemosiderosis. Radiological findings are discussed.
Assuntos
Cistos/diagnóstico , Hemossiderose/diagnóstico , Pneumopatias/diagnóstico , Cistos/patologia , Diagnóstico Diferencial , Hemossiderose/patologia , Humanos , Pneumopatias/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
Phagocytic cells play an important role in nonspecific resistance to fungal infection by mediating an inflammatory response and by a direct fungicidal action. In this study, the functional activity of peritoneal macrophages obtained from hamsters experimentally infected with strain Pb18 of Paracoccidioides brasiliensis was evaluated during 16 weeks of infection. The results showed that macrophages had a higher spreading ability associated with increased production of tumor necrosis factor alpha (TNF-alpha) and enhanced fungicidal activity during the early periods of infection. TNF-alpha levels remained elevated during all periods studied, while low levels of interleukin-1 beta (IL-1 beta) were produced during the infection. A necrotic area with dead fungi was observed at the inoculation site and the infection disseminated only to liver and lymph nodes in a few animals. These results suggest that during the early stages of infection with P. brasiliensis, macrophage activation by the high levels of TNF-alpha limited fungal dissemination. In contrast, in the later stages of infection, high levels of TNF-alpha were observed while the fungicidal activity of macrophages was lower and the animals presented loss of vitality resulting in their death. These observations suggest a complex role of TNF-alpha in experimental paracoccidioidomycosis of Syrian hamsters, involving not only resistance but also pathogenesis.
Assuntos
Interleucina-1/biossíntese , Macrófagos Peritoneais/imunologia , Paracoccidioides/imunologia , Paracoccidioidomicose/imunologia , Fator de Necrose Tumoral alfa/biossíntese , Animais , Cricetinae , Ativação de Macrófagos , Masculino , Mesocricetus , Paracoccidioides/crescimento & desenvolvimento , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/microbiologia , Paracoccidioidomicose/patologia , Testículo/patologiaRESUMO
OBJECTIVES: To evaluate the effect of increased of laryngeal mask airway (LMA) intracuff pressures on the laryngopharyngeal mucosa. STUDY DESIGN: Animal model. METHODS: Sixteen mixed-breed dogs were randomly allocated to two groups, G1 (intracuff volume, 30 mL; n = 8) and G2 (intracuff volume, 54 mL; n = 8), to produce, respectively, high or very high intracuff pressures. Anesthesia was induced and maintained with pentobarbital. Intracuff pressures were measured immediately after insertion and inflation of a No. 4 laryngeal mask airway (LMA) and 30, 60, 90, and 120 minutes thereafter. The dogs were euthanized, and biopsy specimens from eight predetermined areas of the laryngopharynx in contact with LMA cuff were collected for light microscopic (LM) and scanning electron microscopic (SEM) examination. RESULTS: Initial LMA cuff inflation in G1 and G2 resulted in intracuff pressures of 119 mm Hg +/- 4 mm Hg and 235 mm Hg +/- 13 mm Hg, respectively. Over a 2-hour period, the intracuff pressure decreased significantly in G1 (P < .001) and G2 (P < .01), and there was a significant difference between the groups over time (P < .001). The LM study of laryngopharyngeal mucosa in both groups showed mild congestion in the subepithelial layer. There were no differences between the groups (P > .10) or among the areas sampled (P > .10). In some areas of G2, the SEM study showed epithelial desquamation that was more intense than that in G1. CONCLUSIONS: The increase in LMA intracuff pressure caused only mild alterations in the laryngopharyngeal mucosa of the dog.
Assuntos
Máscaras Laríngeas , Laringe/lesões , Faringe/lesões , Animais , Cães , Feminino , Laringe/patologia , Masculino , Microscopia Eletrônica de Varredura , Mucosa/lesões , Mucosa/patologia , Faringe/patologia , PressãoRESUMO
Adult Swiss (susceptible) and BALB/c (non-susceptible) mice were inoculated by the intravenous route with 1 x 10(6) yeast cells of Paracoccidioides brasiliensis, strain 18. Immunologic parameters, histopathology and features of the bronchoalveolar lavage (BAL) were evaluated at week 2, 4, 8 and 16 post-infection. The pulmonary infection was progressive in Swiss mice and regressive in Balb/c mice. The numbers of total cells, lymphocytes and polymorphonuclear neutrophils increased in BAL, as well as the percentages of giant cells, and CD4 and CD8 positive cells. The ultrastructural study of BAL cells revealed a predominance of macrophages and a frequency of 13.2% of type II pneumocytes. As the infection progressed, the number of fungal cells and spreading macrophages, as well as the stimulated release of H2O2 by macrophages, increased. The animals exhibited an exacerbation of the humoral immune response and a depression of cellular immunity during the infection. There was a good correlation between the intensity and the pattern of the pulmonary histopathology and the cellular findings in the BAL. The present model reproduces some anatomoclinical patterns of the human disease and shows that BAL may be a useful tool in monitoring the pulmonary infection caused by P. brasiliensis.
