SHORT REPORT: PERSISTENCE OF TUMOR NECROSIS FACTOR-α IN SITU AFTER LESION HEALING IN MUCOSAL LEISHMANIASIS

VALDIR S. AMATO Department of Infectious and Parasitic Diseases, and Laboratory of the Discipline of Pathology of Transmissible Disease, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Institute of Tropical Medicine of Sao Paulo, Sao Paulo, Brazil

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HEITOR F. ANDRADE JR. Department of Infectious and Parasitic Diseases, and Laboratory of the Discipline of Pathology of Transmissible Disease, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Institute of Tropical Medicine of Sao Paulo, Sao Paulo, Brazil

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VICENTE AMATO NETO Department of Infectious and Parasitic Diseases, and Laboratory of the Discipline of Pathology of Transmissible Disease, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Institute of Tropical Medicine of Sao Paulo, Sao Paulo, Brazil

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MARIA IRMA S. DUARTE Department of Infectious and Parasitic Diseases, and Laboratory of the Discipline of Pathology of Transmissible Disease, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Institute of Tropical Medicine of Sao Paulo, Sao Paulo, Brazil

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Mucosal leishmaniasis (ML) is a disease characterized by intense activation of inflammatory cells and extensive tissue destruction. Among the cytokines involved in the immune response to ML, tumor necrosis factor-α (TNF-α) has attracted strong interest because of its roles in the modulation of the immune response. We studied 20 patients with ML who provided biopsy specimens before treatment and after lesion healing obtained by specific therapy. The biopsy specimens were subjected to immunohistochemical analysis for in situ quantification of cellular and extra-cellular TNF-α. The amount of TNF-α was significantly lower in the healed lesions compared with pretreatment biopsy specimens, although TNF-α persisted at the tissue level even after lesion healing. This relevant finding demonstrates for the first time an in situ tissue reduction of TNF-α after treatment and shows persistence of TNF-α in healed lesions may be related to the maintenance of an immunopathologic background for relapses observed in ML.

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