<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0535-5133</journal-id>
<journal-title><![CDATA[Investigación Clínica]]></journal-title>
<abbrev-journal-title><![CDATA[Invest. clín]]></abbrev-journal-title>
<issn>0535-5133</issn>
<publisher>
<publisher-name><![CDATA[Instituto de Investigaciones Clínicas "Dr. Américo Negrette", Facultad de Medicina, Universidad del Zulia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0535-51332006000300006</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Proliferation and bystander suppression induced by antigens of Trypanosoma cruzi: Evaluation with a modification of the T cell blot technique]]></article-title>
<article-title xml:lang="es"><![CDATA[Proliferación y supresión circunstancial inducida por antígenos de Tripanosoma cruzi: Evaluación con una modificación de la técnica de T cell blot]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mosca]]></surname>
<given-names><![CDATA[Walter]]></given-names>
</name>
<xref ref-type="aff" rid="A01"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Navarro]]></surname>
<given-names><![CDATA[Niurka]]></given-names>
</name>
<xref ref-type="aff" rid="A01"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Campos]]></surname>
<given-names><![CDATA[Yelitza]]></given-names>
</name>
<xref ref-type="aff" rid="A01"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Briceño]]></surname>
<given-names><![CDATA[Luis]]></given-names>
</name>
<xref ref-type="aff" rid="A01"/>
</contrib>
</contrib-group>
<aff id="A01">
<institution><![CDATA[,Universidad Central de Venezuela Facultad de Medicina Instituto de Biomedicina]]></institution>
<addr-line><![CDATA[Caracas ]]></addr-line>
<country>Venezuela</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2006</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2006</year>
</pub-date>
<volume>47</volume>
<numero>3</numero>
<fpage>265</fpage>
<lpage>282</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://ve.scielo.org/scielo.php?script=sci_arttext&amp;pid=S0535-51332006000300006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://ve.scielo.org/scielo.php?script=sci_abstract&amp;pid=S0535-51332006000300006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://ve.scielo.org/scielo.php?script=sci_pdf&amp;pid=S0535-51332006000300006&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[We have studied in vitro proliferation induced by soluble antigenic fractions of T. cruzi epimastigotes and trypomastigotes, as well as their regulatory effect on the proliferative response to PPD. Both crude extracts of the parasite as well as bands from Western blots of soluble epimastigotes and trypomastigotes antigens were tested. Crude extracts elicited higher proliferation in mononuclear cells from patients with chagasic cardiomyopathy (CDM) than in those from patients with no evidence of cardiac pathology (INF). Fractionated antigens induced a lower proliferative response, in intensity as well as in frequency, than the crude extracts. With the soluble antigenic fractions of epimastigotes, cells from CDM patients gave higher responses to low molecular weight (MW) bands (17 to 30 kDa), and from INF patients, to bands of intermediate MW (31 to 62 kDa); this pattern was inverted with soluble antigenic fractions of trypomastigotes. The two crude preparations induced either up-regulation or down-regulation of the PPD response in variable numbers of patients from both groups. With fractionated antigens, down-regulation intensity was stronger in patients without evidence of heart disease, but frequency was greater in patients with Chagasic cardiomyopathy (CDM). Six bands of western-blot of soluble trypomastigote antigens (B1, 4-7, and 9) induced significant down-regulation in 100% of CDM patients. The up-regulation elicited by most bands of the antigenic fractions was significantly higher, and more frequent in patients without heart pathology. Most bands of soluble trypomastigote antigens (10/15; 66.6%) did not induce up-regulation in patients with cardiomyopathy. These data suggest that differences in the clinical status of the two groups may reflect the recognition of different groups of antigens together with variations in the nature of the regulatory response.