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Revista da Sociedade Brasileira de Medicina Tropical

Print version ISSN 0037-8682

Rev. Soc. Bras. Med. Trop. vol.24 no.2 Uberaba Apr./June 1991

http://dx.doi.org/10.1590/S0037-86821991000200008 

ARTICLES

 

Isoniazid acetylating phenotype in patients with paracoccidioidomycosis and its relationship with serum sulfadoxin levels, glucose-6-phosphate dehydrogenase and glutathione reductase activities

 

 

Benedito Barraviera; Paulo Câmara Marques Pereira; Jussara Marcondes Machado; Maria Julia de Souza; Carlos Roberto G. Lima; Paulo Roberto Curi; Rinaldo Poncio Mendes; Domingos Alves Meira

Adress to correspondence

 

 


ABSTRACT

The authors evaluated the isoniazid acetylating phenotype and measured hematocrit, hemoglobin, glucose-6-phosphate dehydrogenase and glutathione reductase activities plus serum sulfadoxin levels in 39 patients with paracoccidioidomycosis (33 males and 6 females) aged 17 to 58 years. Twenty one (53.84%) of the patients presented a slow acetylatingphenotype and 18(46.16%) a fast acetylating phenotype. Glucose-6-phosphate- dehydrogenase (G6PD) acti vity was decreased in 5(23.80%) slow acetylators and in 4(22.22%) fast acetylators. Glutathione reductase activity was decreased in 14 (66.66%) slow acetylators and in 12 (66.66%) fast acetylators. Serum levels of free and total sulfadoxin Were higher in slow acetylator (p < 0.02). Analysis of the resultspermitted us to conclude that serum sulfadoxin levels are related to the acetylatorphenotype. Furthermore, sulfadoxin levels were always above 50 µg/ml, a value considered therapeutic. Glutathione reductase deficiency observed in 66% of patients may be related to the intestinal malabsorption of nutrients, among them riboflavin, a FAD precursor vitamin, inpatients with paracoceidioidomycosis.

Keywords: Isoniazid acetylating phenotype. Paracoccidioidomycosis. Glucose-6-phosphate dehydrogenase (G6PD). Glutathione reductase. Sulfadoxin.


RESUMO

Os autores avaliaram o fenótipo acetilador da isoniazida, hematócrito, hemoglobina, atividade da glicose-6- fosfato desidrogenase, glutationa redutase e os níveis séricos de sulfadoxina de 39 doentes com paracoccidíoidomicose, senão 33 do sexo masculino e 6 do feminino, com idades compreendidas entre 17 e 58 anos. Vinte e um (53,84%) doentes apresentaram fenótipo acetilador lento e 18 (46,16%) rápido. A atividade da glicose-6-fosfato desidrogenase (G6PD) esteve diminuída em 5 (23,80%) acetiladores lentos e 4 (22,22%) rápidos. A atividade da glutationa redutase esteve diminuída em 14 (66,66%) acetiladores lentos e 12 (66,66%) rápidos. Os níveis séricos de sulfadoxina livre e total foram maiores nos acetiladores lentos (p < 0,02). A análise dos resultados permite concluir que os níveis séricos de sulfadoxina relaciona-se com o fenótipo acetilador. Além disso, os níveis estiveram sempre acima de 50 µg/ml, níveis estes considerados terapêuticos. Por outro lado, a deficiência de glutationa redutase pode estar relacionada com a má absorção intestinal de nutrientes, entre eles riboflavina, vitamina precursora de FAD.

Palavras-chave: Fenótipo acetilador da isoniazida. Paracoccidioidomicose. Glicose-6-fosfato desidrogenase (G6PD). Glutationa redutase. Sulfadoxina.


 

 

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

 

 

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Adress to correspondence:
Dr. Benedito Barraviera
Faculdade de Medicina de Botucatu/UNESP
CP: 576
18610
Botucatu, SP, Brasil.

 

 

Recebido para publicação em 28/12/90.

 

 

Department of Infectious and Parasitologic Diseases, and Section of Statistics, School of Medicine of Botucatu, University Paulist State, São Paulo, SP, Brazil.
Research Supported by FUNDUNESP, Grant 007/89 and CNPq, Grant 300398/88-3.

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