DIFFERENTIAL CORRELATION BETWEEN INTERLEUKIN PATTERNS IN DISSEMINATEDAND CHRONIC HUMAN PARACOCCIDIOIDOMYCOSIS

In an attempt to understand better the immunoregulatory disorders in p aracoccidioidomycosis (PCM), the possible correlation between interleu kin pattern, lymphoproliferation, C-reactive protein (CRP) and specifi c antibody levels was investigated in the polarized clinical forms of this disease. We studied 16 PCM patients, eight with the disseminated disease (four under treatment and four non-treated) and eight with the chronic disease. The patients with disseminated disease exhibited hig h antibody titres specific to Paracoccididoides brasiliensis antigen c ompared with patients with the chronic form of disease. Tumour necrosi s factor (TNF), IL-1, IL-6 and CRP in the serum of non-treated dissemi nated PCM patients were increased, which correlated positively with th e low mitogenic response of peripheral blood mononuclear cells (PBMC) to phytohaemagglutinin (PHA) (P<0.01) and with the high antibody titre s (P<0.001) of these patients. Moreover, we found in the disseminated PCM patients positive correlations between IL-1 and IL-6 (P=0.0007); I L-1 and TNF (P=0.0045); IL-I and IL-6 with the high antibody titres (P =0.0834 and P=0.0631, respectively); IL-1, IL-6 and TNF with CRP level s. By contrast, no correlations were found with those interleukins in the treated disseminated and chronic patients or in controls. It was i nteresting to find an inverse correlation between IL-4 and antibody pr oduction in non-treated disseminated PCM (r=-0.4770); moreover, a sign ificant correlation (P=0.0820) was found in chronic PCM patients with respect to the low level of either IL-4 and antibody titres against fu ngus antigen. Chronic PCM patients also had IL-2 levels inversely corr elated with antibody production (r=-0.6313; P=0.0628). Inverse correla tions were also observed between IL-2 and IL-6 levels in non-treated d isseminated patients (P=0.0501) and between IL-2 and IL-4 in chronic p atients (P=0.0131). The inflammatory cytokines might have a pivotal ro le in the genesis and in control of some aspects of the disease, such as granulomatous reaction, hypergammaglobulinaemia and depression of T cell-mediated immunity in PCM.