Papel dos receptores TLR2 e TLR4 na produção de citocinas em pacientes chagásicos crônicos
Carregando...
Arquivos
Data
2016-02-26
Autores
Silva, Laura Denise Mendes da [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
A doença de Chagas (DC), causada pelo protozoário Trypanosoma cruzi (T. cruzi), é uma doença negligenciada e considerada um grave problema de saúde pública. A sua evolução no individuo infectado ocorre em duas fases distintas: a fase aguda que dura de 2 a 4 meses, caracterizada pela alta parasitemia, mas ausência de sinais e sintomas específicos, o que dificulta sua detecção, e a fase crônica na qual a maioria dos indivíduos é diagnosticada. Nessa fase, uma boa parte dos indivíduos apresenta a forma indeterminada ou assintomática da doença. No entanto, cerca de 30 a 40% dos indivíduos infectados desenvolvem a DC sintomática, que pode se apresentar na forma de doença cardíaca ou doença digestiva. Um dos desafios mais importantes no estudo da DC é a determinação dos mecanismos relacionados à resposta imune do hospedeiro que levam a essas diferentes apresentações clinicas. A resposta imune celular via liberação das citocinas pró-inflamatórias como IFN-y, TNF-α e IL-17 é considerada determinante na resistência do hospedeiro. No entanto, um fino controle da liberação dessas citocinas deve ocorrer para que a resposta não se intensifique ou não se perpetue e resulte em lesão tecidual, o que ocorre através da ativação de citocinas anti-inflamatórias como a IL-10 e o TGF-y. Esse controle de resposta seria responsável pelo não aparecimento de sintomas nos indivíduos com doença de Chagas assintomática. Os receptores de reconhecimento padrão (PRRs), particularmente os Toll-Like Receptors (TLRs) são extremamente importantes na definição do perfil de citocinas que será liberado em resposta a um microrganismo. Assim, a nossa hipótese foi de que pacientes com as formas sintomáticas e assintomáticas da doença liberam um padrão de citocinas mais inflamatório e anti-inflamatório respectivamente, devido ao fato de que os TLRs envolvidos na produção desses dois tipos de citocinas, com enfoque para o TLR2 e o TLR4, seriam diferentemente expressos ou ativados nesses dois grupos. Como esperado, detectamos que, células mononucleares de pacientes com a forma cardíaca liberam predominantemente IFN-y, TNF-α e IL-17 quando comparados com os demais grupos. Diferentemente, pacientes com a forma assintomática liberam níveis maiores de IL-10 e TGF-β. Detectamos ainda que o TLR2 e o TLR4 estão envolvidos tanto na produção de citocinas pró como anti-inflamatórias, detectadas respectivamente pelos pacientes sintomáticos e assintomáticos, o que nos permite concluir que a estimulação dos mesmos receptores pode levar a liberação de um padrão diferente de citocinas na dependência do grupo de pacientes testados. Os prováveis mecanismos que levam a essas diferenças são discutidos.
Chagas disease (CD), caused by the protozoan Trypanosoma cruzi (T. cruzi), is a neglected disease and considered a serious problem of public health. Its evolution in a infected host occurs in two distinct stages: the acute stage which lasts 2 to 4 months and is characterized by high parasitemia, but no detection of specific signs and symptoms, which difficult its detection, and the chronic stage in which most individuals are diagnosed. At this second stage, most individuals present the indeterminate or asymptomatic chronic disease. However, about 30 to 40% of them become symptomatic and present the cardiac or digestive disease. One of the most important challenges in the CD study is to determine the mechanisms related to the host immune response that lead to these different clinical manifestations. The cellular immune response characterized by the release of pró-inflammatory cytokines such as IFN-y, TNF-α and IL-17 is considered crucial in host resistance. However, it is suggested that a fine control of this response must occur in order to avoid a perpetuated inflammatory process which results in tissue injury. This control was found to be responsible by the absence of clinical symptoms in individuals with the indeterminate chronic form and depends on activation of anti-inflammatory cytokines such as IL-10 and TGF-β. The pattern recognition receptors (PRRs), particularly the Toll-Like Receptors (TLRs) are extremely important in defining the cytokine profile that will be released in response to a microorganism. Therefore, our hypothesis was that patients with symptomatic and asymptomatic disease release different profile of cytokines, i.e pró-inflammatory and anti-inflammatory respectively, because TLRs involved in the production of each profile of cytokines, would be differently expressed or activated in these two groups. As expected, we found that mononuclear cells of patients with the cardiac form release predominantly IFN-y, TNF-α and IL-17 when compared with other groups . In contrast, patients with asymptomatic disease release predominantly IL-10 and TGF-β. Of note, TLR2 and TLR4 were involved in the production of both, inflammatory and anti-inflammatory cytokines detected in symptomatic and asymptomatic patients, respectively. We conclude that stimulation of these receptors may lead to release of different profiles of cytokines in a dependency of the patients group that is being evaluated. Probable mechanisms involved in such differences are discussed.
Chagas disease (CD), caused by the protozoan Trypanosoma cruzi (T. cruzi), is a neglected disease and considered a serious problem of public health. Its evolution in a infected host occurs in two distinct stages: the acute stage which lasts 2 to 4 months and is characterized by high parasitemia, but no detection of specific signs and symptoms, which difficult its detection, and the chronic stage in which most individuals are diagnosed. At this second stage, most individuals present the indeterminate or asymptomatic chronic disease. However, about 30 to 40% of them become symptomatic and present the cardiac or digestive disease. One of the most important challenges in the CD study is to determine the mechanisms related to the host immune response that lead to these different clinical manifestations. The cellular immune response characterized by the release of pró-inflammatory cytokines such as IFN-y, TNF-α and IL-17 is considered crucial in host resistance. However, it is suggested that a fine control of this response must occur in order to avoid a perpetuated inflammatory process which results in tissue injury. This control was found to be responsible by the absence of clinical symptoms in individuals with the indeterminate chronic form and depends on activation of anti-inflammatory cytokines such as IL-10 and TGF-β. The pattern recognition receptors (PRRs), particularly the Toll-Like Receptors (TLRs) are extremely important in defining the cytokine profile that will be released in response to a microorganism. Therefore, our hypothesis was that patients with symptomatic and asymptomatic disease release different profile of cytokines, i.e pró-inflammatory and anti-inflammatory respectively, because TLRs involved in the production of each profile of cytokines, would be differently expressed or activated in these two groups. As expected, we found that mononuclear cells of patients with the cardiac form release predominantly IFN-y, TNF-α and IL-17 when compared with other groups . In contrast, patients with asymptomatic disease release predominantly IL-10 and TGF-β. Of note, TLR2 and TLR4 were involved in the production of both, inflammatory and anti-inflammatory cytokines detected in symptomatic and asymptomatic patients, respectively. We conclude that stimulation of these receptors may lead to release of different profiles of cytokines in a dependency of the patients group that is being evaluated. Probable mechanisms involved in such differences are discussed.
Descrição
Palavras-chave
Doença de Chagas, Citocinas, Receptores Toll-like, Sistema imune