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PENTOXIFYLLINE IMMUNOMODULATION IN THE TREATMENT OF EXPERIMENTAL CHRONIC PULMONARY PARACOCCIDIOIDOMYCOSIS
Author
Affilliation
Medical and Experimental Mycology Group. Corporación para Investigaciones Biológicas. Medellín, Colombia.
Medical and Experimental Mycology Group. Corporación para Investigaciones Biológicas. Medellín, Colombia / Universidad Pontificia Bolivariana. Escuela de Ciencias de la Salud, Medellin, Colombia.
Hospital Universitario San Vicente de Paúl. Department of Radiology. Medellin, Colombia.
Medical and Experimental Mycology Group. Corporación para Investigaciones Biológicas. Medellín, Colombia.
Hospital Universitario San Vicente de Paúl. Department of Radiology. Medellin, Colombia.
Medical and Experimental Mycology Group. Corporación para Investigaciones Biológicas. Medellín, Colombia.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Patologia. Rio de Janeiro, RJ, Brasil.
Medical and Experimental Mycology Group. Corporación para Investigaciones Biológicas. Medellín, Colombia. / Universidad de Antioquia. Microbiology School. Medellín, Colombia.
Medical and Experimental Mycology Group. Corporación para Investigaciones Biológicas. Medellín, Colombia / Universidad Pontificia Bolivariana. Escuela de Ciencias de la Salud, Medellin, Colombia.
Hospital Universitario San Vicente de Paúl. Department of Radiology. Medellin, Colombia.
Medical and Experimental Mycology Group. Corporación para Investigaciones Biológicas. Medellín, Colombia.
Hospital Universitario San Vicente de Paúl. Department of Radiology. Medellin, Colombia.
Medical and Experimental Mycology Group. Corporación para Investigaciones Biológicas. Medellín, Colombia.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Patologia. Rio de Janeiro, RJ, Brasil.
Medical and Experimental Mycology Group. Corporación para Investigaciones Biológicas. Medellín, Colombia. / Universidad de Antioquia. Microbiology School. Medellín, Colombia.
Abstract
Background: Pentoxifylline (PTX) is a methylxanthine compound with immunomodulatory and antifibrotic
properties. The simultaneous use of PTX and antifungal therapy (itraconazole) has previously been evaluated in an
experimental model of pulmonary paracoccidioidomycosis (PCM), a systemic fungal disease caused by the fungus
Paracoccidioides brasiliensis (Pb) and characterized by chronic inflammation and lung fibrosis that appears even after
a successful course of antifungal therapy. The results revealed prompt and statistically significant reductions in
inflammation and fibrosis when compared to itraconazole alone. However, the effect of monotherapy with PTX on
the host response to PCM has not been well-documented. Our aim was to determine the effect of PTX on the
course of pulmonary lesions and on the local immune response.
Results: At the middle and end of treatment, the Pb-infected-PTX-treated mice exhibited significant reductions in
lung density compared to the Pb-infected-non-treated mice as assessed by the quantification of Hounsfield units
on high-resolution computed tomography (HRCT) (p <0.05 by Kruskal-Wallis test); additionally, at the end of therapy,
the lung areas involved in the inflammatory reactions were only 3 vs. 22 %, respectively, by histomorphometry
(p <0.05 by Mann–Whitney test), and this reduction was associated with a lower fungal burden and limited collagen
increment in the pulmonary lesions. PTX treatment restored the levels of IFN-γ, MIP-1β, and IL-3 that had been
down-regulated by Pb infection. Additionally, IL-12p70, IL-10, IL-13, and eotaxin were significantly increased, whereas
Regulated upon Activation, Normal T cell Expressed and Secreted (RANTES) levels were decreased in the lungs of
the Pb-infected-PTX-treated mice compared to the non-treated group.
Conclusions/significance: This study showed that PTX therapy administered at an “early” stage of granulomatous
inflammation controlled the progress of the PCM by diminishing the pulmonary inflammation and the fungal
burden and avoiding the appearance of collagen deposits in the pulmonary lesions.
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