La physiopathologie artérielle comprend différentes pathologies telles que l'hypertension, l'athérosclérose, l'hyperplasie intimale qui sont caractérisées par un remodelage artériel en réponse à différents stress environnementaux. Mon travail de thèse s'est intéressé à décrire les mécanismes cellulaires et moléculaires mis en jeu en réponse à un stress artériel dans des modèles murins et de proposer de nouvelles approches thérapeutiques dans la prévention des dommages artériels. Ainsi, nous nous sommes intéressés au rôle d'une isoforme particulière de la famille des phosphoinositide 3-kinase, la PI3Ky. Cette protéine est largement exprimée dans le compartiment hématopoïétique, où son activité catalytique intervient dans l'inflammation de la paroi artérielle, mais elle est également présente à de plus faible niveau dans les CML et les CE. Associée à son rôle catalytique largement impliqué dans la migration et la libération de facteurs inflammatoires, la PI3Ky a été décrite comme ayant des fonctions non-catalytiques, dite " d'ancrage ", activant des phosphodiestérases (PDE). Ainsi, en utilisant deux modèles murins génétiquement modifiés pour la PI3Ky, l'un délété pour la PI3Ky (PI3KyKO pour knockout) et l'autre exprimant une forme inactive de la PI3Ky (PI3KyKD pour kinase dead) nous avons pu évaluer le rôle des 2 fonctions dans des modèles murins de lésions artérielle. Dans un premier temps, nous nous sommes intéressés au rôle non-catalytique de la PI3Ky dans les CML. A partir d'un modèle murin de remodelage artériel induit par un stress hypertenseur nous avons observé que l'hyperplasie médiale des CML est dépendante de la PI3Ky, mais indépendante de son activité catalytique. In vitro à partir de cultures primaires de CML de souris nous avons démontré que la PI3Ky régule l'activité des PDE indépendamment de son activité, limitant les taux intracellulaires d'AMPc qui est un puissant frein de la prolifération des CML. Ces modèles nous ont aussi permis de tester une stratégie thérapeutique originale utilisant un peptide perméant inhibant l'interaction PI3Ky/PDE. Ce peptide est capable de prévenir à la fois la prolifération des CML in vitro mais aussi l'hyperplasie médiale in vivo. Dans un deuxième temps, nous avons étudié comment l'activité PI3Ky inflammatoire, inhibe la cicatrisation endothéliale suite à une lésion endovasculaire. A l'aide de différents modèles in vivo et ex vivo de réendothélialisation chez la souris, nous avons pu observer que suite à une lésion vasculaire l'activité de PI3Ky des lymphocytes T induit la sécrétion d'IFNy, entrainant une production locale de CXCL10 par les CML. Cette chimiokine va directement inhiber la cicatrisation endothéliale, indépendamment du compartiment immun. Ces travaux ont permis d'une part de démontrer que l'inhibition de la PI3Ky représentait une stratégie thérapeutique envisageable dans les complications de l'angioplastie mais ont également permis de montrer les mécanismes d'interactions cellulaires complexes mis en jeu lors d'une agression artérielle. Ils ont notamment permis de démontrer un rôle central de la CML agissant comme un relai entre l'inflammation adventitielle et l'endothélium. L'ensemble de ces données a pu mettre en avant une double fonction de la PI3Ky dans les processus de réponse à un stress inflammatoire ou hémodynamique. D'une part, son rôle pro-inflammatoire contrôlé par son activité catalytique, responsable d'une inhibition de la cicatrisation endothéliale via l'activation des CML. D'autre part, son rôle non-catalytique dans les CML, modulant leur prolifération via la signalisation de l'AMPc. Ces travaux permettent d'envisager de nouvelles stratégies thérapeutiques visant d'une part à inhiber son activité en utilisant des inhibiteurs hautement spécifiques pour cette isoforme et d'autre part des peptides capables de bloquer le rôle non catalytique de la PI3Ky. / Cardiovascular diseases represent the first cause of death worldwide and a large part of them concerns different arterial disorders as hypertension, atherosclerosis, intimal hyperplasia and aneurism. All of these diseases are characterized by arterial remodeling resulting in a complex collaboration between environment and arterial physiology participants: Blood flow, endothelial cells (EC), smooth muscle cells (SMC) and arterial inflammation. In this context, this thesis project is interested in y-isoform of phosphoinositide 3-kinase (PI3Ky). PI3Ky is largely expressed in hematopoietic compartment where its catalytic activity drives arterial wall inflammation, but it is also lower expressed in cardiovascular system such as SMC and EC. Moreover, in addition to catalytic function implicated in chemoattraction and release of inflammatory mediators, PI3Ky has been described to activate phosphodiesterases (PDE) activity, through a non-catalytic "docking" function. At first, this work studied studied non-catalytic docking function of PI3Ky in SMC. Using hypertension-induced arterial remodeling in mice showed that SMC hyperplasia was dependent of PI3Ky protein expression but independent of