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Se estudió tanto la respuesta proliferativa inducida por antígenos solubles de epimastigotes y tripomastigotes de T. cruzi, como su efecto regulador en la respuesta proliferativa a PPD. Se evaluaron tanto los extractos crudos del parásito como las bandas de “Western blots” de antígenos solubles de epimastigotes y tripomastigotes. La proliferación de las células mononucleares, en respuesta a los extractos crudos, fue mas intensa en los pacientes con cardiomiopatía chagásica (CDM) que en los pacientes sin evidencia de patología cardiaca (INF). La respuesta a los antígenos fraccionados fue menor, en frecuencia e intensidad, a la observada con los antígenos crudos. Las bandas de bajo peso molecular (17 a 30 kDa) de los antígenos solubles de epimastigotes dieron una respuesta mas alta en pacientes CDM y las de peso molecular intermedio (31 a 62 kDa). Este patrón se invirtió con las bandas de antígenos solubles de tripomastigotes. Ambos extractos solubles indujeron sobre regulación o baja regulación de la respuesta a PPD en un número variable de pacientes en ambos grupos. Con los antígenos semi purificados la intensidad de la baja regulación fue mas intensa en pacientes sin evidencia de enfermedad cardiaca, sin embargo la frecuencia fue mayor en los pacientes con cardiomiopatía chagásica (CDM). Seis bandas del Western blot de antígenos solubles de tripomastigotes (B1, 4-7, y 9) se asociaron con una baja regulación en 100% de los pacientes CDM. La sobre regulación observada con la mayoría de las bandas de la fracciones crudas fue significativamente mas alta, y mas frecuente en pacientes con patología cardíaca. La mayoría de las bandas de antígeno soluble de tripomastigotes (10/15; 66,6%) no indujeron sobre regulación en pacientes con cardiomiopatía. Estos datos sugieren que la diferencia en la clínica de los dos grupos pueden deberse a que los pacientes de cada grupo reconocen diferentes antígenos conjuntamente con variaciones en la regulación asociada con esto.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Chagas’ disease]]></kwd>
<kwd lng="en"><![CDATA[antigens]]></kwd>
<kwd lng="en"><![CDATA[regulation]]></kwd>
<kwd lng="en"><![CDATA[cellular immunity]]></kwd>
<kwd lng="es"><![CDATA[Enfermedad de Chagas]]></kwd>
<kwd lng="es"><![CDATA[antígenos]]></kwd>
<kwd lng="es"><![CDATA[regulación]]></kwd>
<kwd lng="es"><![CDATA[inmunidad celular]]></kwd>
</kwd-group>
</article-meta>
</front><body><![CDATA[  <BASEFONT SIZE="3">     <P ALIGN="center"><font color="#1f1a17" face="Verdana" size="3"><b>Proliferation and bystander suppression induced by antigens of <I>Trypanosoma  cruzi</I>. Evaluation with a modification of the T cell blot technique.&nbsp;</b></font></P>     <P ALIGN="center"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Walter Mosca, Niurka Navarro, Yelitza Campos and Luis Brice&#241;o.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Laboratorio de Fisiopatolog&#237;a, Instituto de Biomedicina, Facultad de Medicina,  Universidad Central de Venezuela. Apartado 4043, Caracas 101OA, Venezuela. E-mail:  Wmosca@telcel.net.ve&nbsp; </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Abstract. </FONT> </B><FONT COLOR="#1f1a17" face="Verdana"> We have studied <I>in vitro</I> proliferation induced by soluble antigenic  fractions of <I>T. cruzi</I> epimastigotes and trypomastigotes, as well as their  regulatory effect on the proliferative response to PPD. Both crude extracts  of the parasite as well as bands from Western blots of soluble epimastigotes  and trypomastigotes antigens were tested. Crude extracts elicited higher  proliferation in mononuclear cells from patients with chagasic cardiomyopathy  (CDM) than in those from patients with no evidence of cardiac pathology  (INF). Fractionated antigens induced a lower proliferative response, in  intensity as well as in frequency, than the crude extracts. With the soluble  antigenic fractions of epimastigotes, cells from CDM patients gave higher  responses to low molecular weight (MW) bands (17 to 30 kDa), and from INF  patients, to bands of intermediate MW (31 to 62 kDa); this pattern was  inverted with soluble antigenic fractions of trypomastigotes. The two crude  preparations induced either up-regulation or down-regulation of the PPD  response in variable numbers of patients from both groups. With fractionated  antigens, down-regulation intensity was stronger in patients without evidence  of heart disease, but frequency was greater in patients with Chagasic cardiomyopathy  (CDM). Six bands of western-blot of soluble trypomastigote antigens (B1,  4-7, and 9) induced significant down-regulation in 100% of CDM patients.  The up-regulation elicited by most bands of the antigenic fractions was  significantly higher, and more frequent in patients without heart pathology.  Most bands of soluble trypomastigote antigens (10/15; 66.6%) did not induce  up-regulation in patients with cardiomyopathy. These data suggest that  differences in the clinical status of the two groups may reflect the recognition  of different groups of antigens together with variations in the nature  of the regulatory response.