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Histopathology of mucocutaneous leishmaniasis caused by Leishmania brasiliensis brasiliensis. 2. Tissue humoral response

The Authors analysed the humoral response in biopsy material from 90 patients with Mucocutaneous Leishmaniasis caused by Leishmania braziliensis braziliensis, utilising the immunoperoxidase method to identify IgA, IgG, IgM, C3 complement fraction and fibrin in the tissue. The presence of IgG, IgA and IgM was found in tissue plasma cells with a predominance of IgG and this was correlated significantly with the number of plasma cells in the lesion. The presence of immunoglobulins in the tissues stimulated the opsonisation of parasites and/or their antigens resulting in necrosis which represents one of the effective mechanisms to reduce parasite load. In ne- crotic areas and the walls of inflammed vessels immunoglobulins were deposited as well as the C3 fraction of complement and fibrin — immunocomplex fractions derived from the host. This tissue necrosis was interpreted as the result of the action of immunocomplexes in a region with equivalent or a smally excess of antigen (Arthus type reaction). The presence of parasite antigens expressed on the macrophage membrane in the initial phase of the lesion when in contact with tissue immunoglobulins, leads to the installation of an antigen-antibody reaction resulting in the appearance of necrosisin Mucocutaneous Leishmaniasis.

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