its activity. Further, in vitro exploration with primary-SMC from mice aorta highlighted that PI3Ky activates PDE independently of its catalytic function, which promotes SMC proliferation by hydrolysis of an anti-mitotic second messenger: the cyclic-AMP. In the same approach, we tested original therapeutic strategy using a permeant-peptide which inhibits PI3Ky/PDE interaction. This permeant-peptide showed good efficiency to prevent both in vitro SMC proliferation and in vivo arterial SMC hyperplasia. The second part of this work how PI3Ky activity in inflammatory cells modulates endothelial healing following endovascular injury. Using in vivo and ex vivo models of arterial de-endothelialization in mouse, we observed a cellular cross talk in arterial wall between T-cells, SMC and EC. PI3Ky activity in T-cells promotes IFNy secretion following arterial injury which indirectly decreases re-endothelialization through a local secretion of CXCL10 by SMC. Indeed, CXCL10 directly inhibits endothelial healing independently of immune compartment. Our findings provide a new promising target to promote endothelial repair and therefore prevent cardiovascular events following endovascular intervention.Altogether, these works unravel an interesting dual function of PI3Ky in arterial stress response. In one hand, catalytic function of PI3Ky drives inflammatory-induced inhibition of endothelial healing, and in other hand, non-catalytic function controls SMC proliferation via inhibition of cyclic-AMP pathway.

Submitted by Taiwany Oliveira (taiwanyrodriguess@gmail.com) on 2018-10-22T14:48:18Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) TESE DE DOUTORADO LIGIA FERNANDES ABDALLA.pdf: 4835970 bytes, checksum: 41de8abe90eea5b202c2800675761f12 (MD5) / Approved for entry into archive by Marcos Roberto Gomes (mrobertosg@gmail.com) on 2018-10-22T15:27:12Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) TESE DE DOUTORADO LIGIA FERNANDES ABDALLA.pdf: 4835970 bytes, checksum: 41de8abe90eea5b202c2800675761f12 (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2018-10-23T14:07:04Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) TESE DE DOUTORADO LIGIA FERNANDES ABDALLA.pdf: 4835970 bytes, checksum: 41de8abe90eea5b202c2800675761f12 (MD5) / Made available in DSpace on 2018-10-23T14:07:04Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) TESE DE DOUTORADO LIGIA FERNANDES ABDALLA.pdf: 4835970 bytes, checksum: 41de8abe90eea5b202c2800675761f12 (MD5) Previous issue date: 2018-09-26 / Zika virus (ZIKV) is an emergent arbovirus of the family Flaviviridae and the genus Flavivirus, which until 2007 was restricted to some cases of mild disease in Africa and Asia. In Brazil, it`s suspected that the entry of the virus occurred during the 2013 Confederations Cup and in the first half of 2015, there were already confirmed cases in states in all regions of the country. The Brazilian epidemic revealed that the usually mild and self-limiting infection could be related to neurological disorders. The objectives of this study were to clarify numerous questions regarding ZIKV infection, aiming to contribute to a better understanding of the mechanisms involved in the immunopathogenesis and course of the disease. As a result, the first report of atrial fibrillation in patients with Zika was described and could be considered an atypical manifestation during the virus infection; elevation of proinflammatory cytokines during ZIKV infection was observed; CXCL10 chemokine was identified as a potential biomarker for infection; saliva was characterized as the fluid of choice for the detection of Zika virus in the acute phase of the disease and a logistic regression model for the classification of cases of zika in relation to dengue was set up based on the clinical evaluation. / O Zika virus (ZIKV) é um arbovírus emergente da família Flaviviridae e do gênero Flavivirus, que até 2007 estava restrito a alguns casos de doença leve na África e na Ásia. No Brasil, suspeita-se que a entrada do vírus tenha se dado durante a Copa das Confederações de 2013 e no primeiro semestre de 2015, já havia casos confirmados em estados de todas as regiões do país. A epidemia brasileira revelou que a infecção geralmente leve e autolimitada poderia estar relacionada à distúrbios neurológicos. Os objetivos deste trabalho era esclarecer inúmeros questionamentos existentes em relação à infecção pelo ZIKV, visando contribuir com uma melhor compreensão dos mecanismos envolvidos na imunopatogênese e curso da doença. Como resultados, descreveu-se o primeiro relato de fibrilação atrial em pacientes com Zika, podendo ser considerado uma manifestação atípica durante a infecção pelo vírus; observou-se elevação de citocinas pró-inflamatórias durante a infecção ZIKV; identificou-se a quimiocina CXCL10 como um biomarcador potencial de infecção; caracterizou-se a saliva como fluído de escolha para o detecção do vírus Zika na fase aguda da doença e, montouse um modelo de regressão logística para a classificação de casos de zika em relação à dengue, com base na avaliação clínica.