&nbsp; </FONT></font></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Key words:&nbsp;</FONT></B><FONT COLOR="#1f1a17" face="Verdana"> Chagas&#146; disease, antigens, regulation, cellular immunity.&nbsp;</FONT></font></P>     <P ALIGN="center"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Proliferaci&#243;n y supresi&#243;n circunstancial inducida por ant&#237;genos de </FONT> </B><FONT COLOR="#1f1a17" face="Verdana"> <I><B>Tripanosoma  cruzi</B></I><B>. Evaluaci&#243;n con una modificaci&#243;n de la t&#233;cnica de T cell blot.&nbsp;</B> </FONT></font></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Resumen. </FONT> </B><FONT COLOR="#1f1a17" face="Verdana"> Se estudi&#243; tanto la respuesta proliferativa inducida por ant&#237;genos  solubles de epimastigotes y tripomastigotes de <I>T. cruzi, </I>como su efecto  regulador en la respuesta proliferativa a PPD. Se evaluaron tanto los extractos  crudos del par&#225;sito como las bandas de &#147;Western blots&#148; de ant&#237;genos solubles  de epimastigotes y tripomastigotes. La proliferaci&#243;n de las c&#233;lulas mononucleares,  en respuesta a los extractos crudos, fue mas intensa en los pacientes con  cardiomiopat&#237;a chag&#225;sica (CDM) que en los pacientes sin evidencia de patolog&#237;a  cardiaca (INF). La respuesta a los ant&#237;genos fraccionados fue menor, en  frecuencia e intensidad, a la observada con los ant&#237;genos crudos. Las bandas  de bajo peso molecular (17 a 30 kDa) de los ant&#237;genos solubles de epimastigotes  dieron una respuesta mas alta en pacientes CDM y las de peso molecular  intermedio (31 a 62 kDa). Este patr&#243;n se invirti&#243; con las bandas de ant&#237;genos  solubles de tripomastigotes. Ambos extractos solubles indujeron sobre regulaci&#243;n  o baja regulaci&#243;n de la respuesta a PPD en un n&#250;mero variable de pacientes  en ambos grupos. Con los ant&#237;genos semi purificados la intensidad de la  baja regulaci&#243;n fue mas intensa en pacientes sin evidencia de enfermedad  cardiaca, sin embargo la frecuencia fue mayor en los pacientes con cardiomiopat&#237;a  chag&#225;sica (CDM). Seis bandas del Western blot de ant&#237;genos solubles de  tripomastigotes (B1, 4-7, y 9) se asociaron con una baja regulaci&#243;n en  100% de los pacientes CDM. La sobre regulaci&#243;n observada con la mayor&#237;a  de las bandas de la fracciones crudas fue significativamente mas alta,  y mas frecuente en pacientes con patolog&#237;a card&#237;aca. La mayor&#237;a de las  bandas de ant&#237;geno soluble de tripomastigotes (10/15; 66,6%) no indujeron  sobre regulaci&#243;n en pacientes con cardiomiopat&#237;a. Estos datos sugieren  que la diferencia en la cl&#237;nica de los dos grupos pueden deberse a que  los pacientes de cada grupo reconocen diferentes ant&#237;genos conjuntamente  con variaciones en la regulaci&#243;n asociada con esto.&nbsp; </FONT></font></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Palabras clave:&nbsp;</FONT></B><FONT COLOR="#1f1a17" face="Verdana"> Enfermedad de Chagas, ant&#237;genos, regulaci&#243;n, inmunidad celular.&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Received: 13-07-2005. Accepted: 02-03-2006.&nbsp; </FONT></P>     ]]></body>
<body><![CDATA[<P ALIGN="justify"> <B><FONT COLOR="#1f1a17" size="2" face="Verdana"> INTRODUCTION&nbsp; </FONT></B> </P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Chagas&#146; disease is a parasitic zoonosis, endemic in Central and South America,  caused by the protozoan parasite <I>Trypanosoma cruzi.</I> According to the World  Health Organization (1), there are 18 million people infected with <I>T. cruzi  </I>in Latin America. Thirty percent of these have, or will develop, chronic  cardiomyopathy that will limit their productive capacity and require medical  care.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Since<I> T. cruzi </I>is an intracellular parasite, the cell-mediated immune response  plays a central role in its control. This aspect has been evaluated in  numerous studies (2-7), all of which have shown <I>in vitro</I> proliferation  of mononuclear cells stimulated with <I>T. cruzi</I> antigens. The existence of  suppression of the immune response has been reported in experimental models  (8-13) as well as in Chagas&#146; disease patients (7, 14).&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Recently, a proline racemase of the parasite has been described<FONT COLOR="#ff0000" FACE="Caslon224 Bk BT" SIZE="3"> </FONT><FONT COLOR="#1f1a17" FACE="Caslon224 Bk BT" SIZE="3">whose activity  seems to be essential for B-cell mitogenicity</FONT><FONT COLOR="#ff0000" FACE="Caslon224 Bk BT" SIZE="3"> </FONT><FONT COLOR="#1f1a17">and the induction of the  suppression observed during the acute phase of the experimental infection  of mice (15).