Abstract

Paracoccidioidomycosis (PCM is classified into 4 clinical groups: asymptomatic or subclinical, juvenile acute/subacute, adult or chronic and residual forms. The chronic presentation is the most common (90%) of all human cases and takes months to years to become apparent. At diagnosis, pulmonary lesions are frequent with lesions being at different stages of development including fibrosis, a sequel that may also occurs de novo during antifungal therapy. ਀圀攀 栀愀瘀攀 猀琀甀搀椀攀搀 挀攀爀琀愀椀渀 椀洀洀甀渀攀Ⰰ 栀椀猀琀漀氀漀最椀挀愀氀 愀渀搀 爀愀搀椀漀氀漀最椀挀愀氀 愀猀瀀攀挀琀猀 漀昀 琀栀攀 瀀甀氀洀漀渀愀爀礀 氀攀猀椀漀渀猀 戀礀 甀猀椀渀最 漀甀爀 攀砀瀀攀爀椀洀攀渀琀愀氀 瀀甀氀洀漀渀愀爀礀 倀䌀䴀 洀漀搀攀氀 ⠀洀愀氀攀 䈀䄀䰀䈀⼀挀 洀椀挀攀 椀渀琀爀愀渀愀猀愀氀氀礀 椀渀漀挀甀氀愀琀攀搀 眀椀琀栀 㰀椀㸀倀愀爀愀挀漀挀挀椀搀椀漀椀搀攀猀 戀爀愀猀椀氀椀攀渀猀椀猀 ⠀倀戀⤀㰀⼀椀㸀  挀漀渀椀搀椀愀⤀⸀ 䐀攀瘀攀氀漀瀀洀攀渀琀 漀昀 氀攀猀椀漀渀猀 眀愀猀 昀漀氀氀漀眀ⴀ甀瀀 戀礀 栀椀猀琀漀瀀愀琀栀漀氀漀最礀 ⠀攀愀爀氀礀 愀渀搀 挀栀爀漀渀椀挀 瀀攀爀椀漀搀猀⤀ 愀渀搀 栀椀最栀ⴀ爀攀猀漀氀甀琀椀漀渀 挀漀洀瀀甀琀攀搀 琀漀洀漀最爀愀瀀栀礀ⴀ䠀刀䌀吀 ⠀挀栀爀漀渀椀挀 瀀攀爀椀漀搀猀⤀⸀ 吀栀攀 氀漀挀愀氀 椀洀洀甀渀攀 爀攀猀瀀漀渀猀攀 眀愀猀 洀攀愀猀甀爀攀搀 戀礀 搀攀琀攀爀洀椀渀椀渀最 搀椀昀昀攀爀攀渀琀 挀礀琀漀欀椀渀攀猀 椀渀 猀甀瀀攀爀渀愀琀愀渀琀猀 漀昀 瀀甀氀洀漀渀愀爀礀 栀漀洀漀最攀渀愀琀攀猀⸀  The results showed that during the early stages of infection (2hs to 2 wks) the lungs of Pb-infected mice presented a bronchopneumonic acute type response with PMNs accumulation that fused with each other to constitute a large, ill-defined accumulation located preferentially at the peribronchiolar level that evolved towards lympho-histo-plasmocytic infiltrates. This period of infection was accompanied by an intense pro-inflammatory cytokine burst. ਀䐀甀爀椀渀最 琀栀攀 挀栀爀漀渀椀挀 椀渀昀攀挀琀椀漀渀 猀琀愀最攀猀 最爀愀渀甀氀漀洀愀琀漀甀猀 爀攀愀挀琀椀漀渀 愀爀爀愀渀最攀猀 椀渀 ㌀ 搀椀昀昀攀爀攀渀琀 氀攀猀椀漀渀 瀀愀琀琀攀爀渀猀㨀 渀漀搀甀氀愀爀ⴀ搀椀昀昀甀猀攀Ⰰ 挀漀渀昀氀甀攀渀琀 愀渀搀 瀀猀攀甀搀漀ⴀ琀甀洀漀爀愀氀 琀栀愀琀 眀攀爀攀 洀愀椀渀氀礀 氀漀挀愀琀攀搀 愀爀漀甀渀搀 琀栀攀 栀椀氀甀猀 愀渀搀 愀昀昀攀挀琀攀搀 洀漀爀攀 昀爀攀焀甀攀渀琀氀礀 琀栀攀 氀攀昀琀 氀甀渀最⸀ 䄀琀 琀栀攀 㠀琀栀 愀渀搀 ㄀㈀琀栀 眀欀猀 瀀漀猀琀ⴀ挀栀愀氀氀攀渀最攀Ⰰ 挀漀氀氀愀最攀渀攀猀椀猀 爀攀愀挀栀攀搀 椀琀猀 栀椀最栀攀猀琀 瀀攀愀欀 眀椀琀栀 瀀愀爀琀椀挀甀氀愀爀 椀渀瘀漀氀瘀攀洀攀渀琀 漀昀 琀栀攀 瀀攀爀椀愀爀琀攀爀椀愀氀 猀瀀愀挀攀⸀ 䌀礀琀漀欀椀渀攀 瀀爀漀昀椀氀攀猀 挀栀愀渀最攀搀 猀栀漀眀椀渀最 愀渀 椀洀洀甀渀漀猀甀瀀瀀爀攀猀猀椀瘀攀 瀀愀琀琀攀爀渀⸀   We also evaluated the effects of itraconazole (ITC) treatment, alone or plus pentoxifilline (PTX) beginning at 4th or 8th week after Pb-infection. The ITC+PTX therapy resulted in a significantly and more rapid reduction of granulomatous inflammation and pulmonary fibrosis when compared with the results of classical antifungal therapy using ITC alone. These promissory results open a new window for implementing novel treatment strategies for PCM patients and with other diseases leading to fibrotic sequelae.਀㰀⼀昀漀渀琀㸀㰀⼀瀀㸀㰀戀爀㸀㰀戀㸀䬀攀礀眀漀爀搀㨀 㰀⼀戀㸀☀渀戀猀瀀㬀倀愀爀愀挀漀挀挀椀搀椀漀椀搀漀洀礀挀漀猀椀猀Ⰰ 䤀洀洀甀渀攀 爀攀猀瀀漀渀猀攀Ⰰ 䠀椀猀琀漀瀀愀琀栀漀氀漀最礀Ⰰ 䘀椀戀爀漀猀椀猀㰀⼀琀搀㸀㰀⼀琀爀㸀㰀⼀琀愀戀氀攀㸀㰀⼀琀爀㸀㰀⼀琀搀㸀㰀⼀琀愀戀氀攀㸀㰀⼀戀漀搀礀㸀㰀⼀栀琀洀氀㸀