Les adénocarcinomes lépidiques prédominant (ALP) sont une entité originale sur le plan histologique, clinique et biologique parmi les adénocarcinomes pulmonaires. Il s’agit de tumeurs non-mucineuses mais il existe un variant mucineux, l’adénocarcinome mucineux invasif (AMI), caractérisé par un plus mauvais pronostic et l’absence de traitement efficace dans les formes avancées. L’objectif de ce travail était d’étudier les différences moléculaires distinguant ALP et AMI et d’en dégager les implications biologiques. Après avoir détaillé les caractéristiques cliniques et les altérations oncogéniques d’une cohorte d’ALP et d’AMI, nous avons exploité les banques de prélèvements issus de cette cohorte. Une étude de l’expression en immunohistochimie des mucines MUC1, 2, 5B, 5AC et 6 au sein des pièces opératoires de 27 ALP et 27 AMI montrait un profil d’expression spécifique entre ALP et AMI. L’expression de MUC1 était associée aux ALP, celle de MUC5AC, 5B et 6 aux AMI. L’expression de MUC1 était associée aux mutations EGFR et MUC5B et 5AC aux mutations KRAS. Un réarrangement NRG1 a été détecté par FISH dans 1 AMI sur 25. La chimiokine CXCL10 était surexprimée dans les surnageants de lavages broncho-alvéolaires (LBA) de patients avec AMI (n=38) comparés aux ALP (n=25), et cette surexpression était de mauvais pronostic. La voie cytokine/récepteur CXCL10/CXCR3-A était surexprimée dans les AMI, faisait la promotion de la migration des cellules tumorales mucineuses et gouvernait l’expression tumorale de VEGF. Le VEGF issu du LBA des patients était à l’origine in vitro d’une augmentation significative de la formation de tubes vasculaires inhibée par l’anti-VEGF bevacizumab. Le ciblage de CXCL10/CXCR3-A et du VEGF pourraient être des options thérapeutiques dans les AMI. Ces résultats permettent d’affiner les connaissances biologiques des ALP et des AMI et dégagent des voies de recherche originales qui pourraient amener au développement de nouveaux traitements / Lepidic predominant adenocarcinoma (LPA) represents an original entity in terms of histological, clinical and biological characteristics among adenocarcinomas of the lung. While LPA is typically a non-mucinous adenocarcinoma, a mucinous variant does exist, termed invasive mucinous adenocarcinoma (IMA), associated with a worse prognosis and a lack of effective treatment in advanced diseases. This work sought to study molecular differences between LPA and IMA, and explore their biological meanings. A cohort of LPA and AMI has been studied in regard of clinical characteristics and oncogenic drivers and samples from this cohort were exploited. An immunohistochemical study of expression of mucins MUC1, 2, 5B, 5AC and 6 in surgical samples of 27 LPA and 27 IMA showed different profile of expression between LPA and IMA. MUC1 expression was associated to MUC1 and MUC5AC, 5B and 6 to IMA. MUC1 was associated to EGFR mutations and MUC5B and 5AC to KRAS mutations. One NRG1 rearrangement was detected by FISH in one in 25 IMA. The CXCL10 chemokine was overexpressed in bronchoalveolar lavage fluid (BALF) supernatants of IMA (n=38) compared to LPA (n=25). This overexpression was linked to worse prognosis. The cytokine/receptor axis CXCL10/CXCR3-A was overexpressed in IMA and promoted migration of mucinous tumoral cells and drived tumoral expression of VEGF. VEGF from BALF of patients significantly enhanced human lung endothelial tubes formation in vitro which was inhibited by anti-VEGF bevacizumab. CXCL10/CXCR3 and VEGF could present valuable therapeutic targets in IMA. These results improve knowledge in biology of LPA and AMI and identify new lines of research which could lead to development of new therapies.

