This fact may also explain the observation of intense neutrophil infiltration. Few studies have investigated the role of Ki67 and Bcl-2 in infectious diseases and those evaluating these markers in oral and nasal mucosa have focused on dysplasias and cancer (34–37). The finding of proliferating cells (Ki67+) concurrent with Bcl-2 suggests an environment of intense inflammatory activity with increasing numbers of inflammatory cells. The number of Ki67+ cells was significantly
Roxadustat clinical trial higher in oral ATL lesions. This finding might be related to the shorter duration of oral lesions compared to nasal lesions. Proteins of the Bcl-2 family play an important role in the control of cell death (apoptosis) and T- and B-lymphocyte proliferation. In our study, the number of Bcl-2+ cells was much higher
in ATL lesions than in healthy tissues, suggesting a proliferative environment characterized by the accumulation of activated cells, which may be resolved when the stimulus triggered by the parasite starts to decline. click here In addition, Ki67 and Bcl-2 expression levels were similar to those reported for cutaneous ATL lesions (14). A higher expression of Fas and FasL was observed in mucosal ATL lesions than in healthy tissues. The importance of Fas/FasL for the control of inflammation has been demonstrated in cutaneous tissues (38) and intestinal mucosa (39–41), but few studies investigated the mucosa (42,43). The expression of FasL in ATL mucosa suggests that, even during intense proliferation, some cells may be induced to apoptosis, thus controlling inflammation, although the process is still incipient. In mouse leishmaniasis, these molecules have a role during in vivo lesion healing (44). Taken together, our results demonstrated
similar inflammatory responses in nasal and oral ATL lesions and a close relationship with those induced in cutaneous lesions (14,15). However, oral lesions had higher numbers of neutrophils, parasites, proliferating cells and NOS2 molecules than nasal lesions. These findings, together with the shorter duration of oral lesions and more intense clinical symptoms, suggest the presence of a more recent inflammatory process. The shorter duration of oral lesions may be explained by lesion-induced oral cavity changes that lead to eating Resminostat difficulties and certain social problems. Concomitant poor tooth conservation and inflammatory processes in the gingiva tend to amplify tissue destruction and clinical symptoms. On the other hand, the same associations may impair and confuse the correct diagnosis of patients, thus delaying the onset of specific treatment (4). Furthermore, the diagnosis is difficult even for experienced pathologists because the identification of Leishmania spp. is not always possible (45). Some questions remain obscure regarding the cause of intense tissue destruction triggered by mucosal lesions when compared to cutaneous lesions.