Serological follow-up of patients with paracoccidioidomycosis treated with itraconazole using Dot-blot, ELISA and Western-blot
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Data
1997-09-01
Autores
MARTINS, Rosana [UNESP]
MARQUES, Sílvio [UNESP]
ALVES, Marino [UNESP]
Fecchio, Denise [UNESP]
FRANCO, Marcello F. de [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Instituto de Medicina Tropical
Resumo
Vinte e sete pacientes portadores de paracoccidioidomicose (PCM) foram tratados com itraconazole (100-200 mg/dia no primeiro mês e 100 mg/dia até 6-8 meses) e avaliados sob o ponto de vista clínico e sorológico, até 3 e meio anos após o início do tratamento, utilizando-se os testes de Dot-blot e ELISA para medir os títulos de anticorpos IgG, IgA e IgM anti-P. brasiliensis, e Western-blot para determinar os anticorpos IgG, IgA e IgM contra os componentes antigênicos do fungo. Antes do tratamento, 81,5% (Dot-blot) e 84% (ELISA) dos pacientes apresentaram títulos elevados de anticorpos IgG anti-P. brasiliensis, que decresceram levemente com o tratamento. Por outro lado, as porcentagens de soros pré-tratamento com títulos elevados para anticorpos IgA e IgM foram menores (51,9% e 51,8%: Dot-blot; 16% e 36 %: ELISA, respectivamente); com o tratamento, entretanto, estes títulos tenderam mais frequentemente a se negativar. Antes do tratamento, as porcentagens de positividade para anticorpos IgG, IgA e IgM, avaliados por Western-blot, foram 96%, 20,8% e 41,6%, respectivamente. Componentes antigênicos de massas moleculares variando entre 16-78 kDa, 21-76 kDa e 27-78 kDa reagiram com anticorpos das classes IgG, IgA e IgM, respectivamente, As frações antigênicas com massas moleculares de 27, 33 e 43 kDa foram as mais frequentemente reativas com anticorpos da classe IgG, e a de 70 kDa para anticorpos IgA e IgM. Todos os pacientes apresentaram remissão da sintomatologia com o tratamento, durante o período de estudo. Os dados do presente trabalho confirmam a diversidade e a complexidade da resposta humoral dos pacientes com PCM e reforçam a importância de se utilizar diferentes testes sorológicos para se detectar anticorpos IgG, IgA e IgM anti- P. brasiliensis.
Twenty-seven mycologically proven cases of paracoccidioidomycosis (PCM) were treated with itraconazole (100-200 mg/day in month 1 and 100 mg/day until month 6-8) and evaluated clinically and serologically, up to 3.5 years post-therapy, using Dot-blot and ELISA for measuring the titers of IgG, IgA and IgM anti-P. brasiliensis antibodies and Western-blot for determining IgG, IgA and IgM antibodies against the antigen components of the fungus. Before treatment, 81.5% (Dot-blot) and 84% (ELISA) of the patients presented elevated IgG anti-P. brasiliensis antibody titers which dropped slightly with treatment. on the other hand, the percentages of pre-treatment high-titered sera for IgA and IgM anti-P.brasiliensis were lower (5l.9% and 5l.8%: Dot-blot; 16.5 and 36%: ELISA, respectively) but the titers tended to become negative more frequently with treatment. Prior to treatment, the percentages of positivity for IgG, IgA and IgM anti-P.brasiliensis antibodies in Western-blot were 96%, 20.8% and 41.6%, respectively. Antigens with molecular weights varying from 16-78 kDa, from 21-76 kDa and from 27-78 kDa were reactive for IgG, IgA and IgM antibodies, respectively. The most frequently reactive antigenic components had molecular weights of 27, 33 and 43 kDa for IgG, and 70 for IgA and IgM antibodies. During the period of study, the patients responded well to treatment. The present data confirm the diversity and complexity of the humoral response in PCM, and the importance of utilizing different serological tests to detect IgG, IgA and IgM anti-P. brasiliensis antibodies
Twenty-seven mycologically proven cases of paracoccidioidomycosis (PCM) were treated with itraconazole (100-200 mg/day in month 1 and 100 mg/day until month 6-8) and evaluated clinically and serologically, up to 3.5 years post-therapy, using Dot-blot and ELISA for measuring the titers of IgG, IgA and IgM anti-P. brasiliensis antibodies and Western-blot for determining IgG, IgA and IgM antibodies against the antigen components of the fungus. Before treatment, 81.5% (Dot-blot) and 84% (ELISA) of the patients presented elevated IgG anti-P. brasiliensis antibody titers which dropped slightly with treatment. on the other hand, the percentages of pre-treatment high-titered sera for IgA and IgM anti-P.brasiliensis were lower (5l.9% and 5l.8%: Dot-blot; 16.5 and 36%: ELISA, respectively) but the titers tended to become negative more frequently with treatment. Prior to treatment, the percentages of positivity for IgG, IgA and IgM anti-P.brasiliensis antibodies in Western-blot were 96%, 20.8% and 41.6%, respectively. Antigens with molecular weights varying from 16-78 kDa, from 21-76 kDa and from 27-78 kDa were reactive for IgG, IgA and IgM antibodies, respectively. The most frequently reactive antigenic components had molecular weights of 27, 33 and 43 kDa for IgG, and 70 for IgA and IgM antibodies. During the period of study, the patients responded well to treatment. The present data confirm the diversity and complexity of the humoral response in PCM, and the importance of utilizing different serological tests to detect IgG, IgA and IgM anti-P. brasiliensis antibodies
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Palavras-chave
aracoccidioidomycosis, Paracoccidioides brasiliensis, Serology, Itraconazole
Como citar
Revista do Instituto de Medicina Tropical de São Paulo. Instituto de Medicina Tropical, v. 39, n. 5, p. 261-270, 1997.