The Expression Of Dectin-1 And Related Cytokines In Mycetoma And Chromoblastomycosis

Background: Mycetoma is a chronic suppurative granulomatous disease in the skin and subcutaneous tissue that infected by a variety of fungi or bacteria after trauma.It occurs in tropical, subtropical, damp and rainy regions. Abscess, granuloma and antrum are its outstanding performance.Sometimes grains can be observed.The damage can invade deep tissue, including muscles, tendons, fascia, bones, causing periostitis,osteomyelitis, and osteonecrosis.Maybe the pathogenic fungus can cause bone damage,leading to serious deformity and disability.Chromoblastomycosis is chronic hyperplastic disease with the skin and subcutaneous tissue infected by a variety of fungi after trauma.It also occurs in tropical and subtropical regions. It usually performs granulomatous plaque, verrucous hyperplasia, ulcers and scabby.The damage mainly involves exposed parts such as limbs, impacting the function of body joints.These two diseases increase gradually in our country, and a study with a chronic skin mucous membrane chronic skin fungal infections- mucosal candidiasis confirmed that the defects of the pattern recognition receptor Dectin- 1 and its downstream signal sensor CARD9 can increase susceptibility of the disease.This important discovery has confirmed that the pattern recognition of natural immune defense against pathogenic fungi plays an important role.Objective: This study aims to monitor expression and its differences among Dectin- 1, IL-4, IL- 10, IFN-γ,TNF-α in skin lesions and peripheral blood of the patients with mycetoma and chromoblastomycosis. The role of Dectin-1 between the two kinds of fungal disease can be analyzed preliminarily.Methods: We collected 18 cases of subcutaneous tissue infection in dermatology clinic of Peking University Shen Zhen hospital from January 2013 to December 2015. All the infected patients carried out mycologic examination and histopathologic examination according to the criteria. The skin biopsy and peripheral venous blood(centrifugal- 80 ° cryopreservation) of 18 patients were be collected. At the same time we collected skin tissues of 18 normals. The 36 skin tissues were divided into three groups according to the disease.Group A contains 8 skin tissues with mycetoma;Group B 10 cases includes skin tissues with chromoblastomycosis;The rest of normal skin tissues belongs to group C.This research is divided into two parts;The first part is to detect the expression of Dectin- 1, IL-4, IL- 10, IFN-γ,TNF-α of pathological section of in three groups;We used immunohistochemical method to detect the expression of Dectin- 1, IL-4, IL-10, IFN-γ,TNF-α.The second part is to detect expression of each cytokine in the peripheral blood of group A, B;Remove out venous serum of cryopreservation, and test the expression of IL-4,IL- 10, IFN-γ,TNF-α by ELISA.Results: 1 The immunohistochemical test found that the integral optical density value ofDectin – 1, IL-4, IL-10, IFN-γ,TNF-α increased of infection group compared with normal group(p < 0.05);Compared with group B, the integral optical density value of Dectin – 1, IL- 4,IL-10, IFN-γ,TNF-α in group A is no difference(p > 0.05). Compared with group C, the integral optical density value of IL- 4, IFN-γ in group A increased(p < 0.05), while the integral optical density value of Dectin-1、IL-10、TNF-α in group A is no statistical difference(p > 0.05); Compared with group C,the integral optical density value of IL-4、IFN-γ、IL-10、TNF-α in group B increased(p < 0.05), while the integral optical density value of Dectin – 1 in group B no statistical difference(p > 0.05). 2 The expression of IL- 4,IL-10, IFN-γ,TNF-α is no difference between the peripheral blood of group A and B by Elisa(p >0.05).Conclusion: 1 Dectin- 1 can be expressed in normal skin. 2 The expression of Dectin-1 was increased in the skin tissues of fungal infection, which may indicate Dectin – 1 plays a role of mycetoma immunity. 3 The expression of IL-4,IL-10,IFN-γ,TNF-α of infected group were higher than normal group, which might suggest the correlation with Dectin- 1. 4 The expression of Dectin-1 is on differences between mycetoma and chromoblastomycosis, suggesting that Dectin-1 receptor recognition defense are widespread in the skin fungal infection.