Abstract

Introduction. Recovery of the cell-mediated immunity is fundamental for the discontinuation of the antifungal therapy in paracoccidioidomycosis-patients (PCM-p). This study aims to quantify the T lymphocytes subsets of patients before, during and after treatment. Patients and methods. A total of 122 PCM-p, classified as to Mendes et al. (1994), were studied: 32 with acute/subacute form-AF (29 severe-AFs and 3 moderate) and 90 with chronic form-CF (27 severe-CFs, 54 moderate-CFm and 9 mild). PCM-p were evaluated at different moments: M1- before treatment (n=16); M2- under treatment, symptomatic (n=24); M3- asymptomatic, under treatment, positive DID (n=28); M4- asymptomatic, under treatment, negative DID (n=36); M5- asymptomatic, no-treatment, negative DID, within 2-year follow-up (n=44); M6- asymptomatic, no-treatment, negative DID, after 2-year discontinuation therapy (n=42). T lymphocytes subsets counts in 451 blood samples were immunolabelled using antibodies anti-CD3/CD4/CD8 (TriTEST kit-BD^TM) and analysed by flow cytometry; results were expressed as TCD3+, TCD4+, TCD8+ cells counts/mm³ and the TCD4+/TCD8+ ratio. The control group was constituted by 436 healthy individuals. Averages were compared by unpaired T test and ANOVA followed by Tukey test. Significance was set up at p<0.05. Results. 1. CD3 (normal range values: 755-2012) - AF vs. CF - M1: AF=1314; CF=1798, p=0.04; M2: AF=1318; CF=1924, p=0.05; M3: AF=1257; CF=1935, p=0.11; M4: AF=1475; CF=1686, p=0.35; M5: AF=1408; CF=1609, p=0.44; M6: AF=1226; CF=1660, p=0.15. 2. CD4 (437-1209) - AF vs. CF - M1: AF=849; CF=1144, p=0.14; M2: AF=836; CF=1245, p=0.03; M3: AF=798; CF=1173, p=0.16; M4: AF=842; CF=1026, p=0.17; M5: AF=868; CF=1064, p=0.27; M6: AF=763; CF=1126, p=0.08. 3. CD8 (180-774) - AF vs. CF - M1: AF=406; CF=564, p=0.07; M2: AF=393; CF=617, p=0.11; M3: AF=412; CF=696, p=0.11; M4: AF=514; CF=586, p=0.49; M5: AF=470; CF=492, p=0.80; M6: AF=419; CF=474, p=0.61. 4. CD4/CD8 ratio (1.0-3.1) - AF vs. CF - M1: AF=2.2; CF=2.5, p=0.64; M2: AF=2.1; CF=2.3, p=0.63; M3: AF=2.1; CF=2.0, p=0.81; M4: AF=2.0; CF=1.9, p=0.76; M5: AF=2.1; CF=2.4, p=0.46; M6: AF=1.9; CF=2.8, p=0.17. Conclusions. CD3 was higher in CF than in AF before treatment but within the normal limits. During the follow-up AF showed no variation and CF a tendency to decrease CD3 and CD8 and a decrease of CD4 in CFm after treatment.