Analysis of the Expression of Toll-like Receptors 2 and 4 in Keratinocytes of Patients with Extensive Dermatophytosis due Trichophyton rubrum

Abstract

Rationale There are few studies to concern the role of innate immune response in dermatophytosis, so we conducted an investigation to define the involvement of TLRs in the course of tinea corporis by T. rubrum. Methods We allocated 14 patients without primary or secondary immunosuppression with extensive dermatophytosis, defined as the ringworm on at least 3 body segments of the same patient. In each patient the skin were biopsied from the active edge of the tinea and normal skin distant at least 4 cm of the lesion. Other skin fragments (control skin) were obtained from cosmetic surgery and without tinea. We use immunohistochemical staining with antibodies for antigens TLR 2 and 4. Images were analyzed in Image Pro Plus program. Results The Wilcoxon Signed Ranks Test showed: (i) regarding the expression of TLR2 of patients with tinea, found on the skin surface, average percentage of the marked area of 24.36 (1-76) in skin with tinea and 39.77 (9-84) in normal skin, p 0.043; (ii) analysis of TLR4 expression in the epidermis of patients with tinea met index higher optical density in normal skin than in skin with tinea, average 111.21 (99.44 to 134.34) and 104.50 (97.76 to 113.82), respectively, p 0.028. Conclusions We found a lower expression of TLR2 and 4 in the skin with tinea compared to healthy skin of the same patients with extensive dermatophytosis, as well as a tendency toward higher expression of TLR2 in the healthy peripheral skin, which could explain the spread in extension, in these cases of tinea.