Inter-relação de aspectos clínicos, histomorfométricos e imunoistoquímicos na paracoccidioidomicose oral

Abstract

The present study aimed at analyzing histomorphometric, immunohistochemical and clinical features of oral lesions of paracoccidioidomycosis. The sample comprised 50 medical charts and 50 paraffinized blocks of biopsed specimens of oral leisons, both from paracoccidioidomycosis patients diagnosed at Stomatology Department of Hospital São Lucas, PUCRS from 1977 to 2010. Data regarding disease duration, and size and number of oral lesions, as well as erythrocytes, leukocytes, lymphocytes, hematocrit, hemoglobin and erythrocyte sedimentation rate, were collected from medical charts. Histological cuts were obtained from the paraffinized specimens and subjected to hematoxylin and eosin (H&E), Gomori-Grocott and immunohistochemical staining. The sample was classified according to the density of granulomas, and the variables number and diameter of fungi, number and diameter of buds, and IL-2, TNF-alpha and IFN-gamma expression were analyzed and correlated. Bud diameter was significantly greater in intermediate density granulomas compared to higher density granulomas. The other variables (bud number, number and diameter of fungi, expression of IL-2, TNF-alpha and IFN-gamma, and clinical and hematological features) did not significantly change with the density of granulomas. There was a positive correlation between bud number and fungal cell number (r=0.834), bud diameter and fungal cell diameter (r=0.496), erythrocytes and number of fungi (r=0.420), erythrocytes and bud number (r=0.408), and leukocytes and bud number (r=0.396). Negative correlation occurred between number and diameter of fungal cells (r=-0.419), bud diameter and granuloma density (r=-0.367), TNF-alpha expression and number of fungal cells (r=-0.372), TNF-alpha expression and bud number (r=-0.300). Histological, immunological and clinical characteristics of oral lesions of chronic paracoccidioidomycosis did not differ significantly between patients in our sample. TNF-alpha levels in oral lesions were inversely correlated with intensity of infection.