After kidney transplantation the recipient's immune system responds to the donor's antigens and the graft rejection occurs. Borderline changes are a frequent diagnosis after kidney transplantation, representing only mild rejection signs. Some patients with borderline changes undergo progression to rejection. The identification of these at- risk patients by biomarkers will allow enhanced treatment and help to prevent the development of rejection. The aim of my work was to verify biomarkers of rejection in patients with borderline changes. Chemokines CXCL9, CXCL10 and CCL17 in urine/serum of 40 patients with subclinical borderline changes at 3 months and in 25 patients with early borderline changes were determined by ELISA. At 3 months, the higher CXCL10 level predicted rejection with AUC=0.749, p=0.024. High levels of CXL10 had also been found in patients with BKV infection. We did not confirm the relationship between rejection and the CXCL9 and CCL17. In the early posttransplant period the levels of CXCL10 and CXCL9 were elevated in all patients and therefore couldn't be used to predict rejection. The alloreactivity was examined using IFN-γ ELISPOT (n=38). No association between the frequency of IFN-γ producing cells after stimulation with donor cells or CMV peptides and the development of...

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A leishmaniose visceral causada por Leishmania infantum chagasi à caracterizada pela perda da habilidade do hospedeiro gerar uma resposta imunolÃgica eficaz. Neste estudo, foi investigado o papel da quimiocina CXCL10 no controle da infecÃÃo por L. infantum chagasi in vivo. Grupos de camundongos BALB/c foram tratados ou nÃo com CXCL10 (5 μg/kg) com 1, 3 e 7 dias de infecÃÃo e apÃs 1, 7 e 23 dias do tratamento, alguns parÃmetros foram avaliados: a carga parasitÃria, os nÃveis de IFN-, IL-4, TGF-β e IL-10, e as alteraÃÃes histopatolÃgicas no fÃgado. ApÃs 23 dias de tratamento, CXCL10 induziu, no baÃo, uma reduÃÃo expressiva no nÃmero de parasitos, quando comparado ao grupo controle. No fÃgado, a carga parasitÃria mostrou uma queda no grupo tratado, entre o 7 e 23 dia apÃs o tratamento. Entretanto, o efeito leishmanicida de CXCL10, neste trabalho, nÃo parece ser mediado por NO, uma vez que nÃo houve diferenÃa na produÃÃo de NO entre os grupos. IFN-γ foi induzida de maneira mais significativa no grupo tratado do que nos controles, e atingiu sua produÃÃo mÃxima (100 pg/mL) no 23 dia apÃs o tratamento, correlacionando-se com a queda da carga parasitÃria nos ÃrgÃos-alvo. IL-4 foi produzida em baixas concentraÃÃes, em ambos os grupos, embora os animais tratados com CXCL10 tenham mostrado nÃveis mais elevados do que os controles. Em relaÃÃo Ãs citocinas antiinflamatÃrias, apÃs 23 dias do tratamento, os nÃveis de IL-10 nos animais tratados foram menores do que os do controle. A produÃÃo de TGF-β apÃs 7 dias do tratamento foi 2 vezes menor no grupo tratado quando comparado ao controle, e apÃs 23 dias do tratamento, essa citocina continuou com nÃveis mais baixos do que aqueles observados no controle. Na anÃlise histopatolÃgica do fÃgado apÃs o 1 dia do tratamento, foram encontrados, em ambos os grupos, mais granulomas imaturos (GI), do que infiltrados nÃo granulomatosos (NG) e alguns poucos granulomas maduros (GM) apenas no grupo tratado. ApÃs 7 dias do tratamento, a quantidade de infiltrados NG estava menor e os GI ainda foram os mais encontrados, em ambos os grupos, alÃm disso, foi observado um pequeno aumento de GM no grupo tratado. Em resumo, diante dos resultados encontrados, à possÃvel sugerir um importante papel leishmanicida de CXCL10 em camundongos BALB/c infectados por L. infantum chagasi, que parece ser mediado por uma expressiva produÃÃo de IFN-g e supressÃo das citocinas imunorreguladoras, IL-10 e TGF-β, abrindo a hipÃtese se isto nÃo estaria associado a uma diminuiÃÃo na frequÃncia de cÃlulas T regulatÃrias, induzida por CXCL10, nesses animais. / Visceral leishmaniasis caused by Leishmania infantum chagasi is characterized by the loss of the ability of host to generate an effective immune response. In this study it was investigated the role of CXCL10 chemokine in controlling L. infantum chagasi infection in vivo. Groups of BALB/c mice were treated