title: Evaluation of bronchoalveolar cells in pulmonary paracoccidioidomycosis.
abstract: To investigate the local immune response, the cellular infiltrate and cytokine levels were analysed in bronchoalveolar lavage (BAL) from patients with pulmonary paracoccidioidomycosis. The group consisted of 19 patients aged 34-65 yrs. The diagnosis was confirmed by demonstration of the fungus in the sputum or BAL fluid and by serological tests. Cytospin preparations showed an increased number of lymphocytes and neutrophils in BAL. A higher number of CD8+ lymphocytes were observed in BAL compared with peripheral blood. Alveolar macrophages (AM) expressed approximately three-fold more major histocompatibility class II, intercellular adhesion molecule-1 and B7-2 molecules on their surfaces than their circulating counterparts, indicating that they had differentiated into activated macrophages inside the lungs. Cultured AM produced higher levels of interleukin (IL)-6, tumour necrosis factor (TNF)-alpha and macrophage inflammatory protein (MIP)-1alpha than peripheral blood monocytes. BAL fluid contained low but detectable amounts of IL-6, TNF-alpha and MIP-1alpha, and specific antibodies to Paracoccidioides brasiliensis, mainly of the immunoglobulin G2 isotype. As macrophage inflammatory protein-1alpha was shown to selectively attract CD8+ T-cells and this population was elevated in bronchoalveolar lavage, the data suggest that, besides macrophages, CD8+ T-cells may have an important role in the pathogenesis of pulmonary paracoccidioidomycosis.
authors.affiliation: Dept of Clinical Pathology, Faculty of Medical Sciences, State University of Campinas Medical School, Campinas, São Paulo, Brazil.
authors.forename: M C
authors.initials: MC
authors.lastname: Fornazim
authors.forename: A
authors.initials: A
authors.lastname: Balthazar
authors.forename: R
authors.initials: R
authors.lastname: Quagliato
authors.forename: R L
authors.initials: RL
authors.lastname: Mamoni
authors.forename: C
authors.initials: C
authors.lastname: Garcia
authors.forename: M H S L
authors.initials: MH
authors.lastname: Blotta
mesh_terms: D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry* / Q000166:cytology; D002454:Cell Differentiation; D054405:Chemokine CCL3; D054407:Chemokine CCL4; D016207:Cytokines / Q000032:analysis / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000502:physiology; D008172:Lung Diseases, Fungal / Q000276:immunology*; D019402:Macrophage Inflammatory Proteins / Q000032:analysis / Q000096:biosynthesis*; D016676:Macrophages, Alveolar / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010229:Paracoccidioidomycosis / Q000276:immunology*
chemical_list: D054405:Chemokine CCL3; D054407:Chemokine CCL4; D016207:Cytokines; D019402:Macrophage Inflammatory Proteins