Open Journal Systems

Toxoplasma reactivation after renal transplant – low expression of nitric oxide synthase and a Th2 pattern of immune response

Felipe Francisco Tuon, Daiane Maria Cordeiro

Resumo


Background: The mechanism of immunosuppression associated with reactivation of the toxoplasmosis in transplanted patients is known, but the interactions of the human cells and cytokines expression is not well established.

Case report: We described a case of toxoplasmosis reactivation in a renal transplanted patient with pneumonitis. The in situ expression of cytokines and cellular phenotypes was evaluated in this case.

Results: A Th2 pattern of immune response predominated with strong expression of TGF-beta, TNF-alpha and IL-10. The expression of IL-2 receptor, nitric oxide synthase and IFN-gamma were weak.

Conclusion: The reactivation of toxoplasmosis in the lung was associated with a Th2 pattern of immune response and decreased activity of macrophages.


Palavras-chave


Toxoplasmosis; Toxoplasma gondii; kidney transplantation; immune response;

Texto completo:

PDF (English)

Referências


(1) Derouin F, Debure A, Godeaut E, Lariviere M, Kreis H. Toxoplasma antibody titers in renal transplant recipients. Pretransplant evaluation and posttransplant follow-up of 73 patients. Transplantation 1987; 44:515-8.

(2) Wulf MW, van CR, Portier R, et al. Toxoplasmosis after renal transplantation: implications of a missed diagnosis. J Clin Microbiol 2005; 43:3544-7.

(3) Tuon FF, Guedes F, Fernandes ER, Pagliari C, Amato VS, Seixas Duarte MI. In situ immune responses to interstitial pneumonitis in human visceral leishmaniasis. Parasite Immunol 2009; 31:98-103.

(4) Moussallem TM, Guedes F, Fernandes ER, et al. Lung involvement in childhood measles: severe immune dysfunction revealed by quantitative immunohistochemistry. Hum Pathol 2007; 38:1239-47.

(5) Denkers EY, Gazzinelli RT. Regulation and function of T-cell-mediated immunity during Toxoplasma gondii infection. Clin Microbiol Rev 1998; 11:569-88.

(6) Hayashi S, Chan CC, Gazzinelli R, Roberge FG. Contribution of nitric oxide to the host parasite equilibrium in toxoplasmosis. J Immunol 1996; 156:1476-81.

(7) Barcan LA, Dallurzo ML, Clara LO, et al. Toxoplasma gondii pneumonia in liver transplantation: survival after a severe case of reactivation. Transpl Infect Dis 2002; 4:93-6.

(8) Liu YJ. TSLP in epithelial cell and dendritic cell cross talk. Adv Immunol 2009; 101:1-25.

(9) Gazzinelli RT, Wysocka M, Hayashi S, et al. Parasite-induced IL-12 stimulates early IFN-gamma synthesis and resistance during acute infection with Toxoplasma gondii. J Immunol 1994; 153:2533-43.

(10) Filice GA, Clabots CR, Riciputi PE, Goni-Laguardia O, Pomeroy C. Changes in cytokine levels during reactivation of Toxoplasma gondii infection in lungs. Infect Immun 1999; 67:2082-9.

(11) Gazzinelli RT, Eltoum I, Wynn TA, Sher A. Acute cerebral toxoplasmosis is induced by in vivo neutralization of TNF-alpha and correlates with the down-regulated expression of inducible nitric oxide synthase and other markers of macrophage activation. J Immunol 1993; 151:3672-81.

(12) Strannegard O, Lycke E. Effect of antithymocyte serum on experimental toxoplasmosis in mice. Infect Immun 1972; 5:769-74.

(13) Almawi WY, Melemedjian OK. Clinical and mechanistic differences between FK506 (tacrolimus) and cyclosporin A. Nephrol Dial Transplant 2000; 15:1916-8.

(14) Haque S, Dumon H, Haque A, Kasper LH. Alteration of intracellular calcium flux and impairment of nuclear factor-AT translocation in T cells during acute Toxoplasma gondii infection in mice. J Immunol 1998; 161:6812-8.

(15) Sullivan WJ, Jr., Dixon SE, Li C, Striepen B, Queener SF. IMP dehydrogenase from the protozoan parasite Toxoplasma gondii. Antimicrob Agents Chemother 2005; 49:2172-9.




DOI: http://dx.doi.org/10.5380/rmu.v2i4.42008

DOI (PDF (English)): http://dx.doi.org/10.5380/rmu.v2i4.42008.g27160

Apontamentos

  • Não há apontamentos.