or not with recombinant CXCL10 chemokine (5 μg/kg) with 1, 3 and 7 days of infection and after 1, 7 and 23 days of treatment, some parameters were evaluated: parasite load, levels of IFN-g, IL-4, TGF-β and IL-10, and the histopathological alterations in the liver. After 23 days of treatment, CXCL10 induced in the spleen a significant reduction on the number of parasites as compared to control group. In the liver, parasite load decreased in treated group between the 7th and 23th day post treatment. However, the antileishmanial effect of CXCL10, in this work, does not seem to be mediated by NO, since there was no difference in the NO production among the groups. IFN-γ was induced most significantly in treated group than in controls, and reached its maximum production (100 pg/mL) on day 23 after treatment, correlating with the reduction in parasite burden in target organs. IL-4 was produced in low doses, in both groups, although treated animals had shown higher levels than control group. Regarding to anti-inflammatory cytokines, after the 23th day of treatment, IL-10 levels in treated animals were smaller than in control group. Production of TGF-β after 7 days of treatment was 2 times lower in treated group when compared to control, and after the 23th day of treatment, this cytokine remained with lower levels than those observed in control. In the histopathological analysis of the liver after the 1st day of treatment, were found in both groups more immature granulomas (GI) than non-granulomatous infiltrate (NG), and some few mature granulomas (GM) were only observed in treated group. After 7 days of treatment, the amount of NG infiltrates was lower, and GI were still the most frequent in both groups, besides a slight increase of GM was observed in treated group. In summary, at the light of the found results, it is possible to suggest an important leishmanicidal role to CXCL10 in BALB/c mice infected by L. infantum chagasi, which seems to be mediated by a significant IFN-g production, and suppression of immunoregulatory cytokines, IL-10 and TGF-β, opening the hypothesis that this would be associated to a decrease in the frequency of regulatory T cells induced by CXCL10 in these animals.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O diagnóstico da hanseníase neural pura baseia-se em dados clínicos e laboratoriais do paciente, incluindo a histopatologia de espécimes de biópsia de nervo e detecção de DNA de Mycobacterium leprae (M. leprae) pelo PCR. Como o exame histopatológico e a técnica PCR podem não ser suficientes para confirmar o diagnóstico, a imunomarcação de lipoarabinomanana (LAM) e/ou Glicolipídio fenólico 1 (PGL1) - componentes de parede celular de M. leprae foi utilizada na primeira etapa deste estudo, na tentativa de detectar qualquer presença vestigial do M. leprae em amostras de nervo sem bacilos. Além disso, sabe-se que a lesão do nervo na hanseníase pode diretamente ser induzida pelo M. leprae nos estágios iniciais da infecção, no entanto, os mecanismos imunomediados adicionam severidade ao comprometimento da função neural em períodos sintomáticos da doença. Este estudo investigou também a expressão imuno-histoquímica de marcadores envolvidos nos mecanismos de patogenicidade do dano ao nervo na hanseníase. Os imunomarcadores selecionados foram: quimiocinas CXCL10, CCL2, CD3, CD4, CD8, CD45RA, CD45RO, CD68, HLA-DR, e metaloproteinases 2 e 9. O estudo foi desenvolvido em espécimes de biópsias congeladas de nervo coletados de pacientes com HNP (n=23 / 6 BAAR+ e 17 BAAR - PCR +) e pacientes diagnosticados com outras neuropatias (n=5) utilizados como controle. Todas as amostras foram criosseccionadas e submetidas à imunoperoxidase. Os resultados iniciais demonstraram que as 6 amostras de nervos BAAR+ são LAM+/PGL1+. Já entre as 17 amostras de nervos BAAR-, 8 são LAM+ e/ou PGL1+. Nas 17 amostras de nervos BAAR-PCR+, apenas 7 tiveram resultados LAM+ e/ou PGL1+. A detecção de imunorreatividade para LAM e PGL1 nas amostras de nervo do grupo HNP contribuiu para a maior eficiência diagnóstica na ausência recursos a diagnósticos moleculares. Os resultados da segunda parte deste estudo mostraram que foram encontradas imunoreatividade para CXCL10, CCL2, MMP2 e MMP9 nos nervos da