Plasma levels of tumor necrosis factor-alpha in patients with visceral leishmaniasis (Kala-Azar). Association with activity of the disease and clinical remisson following antimonial therapy Níveis plasmáticos do fator de necrose tumoral-alfa (TNF-alfa) em pacientes com leishmaniose visceral (Calazar). Associação com atividade da doença e remissão clínica com terapia antimonial

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Reinaldo Salomão, Adauto Castelo Filho, Iara Marques de Medeiros, Miguel Angel Sicolo
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 1996
• Subjects: Cytokines; TNF-alpha; Visceral Leishmaniasis (Kala-Azar); Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic; Azar
• Online Access: https://doi.org/10.1590/S0036-46651996000200005; https://doaj.org/article/4b90ecde690e4f8fbb0c2d35a005fa08

Evaluation of TNF-alpha in patients with Kala-azar has drawn increasing interest due to its regulatory role on the immune system, in addition to its cachetizing activity. The objective of this study was to examine the association between plasma levels of TNF-alpha, measured by immunore-activity (ELISA) and bioactivity (cytotoxicity assay with L-929 cells), and clinical manifestations of visceral leishmaniasis. Plasma samples from 19 patients with Kala-azar were obtained before, during and at the end of antimonial therapy. TNF-alpha determinations was done by using the cytotoxicity assay (all patients) and the enzyme-linked immunoassay (ELISA - 14 patients). A discrepancy between results obtained by ELISA and cytotoxicity assay was observed. Levels of circulating TNF-alpha, assessed by ELISA, were higher in patients than in healthy controls, and declined significantly with improvement in clinical and laboratory parameters. Plasma levels before treatment were 124.7 ± 93.3 pg/ml (mean ± SD) and were higher than at the end of therapy 13.9 ± 25.1 pg/ml (mean ± SD) (p = 0.001). In contrast, plasma levels of TNF-alpha evaluated by cytotoxicity assay did not follow a predicted course during follow-up. Lysis, in this case, might be not totally attributed to TNF-alpha. The discrepancy might be attributed to the presence of factor(s) known to influence the release and activity of TNF-alpha. Avaliação de TNF-alfa em pacientes com calazar tem despertado grande interesse devido ao seu papel no sistema imunológico e à sua atividade caquetizante. O objetivo deste estudo foi examinar a associação entre os níveis plasmáticos de TNF-alfa, medidos através de sua imunorreatividade (ELISA) e bioatividade (ensaio citotóxico sobre as células L-929), e as manifestações clínicas da leishmaniose visceral. Amostras de 19 pacientes foram obtidas para determinação do TNF-alfa antes, durante e após a terapia antimonial, utilizando o ensaio de citotoxicidade (todos os pacientes) e o ELISA (14 pacientes). Resultados discrepantes entre os ...