Serum cytokines in patients with Brazilian pemphigus foliaceus (fogo selvagem)

Pemphigus foliaceus (PF) is characterized by acantholysis determined by IgG4 binding to desmoglein I, a 160-kDa desmosomal glycoprotein. To investigate the immunopathological aspects of Brazilian PF, we determined levels of serum cytokines in patients with PF. Twenty-five patients with PF and a control group consisting of 10 healthy individuals were studied. Serum IL-2, IL-4, IL-5, IL-10, IL-12 and IFN-gamma were measured in the two groups by ELISA. The median concentration of IL-2 was lower in PF patients compared to the control group (0.45 and 9.50 pg/ml, respectively), as also was the concentration of IL-4 (0.26 and 10.16 pg/ml, respectively). The same was observed for IL-5 (7.94 and 15.74 pg/ml, respectively) and for IFN-gamma (5.90 and 8.58 pg/ml, respectively). For IL-10 and IL-12, higher concentrations were observed in PF compared to the control group (IL-10: 24.76 and 20.92; IL-12: 2.92 and 1.17 pg/ml, respectively). Considering the Th1/Th2 paradigm, it seems that a Th2 profile, mainly represented by IL-10, predominates in PF

Nutritonal evaluation of pemphigus foliaceus patients on long term glucocorticoid therapy

Our objective was to compare food intake and nutritional status of Pemphigus Foliaceus patients (PG) on long term glucocorticoid therapy to a Control Group (CG). Fourteen PG female inpatients receiving prednisone (0.33 + or - 0.22mg/kg) for at least 12 months and twelve CG subjects were submitted to nutritional evaluation, including anthropometry, urinary creatinine determination and serum biochemical measurements, besides 48-h-based food intake records. Groups were compared by Chi-square, Mann-Whitney and "t" tests. PG patients and CG were paired, respectively, in relation to age (24.7 + or - 14.1 vs. 22.0 + or - 12.0 years), body mass index (25.8 + or - 6.4 vs. 24.0 + or - 5.6kg/m2), daily protein intake (132.9 + or - 49.8 vs. 95.2 + or - 58.9g), and serum albumin (median; range) (3.8; 3.5-4.1 vs. 3.8; 3.6-5.0g/dl). However, PG patients had lower height-creatinine index (64.8 + or - 17.6 vs. 90.1 + or - 33.4 percent), and higher daily energy (3080 + or - 1099 vs. 2187 + or - 702kcal) and carbohydrate (376.8 + or - 135.8 vs. 242.0 + or - 80.7g) intakes. Despite high food, protein and energy consumption, PG patients on long term glucocorticoid therapy had lower body muscle mass than controls, while showing high body fat stores. These findings are possibly related to combined metabolic effects of long term corticotherapy and inflammatory disease plus corticosteroid-induced increased appetite

Imunofluorescencia direta na pele aparentemente sã, lesada e perilesional e indireta no penfigo foliaceo endemico (Fogo selvagem) / Direct immunofluorescence on the apparently healthy, injured and perilesional and indirect skin in endemic foliaceous pemphigus (Wildfire)

As imunofluorescencias direta e indireta constituem importante diagnostico nos penfigos. Foram estudados o soro e a pele aparentemente sa, lesada, eperilesional de 47 doentes de penfigo foliaceo endemico, sendo 15 doentes nao tratados e 32 em tratamento com prednisona. Quanto a forma clinica, 29 possuiam a forma localizada e 18 a generalizada da doenca. Atraves da imunofluorescencia direta analisou-se a frequencia de deposicao de IgA, IgM, IgG e suas subclasses (IgG1, IgG2, IgG3 e IgG4) e a fracao C3 do complemento nos espacos intercelulares da epiderme nas tres peles. A imunofluorescencia indireta, analisou-se frequencia de positividade dos titulos sorologicos da IgG e suas subclasses (IgG1, IgG2, IgG3 e IgG4), assim como as medias dos titulos nos dois grupos

Provas de atividade inflamatória no penfigo foliáceo endêmico / Tests of inflammatory activity in endemic pemphigus foliaceus

Endemic pemphigus foliaceus (EPF) has its pathogenesis frequently associated to autoimmune phenomena. In this paper, a few routine laboratory tests, usually disturbed in some autoimmune diseases, were taken in 20 patients with EPF, which were screened for antinuclear antibodies (ANA), rheumatoid factor (RF), C-reactive protein (CRP) and changes of erythrocyte sedimentation rate (ESR), serologic proteins electrophoresis and total leucocyte count. The CRP was found in 60 per cent of cases, leukocytosis in 85 per cent , high ESR in all of them and mild alterations in serologic proteins analysis. No ANA or RF was found. Although widely accepted as nonspecific tests, we believe that an association of the laboratory routine tests with clinical findings, can prove to be helpful in the follow up care of these patients