&nbsp;</FONT> </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Antigens recognized by the immune system play an important role in determining  the characteristics of the host response. Antigenic determinants that selectively  activate <I>in vivo</I> T cells with either helper or suppressor activity have  been shown with several antigens (16,17). Miller <I>et al. </I>(18) reported that  cells from rats made tolerant by oral administration of antigen, down-regulate  the response to a different antigen, to which the animal is immune, when  stimulated with both antigens. This effect was termed &#147;bystander suppression&#148;.  Using an <I>in vitro</I><B> </B>assay, we have demonstrated that <I>T. Cruzi</I> antigens induce  bystander suppression of the proliferative response to PPD or tetanus toxoid  (14). On the other hand, Rowland <I>et al</I>. (19), have shown that resistance  or susceptibility of mice to <I>T. cruzi</I> infection is associated with the  response to different antigens. Other studies have shown that immunization  with a soluble sub cellular epimastigote fraction induces pathology, while  a flagellar fraction induces protective immunity (20-22). These studies  suggest that in Chagas&#146; disease, the outcome of the host-parasite interaction  depends on the balance established between the effector and regulatory  immune responses elicited by the different parasite antigens.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> To obtain a better understanding of these complex interactions, it is fundamental  to study purified antigens rather than crude extracts of the parasite.  The T-cell blot technique, described by Aboud Zeid <I>et al.</I> (23), is a powerful  method for evaluating cell-mediated immunity to semi-purified antigens.  However, it has not been widely used because of the variability observed  among the responses produced by different batches of antigen. Antigens  have to be trapped and internalized by antigen presenting cells (APC),  processed and incorporated in MHC to activate T cells. To be phagocytosed  efficiently the NC particles can not be too large. Furthermore, to minimize  the random difference in phagocytosis, the size of NC particles should  have a low dispersion. We have developed a modification of this technique  that minimizes the variability of the size of NC particles and of the proliferative  response of mononuclear cells, observed with different batches of NC particles.  Combining this methodology with the evaluation of the bystander suppression  of the proliferative response to PPD, we have compared the proliferation  and regulation induced by trypomastigote, i.e. the infective form of <I>Trypanosoma  cruzi</I>, and epimastigote antigens. Most trypomastigote and epimastigote  antigens provoked negative regulation of the PPD induced proliferation.&nbsp; </FONT></P>     <P ALIGN="justify"> <B><FONT COLOR="#1f1a17" size="2" face="Verdana"> MATERIALS AND METHODS&nbsp; </FONT></B> </P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Patient groups</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Patients were selected from the Cardiology Clinic for Chagas&#146; disease at  the Vargas Hospital in Caracas, Venezuela. A total of 38 patients (24 males,  14 females), with positive serology to <I>T. cruzi</I> antigens, agreed to participate  in this study. Patients were classified into two groups according to previous  criteria (23). The 19 patients assigned to group I (INF) were seropositive  for <I>T. cruzi</I> with no evidence of heart disease (mean age 46 years; range  34 to 66 years). The 19 patients assigned to group II (CDM) presented electrocardiographic  abnormalities characteristic of either complete right bundle branch block  plus anterior or posterior hemiblock of the left bundle, or complete atrioventricular  block with wide QRS complex (mean age 50.8 years; range 25 to 68 years).&nbsp; </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Evaluation of different procedures to produce NC particles Preparation  of NC particles as described by Abou Zeid </FONT> </B><FONT COLOR="#1f1a17" face="Verdana"> <I><B>et al.</B></I><B> (23)</B>&nbsp; </FONT></font></P>     ]]></body>