hanseníase, mas não em amostras de nervos com outras neuropatias. Além disso, essa imunomarcação foi encontrada predominantemente em células de Schwann e em macrófagos da população celular inflamatória nos nervos HNP. Os outros marcadores de ativação imunológica foram encontrados em leucócitos (linfócitos T e macrófagos) do infiltrado inflamatório encontrados nos nervos. A expressão de todos os marcadores, exceto CXCL10, apresentou associação com a fibrose, no entanto, apenas a CCL2, independentemente dos outros imunomarcadores, estava associada a esse excessivo depósito de matriz extracelular. Nenhuma diferença na frequência da imunomarcação foi detectada entre os subgrupos BAAR+ e BAAR-, exceção feita apenas às células CD68+ e HLA-DR+, que apresentaram discreta diferença entre os grupos BAAR + e BAAR- com granuloma epitelioide. A expressão de MMP9 associada com fibrose é consistente com os resultados anteriores do grupo de pesquisa. Estes resultados indicam que as quimiocinas CCL2 e CXCL10 não são determinantes para o estabelecimento das lesões com ou sem bacilos nos em nervo em estágios avançados da doença, entretanto, a CCL2 está associada com o recrutamento de macrófagos e com o desenvolvimento da fibrose do nervo na lesão neural da hanseníase. / The diagnosis of pure neural leprosy (PNL) is based on clinical and laboratory data, including the histopathology of nerve biopsy specimens and detection of M. leprae DNA by polymerase chain reaction (PCR). Given that histopathological examination and PCR methods may not be sufficient to confirm diagnosis, immunolabeling of lipoarabinomanan (LAM) and/or phenolic glycolipid 1 (PGL1) M. leprae wall components were utilized in the first step of this investigation in an attempt to detect any vestigial presence of M. leprae in AFB- nerve samples. Furthermore, its well known that nerve damage in leprosy can be directly induced by Mycobacterium leprae in the early stages of infection; however, immunomediated mechanisms add gravity to the impairment of neural function in symptomatic periods of the disease. Therefore, this study also investigated the immunohistochemical expression of immunomarkers involved in the pathogenic mechanisms of leprosy nerve damage. These markers selected were CXCL10, CCL2 chemokines and CD3, CD4, CD8, CD45RA, CD45RO, CD68, HLA-DR, metalloproteinases 2 and 9 in nerve biopsy specimens collected from leprosy (23) and nonleprosy patients (5) suffering peripheral neuropathy. Twenty-three PNL nerve samples (6 AFB+ and 17 AFB-PCR+) were cryosectioned and submitted to LAM and PGL1 immunohistochemical staining by immunoperoxidase; 5 nonleprosy nerve samples were used as controls. The 6 AFB-positive samples showed LAM/PGL1 immunoreactivity. Among the 17 AFB- samples, only 8 revealed LAM and/or PGL1 immunoreactivity. In 17 AFB-PCR+ patients, just 7 had LAM and/or PGL1-positive nerve results. In the PNL cases, the detection of immunolabeled LAM and PGL1 in the nerve samples would have contributed to enhanced diagnostic efficiency in the absence of molecular diagnostic facilities. The results of the second part of this study showed that CXCL10-, CCL2-, MMP2- and MMP9-immunoreactivities were found in the leprosy nerves but not in nonleprosy samples. Immunolabeling was predominantly found in recruited macrophages and Schwann cells composing the inflammatory cellular population in the leprosy-affected nerves. The immunohistochemical expression of all the markers, but CXCL10, was associated with fibrosis; however, only CCL2 was, independently from the other markers, associated with this excessive deposit of extracellular matrix. No difference in the frequency of the immunolabeling was detected between the AFB+ and AFB- leprosy subgroups of nerves, exception made to some statistical tendency to difference in regard to CD68+ and HLA-DR+ cells in the AFB- nerves exhibiting epithelioid granuloma. MMP9 expression associated with fibrosis is consistent with previous results of this research group. The findings conveys the idea that CCL2 and CXCL10 chemokines at least in advanced stages of leprosy nerve lesions are not determinant for the establishment of AFB+ or AFB- leprosy lesions, however, CCL2 is associated with macrophage recruitment and fibrosis.