Assuntos
Líquido da Lavagem Broncoalveolar/citologia , Pneumopatias Fúngicas/patologia , Pulmão/patologia , Paracoccidioidomicose/patologia , Animais , Anticorpos Antifúngicos/sangue , Líquido da Lavagem Broncoalveolar/imunologia , Líquido da Lavagem Broncoalveolar/microbiologia , Contagem de Células , Ensaio de Imunoadsorção Enzimática , Peróxido de Hidrogênio/metabolismo , Hipersensibilidade Tardia , Imunidade Inata , Imunodifusão , Pulmão/imunologia , Pulmão/microbiologia , Pneumopatias Fúngicas/imunologia , Pneumopatias Fúngicas/microbiologia , Macrófagos Alveolares/fisiologia , Macrófagos Alveolares/ultraestrutura , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Paracoccidioides/imunologia , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/imunologia , Paracoccidioidomicose/microbiologia , Subpopulações de Linfócitos TRESUMO
We studied three different isolates of Paracoccidioides brasiliensis obtained from the mesenteric lymph node (D3LY1), the spleen (D3S1) and the liver (D3LIV1) of the same armadillo (Dasypus novemcinctus). Pulmonal inflammatory area was evaluated by intravenous inoculation of 10(6) yeast cells of each isolates in young, male, ddY mice. Moreover, the partial sequence of GP43kDa gene of P. brasiliensis was analyzed. The lung inflammatory area was greater in animals inoculated with isolate D3S1. The partial sequence of GP43kDa gene indicated that isolate D3S1 is different from isolates D3LY1 and D3LIV1. This study suggested that the same armadillo might be susceptible to multiple P. brasiliensis isolates simultaneously.
Assuntos
Antígenos de Fungos , Tatus/microbiologia , Proteínas Fúngicas/genética , Glicoproteínas , Paracoccidioides , Microbiologia do Solo , Microbiologia da Água , Animais , Sequência de Bases , Fígado/microbiologia , Pneumopatias Fúngicas/microbiologia , Pneumopatias Fúngicas/patologia , Linfonodos/microbiologia , Masculino , Mesentério , Camundongos , Dados de Sequência Molecular , Paracoccidioides/genética , Paracoccidioides/patogenicidade , Paracoccidioidomicose/microbiologia , Paracoccidioidomicose/patologia , Reação em Cadeia da Polimerase , Organismos Livres de Patógenos Específicos , Baço/microbiologiaRESUMO
Oa autores relatam caso de seminoma primário de mediastino em criança de 13 anos, do sexo masculino, sem sintomas clínicos. Exame tomográfico revelou massa cística no mediatino anterior de aproximadamente 10cm de diâmetro. Foi realizad cirurgia , com ressecçäo de tumor medindo 13x7x6cm, a maior parte representada por área cística unilocular. Microscopicamente, tratava-se de seminoma clássico, que, à semelhança dos originados nos testículos, apresentava hiperplasia linfóide e granulomas epitelióides; ao lado disso, havia formaçäo de corpúsculos de Hassal abortivos associados a intensa hiperplasia epitelial, cuja intensidade näo é relatada na literatura. Estes últimos aspectos sugerem fortemente que o seminoma tenha tido origem intratímica. Os autores chamam ainda a atençäo para a dificuldade de diagnóstico destes casos na biópsia de congelaçäo, podendo ser confundidos com timoma
Assuntos
Humanos , Masculino , Adolescente , Germinoma , Mediastino , Seminoma , Seminoma/diagnóstico , Seminoma/cirurgiaRESUMO
Paracoccidioidomycosis was induced in immunized (IM) and non-immunized (NI) mice. The histopathology, the number of fungi in the lungs, the cellular (footpad test--FPT and macrophage inhibition factor assay--MIF) and humoral (immunodiffusion test) immune response were investigated serially post-infection. In the IM mice, at days 1 and 3, there was intense and predominant macrophagic-lymphocytic alveolitis with loose granulomatous reaction; at day 30, inflammation was mild. In the NI group, up to day 3, the lesions were focal; later there was formation of extensive epithelioid granuloma. The number of fungi in IM mice were always smaller than those of NI group. Immunization alone induced positive FPT and MIF indices with low titer of antibody. After infection, there was a significant decrease of the FPT indices in the IM group, which we interpreted as desensitization due to trapping of sensitized lymphocytes in the lungs. In conclusion, (1) The lesional pattern of pulmonary paracoccidioidomycosis in IM mice was similar to that of a hypersensitivity pneumonitis. This reaction was probably effective in reducing the extension of the infection and decrease the number of fungi. (2) In this model, pulmonary resistance against P. brasiliensis seems to be related to local and systemic delayed-type hypersensitivity reaction.
