Fagocitose e viabilidade monocitária de pacientes com esquistossomose mansônica na forma hepatoesplênica submetidos à esplenectomia e ao auto-implante esplênico Phagocytes rate and cellular viability of the monocytes in patients with hepatosplenic schistosomiasis mansoni who underwent splenectomy and auto-implantation of spleen tissue

Abstract

Esquistossomose mansônica persiste como problema médico-social no nordeste brasileiro. Em crianças, o tratamento cirúrgico inclui esplenectomia e auto-implante esplênico. Este procedimento reduz a septicemia pós-esplenectomia. O objetivo deste estudo foi analisar a taxa de fagocitose e viabilidade de fagócitos mononucleares em portadores de esquistossomose hepatoesplênica, submetidos à cirurgia, de 1991 a 2001. Dos 22 indivíduos analisados, 11 eram portadores de esquistossomose hepatoesplênica, submetidos à esplenectomia e auto-implante esplênico (Grupo estudo) e 11 eram sadios (Grupo Controle). Os grupos tinham média de idades similar e procediam da mesma zona endêmica (Timbaúba-PE). Não se evidenciou diferença na taxa de fagocitose comparando-se o grupo controle (36,1%±4,9%) e o grupo estudo (33,5%±5,7%), p=0,2773. Todavia, a viabilidade dos fagócitos após estímulo com lipopolissacarídio foi maior (94%) no grupo controle, quando comparado ao grupo estudo (65%), pMansonic schistosomiasis remains a medical-social issue in Northeastern Brazil. In children, surgical treatment includes splenectomy and spleen autoimplantation. This procedure reduces post-splenectomy sepsis. The aim of this study was to analyze the phagocyte rate and the cellular viability of monocytes in patients with hepatosplenic schistosomiasis, who underwent splenectomy and spleen autoimplantation from 1991 to 2001. Of the 22 individuals analyzed, 11 were patients who underwent splenectomy and spleen autoimplantation (Study group) and 11 were healthy individuals from the same region (Control group). Both groups presented similar mean age. No difference was found in the phagocyte rate between the control group (36.1%±4.9%) and study group (33.5%±5.7%). However, phagocyte viability after stimulation with lipopolysaccharide was higher (94%) in control group, when compared to the study group (65%), p<0.001. It is possible to hypothesize that monocytes from the study group patients presented a reduced response to the microorganism challenge, in the face of a harmful and long-lasting stimulus.

Keywords

• Esquistossomose hepatoesplênica
• Esplenectomia
• Esplenose
• Monócito
• Fagocitose
• Hepatosplenic schistosomiasis
• Splenectomy
• Splenosis
• Monocyte
• Phagocytosis