COMUNICAÇÃO
INFLAMMATORY RESPONSE AGAINST TRYPANOSOMA
CRUZI PARASITISED CELLS FROM ADRENAL VEIN AND
MYOCARDIUM IN CHRONIC CHAGAS’ DISEASE
Maria Laura Pinto Rodrigues, Maria das Graças Reis, João Franquini
Júnior, Eumênia Costa da Cunha Castro, Marlene Antônia dos Reis e
Vicente de Paula Antunes Teixeira
R e v i s t a d a S o c i e d a d e B r a s i l e i r a d e M e d i c i n a T r o p i c a l 2 9 ( 5 ) : 5 0 7 - 5 0 8 , s e t - o u t , 1 9 9 6 .
W e c o m p a re d in C h a g a s ’ p a tie n ts th e relatio nship b e tw e e n leu c o c y te exu d ate and
T iy p a n o s o m a c ru z i nests in the c entral v ein o f the ad renal g land (CV A G) and nests in the m y o card iu m . Th e inflam m ato ry resp o n se to nests in the m y o card iu m w as m o re freq u ent and stro n g er than to the CVA G o n e. Th ese results su g g est that a p ec u liar env iro nm ent in the CVA G w o u ld m o d ify' T. c m z i surv iv al.
W e h av e p rev io u sly p u b lished a p ap er stressing the hig her freq u en c y o f T. c ru z i nests in the c entral v ein o f ad renal g land (CVA G) (50% ) w h e n c o m p ared to the left v entricu lar m y o card iu m (LVM) (17% ) in p atients w ith c h ro n ic C hag as’ d isease4. T h o se results co u ld b e related to a m ild er inflam m ato ry resp o nse ag ainst the p arasite o r its p ro d u cts in the C V A G . In th i s w o r k , w e c o m p a r e th e in f lam m ato ry re s p o n s e ( f o c a l le u c o c y te exu d ate-FLE) to am astig o te nests o c c u rren c e in b o th CVA G an d LVM.
W e d eterm ined the to p o g rap hic relatio nship b e tw e e n FLE an d 45 n ests o f T. ci~ uzi rand o m ly se le c te d in the CVA G o f 18 p atients and 23
n ests d e tec ted in th e LVM o f 6 p atients. Th e
freq u ency o f “ad hering ” leu co cy tes to p arasitised c ells su rface w as also estim ated by analy sis o f a sing le h isto lo g ical sectio n . This p h en o m en o n w as classified as m ild in the p re sen c e o f o nly o n e o r tw o “ad hering " leu c o c y tes, m o d erate in the p re se n c e o f three to fiv e and m arked in the
Disciplina de Patologia Geral e Centro de ,Microscopia Eletrônica. Faculdade de Medicina do Triângulo Mineiro, Uberaba, Minas Gerais, Brasil.
This w o rk w as su p p o rte d by research grants from Fundação de Ensino e Pesquisa de Uberaba, Fundação de Amparo a Pesquisa do Estado de Minas Gerais and CNPq. A ddres s to: Prof. V icente de Paula A ntunes Teixeira. Disciplina de Patologia Geral/FMTM. Pça Manoel Terra s/n, 38015-050 U beraba - MG, Brasil.
Recebido para publicação em 31/08/96.
p resence o f six o r m o re. M o reo ver, w e ev alu ated the freq u en c y o f leu c o c y te inv asio n in these in fec ted c ells in the CVA G and LVM. Th e results w ere c o m p ared statistically b y the Chi- sq u are test. T h e lev el o f sig n ific an c e w as set at 5%.
T a b l e s 1 a n d 2 s h o w a to p o g r a p h i c c o m p ariso n o f am astig o te nests w ith FLE in the
CVA G o r LVM and th e o c c u rre n c e o f
p arasitised cells w ith “ad h erin g ” o r p enetrated leu c o c y tes, resp ectiv ely . FLE w ere fo u n d in 28.9% o f CVA G c ells su rro u nd ing s and in 69-9% o f p arasitised m y o card ial c ells (Fig u res 1 and 2). Th ree o r m o re “ad h erin g ” leu c o c y tes w ere o b serv ed in 8 .8 % o f CVA G c ells and in 47.8% o f m y o card ial cells. Besid es, leu c o c y te “ in v asio n ” w as fo u nd in 34.8% o f LVM nests. Th e results ab o v e w ere hig hly sig nificant.