Assuntos
Pneumopatias Fúngicas/imunologia , Paracoccidioidomicose/imunologia , Animais , Antígenos de Fungos/imunologia , Inibição de Migração Celular , Contagem de Colônia Microbiana , Imunidade Celular , Imunodifusão , Pneumopatias Fúngicas/microbiologia , Pneumopatias Fúngicas/patologia , Masculino , Camundongos , Paracoccidioides/imunologia , Paracoccidioidomicose/patologiaRESUMO
Bentonite particles uncoated and coated with soluble antigen of Paracoccidioides brasiliensis (Pb) were intravenously injected into mice with and without previous immunization with Pb antigen. The inflammatory reaction around the bentonite emboli in small lung vessels was quantitated and morphologically studied by light and electron (EM) microscopy, 2 to 8 days after challenge. In control nonimmunized animals, coated and uncoated bentonite particles caused mild and nonspecific inflammation made up by macrophages. By EM, they formed loosely aggregated clusters with cytoplasm containing few organelles and borders without interdigitation. In immunized mice injected with coated bentonite particles, the inflammatory area was significantly greater than that in nonimmunized animals in all periods of study with maximum difference at day 2. The inflammatory process at days 2 and 4 was characterized as mature granulomata, composed of macrophages with great number of organelles in the cytoplasm, large euchromatic nuclei and prominent nucleoli. Altogether these findings indicated a lesion with high metabolic activity, compatible with a granulomatous hypersensitivity reaction. At days 6 and 8, there was a change from mature to epithelioid granulomata, well demonstrated by EM which showed macrophages with characteristically interdigitated cytoplasmic borders. The results strengthen the importance of cellular immunity in the genesis of epithelioid granuloma in paracoccidioidomycosis and reinforce the usefulness of the present model in studies of the inflammatory cellular sequency and events in this mycosis.
Assuntos
Antígenos de Fungos/imunologia , Granuloma/patologia , Pulmão/patologia , Fungos Mitospóricos/imunologia , Paracoccidioides/imunologia , Paracoccidioidomicose/patologia , Animais , Feminino , Imunização , Inflamação , Pulmão/ultraestrutura , Camundongos , Microscopia Eletrônica , Microesferas , Paracoccidioidomicose/imunologiaRESUMO
Hypersensitivity pneumonitis was induced in mice immunized with Paracoccidioides brasiliensis and challenged, one week later, with soluble (SPbAg) or particulate (PPbAg) antigen (formalin-killed yeast cells), administered by the intratracheal route. Between 24 and 48 h post-challenge, animals developed an interstitial and intra-alveolar pneumonitis. Macrophages and lymphocytes arranged focally into loose or mature granulomata were observed by light and electron microscopy. The distribution and fate of antigens was studied by immunofluorescence. Three hours after challenge with SPbAg the lungs showed linear fluorescent deposits, whereas after challenge with PPbAg the pattern was globular, corresponding to the particulate antigen. After 24 and 48 h, the pattern was diffuse and finely granular in both groups, with a decreasing number of animals showing detectable fluorescence. Immunization induced a positive footpad swelling test (FPT) in all animals. After pulmonary challenge, there was a significant decrease in FPT indices, interpreted as desensitization due to trapping of specifically sensitized lymphocytes in the lungs. In conclusion, immunization induced a marked cellular immune response, the inflammatory pattern and the tempo of the induced pneumonitis being compatible with delayed hypersensitivity in the lungs. Immunized mice also cleared the injected antigens rapidly. These data suggest that hypersensitivity pneumonitis may be an expression of pulmonary resistance to infection with P. brasiliensis.
Assuntos
Alveolite Alérgica Extrínseca/imunologia , Antígenos de Fungos/imunologia , Fungos Mitospóricos/imunologia , Paracoccidioides/imunologia , Alveolite Alérgica Extrínseca/patologia , Animais , Modelos Animais de Doenças , Feminino , Imunofluorescência , Granuloma/patologia , Imunidade Celular , Imunização , Imunodifusão , Pulmão/patologia , Pulmão/ultraestrutura , Camundongos , Microscopia EletrônicaRESUMO
Bentonite particles coated with polysaccharide antigen or crude soluble antigen of Paracoccidioides brasiliensis were injected intradermally or intravenously in mice. In control animals that were not pre-immunized with P. brasiliensis antigens, coated and uncoated bentonite caused minimal and nonspecific inflammation around the cutaneous injection site or around the bentonite thrombi in small lung vessels after intravenous injection. However, in mice previously immunized with P. brasiliensis antigens, the coated bentonite particles boosted the humoral and cellular immune responses to P. brasiliensis and evoked intense inflammatory reactions. Twelve days after intradermal injection, the inflammatory reaction around the bentonite was rich in neutrophils, macrophages, lymphocytes and plasma cells associated with young granulation tissue. In intravenously injected mice, the pulmonary inflammation was maximal at day 2, and was characterized by a florid neutrophilic and macrophagic cellular infiltration around bentonite thrombi; in some foci, there was incipient organization to mature granuloma. However, in both models, there was no formation of epithelioid granulomata, demonstrating that in paracoccidioidomycosis cellular immunity alone, without the presence of intact micro-organisms, may not be enough for the development of this type of granuloma.