Association of IgG immunoglobulin and subclasses level with the severity of chromoblastomycosis due to Fonsecaea pedrosoi and therapeutic response to itraconazole

Chromoblastomycosis (CBM) is a chronic, suppurative, granulomatous mycosis of the skin and subcutaneous tissues. The aim of this study was to evaluate the association between IgG antibody levels and the severity of CBM and therapeutic response of patients to itraconazole. A longitudinal study was conducted in patients with CBM due to Fonsecaea pedrosoi and in healthy subjects with chromomycin skin test (CST)+. The dosage of anti-F. pedrosoi IgG antibody performed in 47 healthy individuals with CST+ showed positivity in 97.5 %, with an average titer of 2,109 [ standard deviation (SD)+3,676)] and a mean optical density (OD) of 1.174 (SD+0.456), showing positive correlation with the induration area of the CST (mm(2)). The level of antibodies in 55 patients with CBM expressed in OD and titration showed that, before treatment, patients with severe disease had higher levels of IgG, IgG1, IgG2, and IgG3 when compared with moderate or mild disease (p<0.05). According to the time of treatment, the mean antibody titers of IgG, IgG1, and IgG2 were reduced after treatment (p<0.05). In the assessment of therapeutic response, there was reduction of IgG3 and IgG titers in patients with rapid response (p<0.05) and IgG2 on rapid and intermediate response (p<0.05). There was clear evidence of what are the risk factors for exposure to F. pedrosoi in the daily lives of these subjects, with prospects of preventive measures for the target population. The immunological analysis shows that the antibody anti-F. pedrosoi did not exhibit a protective role against infection caused by this agent.