T able 1 - F o c al leu c oc y te ex u dat e as so c iat ed w ith nests o f a T. cru z i
on the cen tral v ein ' ira 11 o f the ad r e n al g lan d an d in the left v en tricu lar m y oc ardiu m in c hro n ic patien ts.
Le u c o c y te in filtrate N Q o f T. c ru z i asso c iate d w ith n ests
n ests ab sen t p resen t nQ % n5 % C entral v ein o f
ad ren al g lan d 45 32 71.1 13 28.9 m y o card iu m 23 7 30.4 16 69.6 (X 2 - 1 0.28: p < 0 .0 0 5 )
Th e inflam m ato ry resp o n se to p arasitised m y o card ial c ells is m o re freq u en t and stro ng er than to c ells fro m the CVA G. W e intend to co m p lem en t this find ing w ith an elec tro n ic m ic ro sc o p ic au xiliary stud y , ac c o rd in g to Lo p es and c o lle g e s2. T h ese results su g g est that a p ec u liar ho rm o nal env iro m ent1 m ig ht fav o r
T. c ru z i surv iv al in the p re sen c e o f antip arasite im m unity . In ac c o rd an c e to rec en t p u b lished d ata3, w e p ro p o se that the CVA G m ay fu n c tio n as a p arasite reserv o ir in p atients w ith c h ro n ic C hag as’ d isease.
C o m un ic a ç ã o . R o drigues M LP, R eis M G , F ra n q u in i Jú n i o r J, C ast ro EC C , R eis M A , T eix eira VPA. Inflam m at o ry res p o ns e a ga ins t Trypanosom a cruzi p aras it is e d cells f ro m a d re t ia l v ein a n d m y o ca rd iu m in c h ro n i c C h a g a s ’ dis ease. R ev ista d a S o c ie da de B ras ileira d e M ed icin a Tro pical 2 9 :5 0 7 - 5 0 8 , set- o ut, 1 9 9 6 .
T able 2 - le u c o c y te s " adherin g ” to T. c ru z i nests o n the w all o f t he cen tral v ein o f the ad r e n al g lan d an d on t he left v en tric u lar m y oc ardiu m o f c hro n ic chcigasic patien ts.
Ny o f Q u an tify o f "ad h e re d " To tal n ests w ith N ests w ith le u c o c y te s . ad h e re d in v ad in g n ests z ero 1-2 3-5 a b o v e 6 le u c o c y te s le u c o c y te s
n
-1
% n0
% na % n e % n - % n - % C en tral v e in o f ad re n al g lan d 45 22 48.9 19 42 .2 2 4.4 2 4.4 23 51.1 0m y o c ard iu m 23 5 21.7 7 30 .4 5 21.7 6 26.1 18 78.3 8 34 .8
In v ad e d n ests: X2 = 17-7; p < 0.005.
F i g u re 1 - Sect io n o f c e n t ra l v ein o f a d re n a l g l a n d s ho w ing t he p re s e n c e o f aT . cruzi nes t (arro w ) as w ell as the a b s en t o f le uco cy t e infiltrat e (H aem at o x y lin a n d eo s in s t aining, X 8 0 ).
F i g u re 2 - Sect io n o f m y o ca rd iu m , s ho w in g “a d h e ri n g ” o r p e n e t r a t e d l e u c o c y t e s ( a r r o w ) i n t h e i n f e c t e d m y o cardio cy t e. to o b s erv e t he p re s e n c e o f f o c a l leuco cy t e e x u d a t e as s o ciat ed w ith T. cruzi nes t (H ae m at o x y lin a n d eo s in s t aining, X 6 0 0 ).
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