Lymphocyte transformation assay for C neoformans antigen is not reliable for detecting cellular impairment in patients with Neurocryptococcosis

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dc.contributor.authorRocha, Katya C.
dc.contributor.authorPinhal, Cinthia
dc.contributor.authorCavalcanti, Sonia
dc.contributor.authorVidal, Monica S. M.
dc.contributor.authorToscano, Matheus
dc.contributor.authorMoraes-Vasconcelos, Dewton
dc.contributor.authorDuarte, Alberto J. S.
dc.contributor.authorFonseca, Fernando Luiz Affonso [UNIFESP]
dc.contributor.authorAbreu, Luiz Carlos de
dc.contributor.authorValenti, Vitor E.
dc.contributor.authorGrumach, Anete S. G.
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionFac Med ABC
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniv Estadual Paulista
dc.date.accessioned2016-01-24T14:27:53Z
dc.date.available2016-01-24T14:27:53Z
dc.date.issued2012-10-30
dc.description.abstractBackground: Cryptococcus neoformans causes meningitis and disseminated infection in healthy individuals, but more commonly in hosts with defective immune responses. Cell-mediated immunity is an important component of the immune response to a great variety of infections, including yeast infections. We aimed to evaluate a specific lymphocyte transformation assay to Cryptococcus neoformans in order to identify immunodeficiency associated to neurocryptococcosis (NCC) as primary cause of the mycosis.Methods: Healthy volunteers, poultry growers, and HIV-seronegative patients with neurocryptococcosis were tested for cellular immune response. Cryptococcal meningitis was diagnosed by India ink staining of cerebrospinal fluid and cryptococcal antigen test (Immunomycol-Inc, SP, Brazil). Isolated peripheral blood mononuclear cells were stimulated with C. neoformans antigen, C. albicans antigen, and pokeweed mitogen. the amount of H-3-thymidine incorporated was assessed, and the results were expressed as stimulation index (SI) and log SI, sensitivity, specificity, and cut-off value (receiver operating characteristics curve). We applied unpaired Student t tests to compare data and considered significant differences for p<0.05.Results: the lymphotoxin alpha showed a low capacity with all the stimuli for classifying patients as responders and non-responders. Lymphotoxin alpha stimulated by heated-killed antigen from patients with neurocryptococcosis was not affected by TCD4+ cell count, and the intensity of response did not correlate with the clinical evolution of neurocryptococcosis.Conclusion: Response to lymphocyte transformation assay should be analyzed based on a normal range and using more than one stimulator. the use of a cut-off value to classify patients with neurocryptococcosis is inadequate. Statistical analysis should be based on the log transformation of SI. A more purified antigen for evaluating specific response to C. neoformans is needed.en
dc.description.affiliationUniv São Paulo, Fac Med, Dept Dermatol, Lab Dermatol & Immunodeficiencias, BR-01246903 São Paulo, Brazil
dc.description.affiliationFac Med ABC, Dept Morfol & Fisiol, BR-09060650 Santo Andre, SP, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Ciencias Biol, Diadema, SP, Brazil
dc.description.affiliationUniv Estadual Paulista, UNESP, Dept Fonoaudiol, Fac Filosofia & Ciencias, BR-17525900 Marilia, SP, Brazil
dc.description.affiliationFac Med ABC, Dept Patol, BR-09060650 Santo Andre, SP, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Ciencias Biol, Diadema, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipFaculdade de Medicina, Universidade de São Paulo
dc.description.sponsorshipUniversidade Estadual Paulista
dc.format.extent8
dc.identifierhttp://dx.doi.org/10.1186/1471-2334-12-278
dc.identifier.citationBmc Infectious Diseases. London: Biomed Central Ltd, v. 12, 8 p., 2012.
dc.identifier.doi10.1186/1471-2334-12-278
dc.identifier.fileWOS000314094100001.pdf
dc.identifier.issn1471-2334
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/35416
dc.identifier.wosWOS:000314094100001
dc.language.isoeng
dc.publisherBiomed Central Ltd
dc.relation.ispartofBmc Infectious Diseases
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectLymphocytesen
dc.subjectAntigensen
dc.subjectBiasesen
dc.subjectStatisticalen
dc.subjectCryptococcusen
dc.subjectMethodsen
dc.subjectCryptococcus neoformansen
dc.titleLymphocyte transformation assay for C neoformans antigen is not reliable for detecting cellular impairment in patients with Neurocryptococcosisen
dc.typeinfo:eu-repo/semantics/article
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