Avalia????o da resposta celular das subpopula????es de linf??citos e n??veis de plaquetas em pacientes com mal??ria vivax segundo hist??rico de infec????o pr??via de mal??ria

• Author(s): Chaves, Yury Oliveira
• Date: 2016
• Origin: Oasisbr
• Subject(s): Plasmodium vivax; Linf??citos; Plaquetopenia; CI??NCIAS BIOL??GICAS: IMUNOLOGIA
• Document Type: Master thesis
• Language: Portuguese

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CAPES - Coordena????o de Aperfei??oamento de Pessoal de N??vel Superior

The innate immune response in the acute phase of malaria results in an immune state that is profoundly altered can protect the host against a grave form of disease. The aim of this study was to evaluate the dynamics of cellular subpopulations of T lymphocytes (CD3+CD4+ e CD3+CD8+), B lymphocytes (CD5+CD19+ e CD5-CD19+) , NK (CD3+CD16+CD56+ e CD16+CD56+) and regulatory T cells ((CD4+CD25+FoxP3+) in patients infected with Plasmodium vivax according to exposure criteria provided malaria and hemoglobin and platelets. During May and November (2012) Peripheral blood samples from patients infected exclusively by P. vivax with uncomplicated malaria were separated into: Group 1 (Primo-infected), Group 2 (Last infection <7 months) and Group 3 (Last infection over 1 year). Mixed infections and co-infections with dengue were excluded by PCR. The expression of adhesion molecules (CD31 and CD54) molecule and memory (CD45RO) and cytokines IL-2, IL-4, IL-6, IL-10, IL-17, TNF-?? and IFN-??, were analyzed by Flow Cytometry. Hematological data showed that patients with vivax malaria had decreased percentages of lymphocytes (p <0.0001) compared to controls. Of the seventy-one patients, 36 were Primo infected; 16 had malaria <7 months and 19 for 1 more year. We observed significant differences in immunophenotyping in relation to the malaria patients recent (<7 months) relative to other features. These patients showed decreased amount of B1 lymphocytes (p=0.042) and T-CD8-CD69 (p=0.027). Was also noted Thrombocytopenia in patients infected with cousin directly proportional correlation with the subpopulations of activated CD4 and CD8 expression and PECAM-1 in CD8 T-lymphocytes. Marked differences in cytokine profile could be observed with cytokines TNF-?? compared with IL-10 and IL-6 and the reduction in the number of some lymphocyte subpopulations in patients whose last malaria occurred <7 months. These results would indicate immunocompensation of the immune response against severe disease in these individuals with recent history malaria, and the state is not immune from the Primo-infected patients could contribute to the change in platelet count behaving as a risk factor for the development of thrombocytopenia in malaria.

A resposta imune inata na fase aguda da mal??ria resulta em um estado imunol??gico que ?? profundamente alterado podendo proteger o hospedeiro contra uma forma grave da doen??a. O objetivo deste estudo foi avaliar a din??mica celular das subpopula????es de Linf??citos T (CD3+CD4+ e CD3+CD8+), Linf??citos B (CD5+CD19+ e CD5-CD19+) , NK (CD3+CD16+CD56+ e CD16+CD56+) e c??lulas T reguladoras (CD4+CD25+FoxP3+) em pacientes infectados pelo Plasmodium vivax segundo crit??rios de exposi????o previa de mal??ria e n??veis de hemoglobina e plaqueta. Durante maio e novembro (2012), amostras de sangue perif??rico de pacientes infectados exclusivamente pelo P. vivax com mal??ria n??o complicada foram separadas em: Grupo 1 (Primo-infectado); Grupo 2 (??ltima infec????o < 7 meses) e Grupo 3 (??ltima infec????o mais de 7 meses). Infec????es mistas e co-infec????es com dengue foram exclu??das por PCR. A express??o mol??culas de Ades??o (CD31 e CD54) e mol??cula de mem??ria (CD45RO e as citocinas IL-2, IL-4, IL-6, IL-10, IL-17, TNF-?? e IFN-??, foram analisadas por Citometria de Fluxo. Os dados hematol??gicos mostraram que os pacientes com mal??ria vivax apresentaram diminu??das as porcentagens de linf??citos (p <0.0001) em rela????o aos controles. Dos setenta e um pacientes, 36 foram Primo infectado; 16 tiveram mal??ria < 7 meses e 19 h?? mais 1 ano. Foi observado diferen??as significativas nas imunofenotipagens em rela????o ao aos pacientes com mal??ria Recente (< 7 meses) em rela????o aos outros hist??ricos. Esses pacientes apresentaram diminu??das quantidade de Linf??citos B1 (p=0.042) e T-CD8-CD69 (p=0.027).Foi tamb??m observada a Plaquetopenia acentuada nos pacientes primo infectados com correla????o diretamente proporcional com as subpopula????es de CD4 e CD8 ativados e express??o PECAM-1 em linf??citos T-CD8. Diferen??as acentuadas no perfil de citocinas puderam de ser observadas com as citocinas TNF-?? em rela????o com IL-10 e IL-6 e a redu????o no numero de algumas subpopula????es linfocit??rias nos pacientes cuja ultima mal??ria ocorreu < 7 meses Estes resultados seriam indicativos de imunocompensa????o da resposta imune contra formas graves da doen??a nestes indiv??duos com historia recente de mal??ria, e o estado n??o imune de pacientes do Primo infectadopoderia contribuir para a altera????o da contagem de plaquetas comportando-se como um fator de risco para o desenvolvimento de Plaquetopenia na mal??ria.