Caracterização fenotípica das moléculas de adesão endotelial e leucocitária em amostras de lesão cutânea na doença de Hansen

Introduction: The infection caused by Mycobacterium leprae leads to a complex relationship parasite-host relationship based mainly on immunopathological aspects, that may result in lepromatous form, preseting a Th2 cell profile, or in the tuberculoid pole presenting a Th1 immune pattern. Rationale: In this process it was necessary to analyze the participation of the endothelium through expression profile of adhesion molecules, thus trying to understand how cell migration occurs in leprosy. Main Objective: the study will determine the profile of expression of adhesion molecule and the participation of the endothelium in the selection of cells to the formation of the inflammatory infiltrate seen in the disease. Specific objectives: to quantify the expression of the adhesion molecules ICAM-1; ICAM-2, VCAM-1; VLA-4; E-selectin; P-selectin. To analyze the expression of adhesion molecules according to the standard histopathological type infiltrate the poles of the disease. Quantitatively evaluate the presence of adhesion molecules and correlate these adhesins with different cell patterns seen at the poles of the infection. Methodology: The skin samples were sectioned taken portions were subjected to immunohistochemical analysis using monoclonal antibodies to ICAM-1; ICAM-2; VCAM-1; VLA-4; P-selectin and E-selectin markers. Results: immunostaining of ICAM-1, VCAM-1 and VLA-4 adhesins, showed a greater presence of these molecules on the endothelium of the tuberculoid form (TT) of the infection. ICAM-1 was presented with 9.92±1.11 cells/mm2 on TT form, whereas LT pole showed 5.87±1.1 cells/mm 2. The VCAM-1 averaged 18.28±1.46 cells/mm2 in TT form, while the lepromatous had on average 10.67±1.25 cells/mm2. The analysis of E-Selectin showed that the infection tuberculoid is present in an amount (13.00±1:59 cells/mm2), significantly (p <0.0001) higher than E-selectin when compared to lepromatous pole which had only 2.58±0:38 cells/mm2. Discussion: The increase quantity of immunoglobulins ICAM-1 and VCAM-1 result in strengthening the signaling of transmigration tissue through the relationship between LFA-1 with its endothelial connector ICAM-1. This same mechanism is involved in strengthening the relationship between the endothelium and migration of cells with Th1 profile towards the tissue. VLA-4 is directly linked to the infiltration of Th1 cell lines, being the mediator of the increased frequency of T CD4+ cells in inflamed tissue. The lack of VLA-4 and of VCAM-1 immunoglobulin can also result in inhibition of adhesion of Th1 lymphocytes. It is also important to notice that the ICAM-1 and VCAM-1 deficiency influences the migration of T CD8+ lymphocytes thus altering the presence of cytotoxic cells in the tissue. Conclusion: The study strengthens the role of the endothelium as one responsible for the profile found in tissue cells. Correlating the expression of adhesion molecules to the selectivity in cell migration, resulting in a direct influence on the immune response present in leprosy.Introdução: A infecção causada pelo Micobacterium leprae leva a uma complexa relação entre o parasito e o hospedeiro, baseada principalmente nos aspectos imunopatológicos, que podem resultar na forma virchoviana, apresentando um perfil de células Th2, ou no pólo tuberculóide que apresenta um padrão imunológico Th1. Justificativa: Neste processo se fez necessário analisar participação do endotélio através do perfil de expressão de moléculas de adesão, buscando assim o entendimento de como a migração celular ocorre na hanseníase. Objetivo Geral: determinara o perfil da expressão de moléculas de adesão e a participação do endotélio na seleção de células para a formação do infiltrado inflamatório visto na doença. Objetivos específicos: quantificar a expressão das moléculas de adesão ICAM-1; ICAM-2, VCAM-1; VLA-4; E-selectina; P-selectina. Analisar a expressão das moléculas de adesão de acordo com o tipo ao padrão do infiltrado histopatológico nos polos da doença. Avaliar de forma quantitativa a presença das moléculas de adesão e correlacionar estas adesinas com os diferentes padrões celulares vistos nos polos da infecção. Metodologia: as amostras de pele foram seccionadas e as porções retiradas foram submetidas a análise imunohistoquímica através de anticorpos monoclonais contra os marcadores ICAM-1; ICAM-2 ; VCAM-1; VLA-4; P-selectina e a E-selectina. Resultados: A imunomarcação das adesinas ICAM-1, VCAM-1 e VLA-4 demonstravam uma maior presença destas moléculas no endotélio da forma tuberculóide (TT) da infecção. O ICAM-1 apresentou-se com 9,92±1,11 células/mm2 na forma TT, enquanto que o polo LL apresentou 5,87±1.01 células/ mm2. O VCAM-1 apresentou uma média 18,28±1,46 células/mm2 na forma TT, enquanto o virchoviana apresentou em média 10,67±1,25 células/ mm2. A análise da E-Selectina demonstrou que no polo tuberculóide da infecção há uma quantidade (13,00±1.59 células/mm2), significativamente (p