<body><![CDATA[<P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Pieces of 63 mm<FONT COLOR="#1f1a17"><SUP>2</SUP> of nitrocellulose membranes were adsorbed with 75 &#181;L of  PPD (10 mg/mL), left to dry at room temperature for sixty minutes, and  placed in serological tubes. To dissolve the NC one mL of DMSO was added  to each tube and the mixture incubated for sixty minutes. At the end of  this period one mL of carbonate/bicarbonate buffer (0.05M; pH 8.5) was  added drop wise to each tube, while vigorously vortexing, to promote formation  of NC particles. The NC particle suspension was centrifuged at 300 G for  ten minutes. The supernatant was discarded and the NC particles were suspended  in PBS. This procedure was repeated three times. After the last centrifugation  the NC particles were suspended in five mL RPMI 1640 (Grand island Biological  Company, USA) supplemented with gentamicin (50&#181;g/mL), aliquoted and stored  at &#150;20&#176;C.<I>&nbsp;</I></FONT> </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Modification of the methodology described by Abou Zeid </FONT> </B><FONT COLOR="#1f1a17" face="Verdana"> <I><B>et al.</B></I><B> (23)</B>&nbsp; </FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> To obtain smaller and more uniform NC particles we did not deliver the  carbonate/bicarbonate buffer drop wise but as a continuous flow, directly  into the DMSO and NC solution, using a peristaltic pump (400 &#181;L/minute).  The rest of the method was as described by Abou Zeid.&nbsp; </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Estimation of the NC particle size</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Twenty-five &#181;L of each NC particle suspension were placed on a microscopic  slide and the size of 400 particles measured using a calibrated ocular.&nbsp; </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Evaluation of the reproducibility of the stimulation of mononuclear cells induced by PPD adsorbed NC particles</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> To evaluate the reproducibility of the proliferative response, four different  batches of <I>PPD</I> adsorbed NC particles, either as described by Abou Zeid  <I>et al. </I>(23), or as modified by us, were used to stimulate mononuclear cells  from a healthy donor.&nbsp; </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Antigens. Antigen A</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Y strain epimastigotes were grown in 199 medium supplemented with 2% fetal  calf serum. The parasites were harvested by centrifugation at 400 g for  20 minutes and washed twice with PBS. After the last wash, they were adjusted  to 30 &#215; 10<FONT COLOR="#1f1a17"><SUP>6</SUP>/mL and autoclaved for 10 min (24); 20 &#181;L of this suspension  were added to each culture well.&nbsp;</FONT> </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Soluble parasite antigens</FONT></B><I><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></I> </font></P>     ]]></body>
<body><![CDATA[<P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Soluble epimastigote (SE) and trypomastigote (ST) antigens were prepared  as described by Segura <I>et al</I>. [20]. The only difference was that parasites  were disrupted by pressure-depressure using a French pressure cell instead  of a Sorvall-Ribi disintegrator. To prepare these crude fractions for mononuclear  cell stimulation, 50 <FONT COLOR="#1f1a17">mg of the crude antigen were adsorbed to 63.3 mm<SUP>2</SUP>  of NC and processed as described for the Western blots bands.&nbsp;</FONT> </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> PPD (Statens Serum Institut, Denmark)</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Protein purified derivative (10 &#181;g/mL) 20 &#181;L/well.&nbsp; </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Antigens semi purified by electrophoresis</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Proteins in antigen samples were resolved by SDS-PAGE using a discontinuos  buffer system (25). Either SE or ST (3 mg per gel) were applied to 10%  acrylamide gels using a blank comb with a single reference well for molecular  weight markers (Sigma Chemical Co. USA) for the determination of molecular  mass. The soluble antigens were run under reducing and denaturalizing conditions,  and transferred to (NC) membranes by the method of Towbin <I>et al. (</I>26).  The Western blots were stained with Ponceau red (Sigma Chemical Co. USA)  to identify the protein bands. The stained and unstained bands were marked,  excised, cut into 63.3 mm<FONT COLOR="#1f1a17"><SUP>2</SUP> pieces and processed as described. After washing  with PBS, the resulting NC particles were suspended in 5 mL RPMI 1640;  100 &#181;L of this suspension were added to each culture well. The molecular  weight (mw) range of the bands is shown in <a href="#TABLE I"> Table I</a>.&nbsp;</FONT> </FONT></P> <basefont>     <p align="center"><font face="Verdana" size="2"><b><font color="#1f1a17"><a name="TABLE I">TABLE I</a></font></b></font></p>     <p align="center"><font face="Verdana" size="2"><font color="#1f1a17" face="Verdana">RANGE OF MOLECULAR WEIGHTS OF SE AND ST WESTERN BLOTS BANDS&nbsp;</font></font></p>     <div align="center">       <center>   <table width="570" border="1" cellspacing="1">     <tbody>       <tr>         <td bgColor="#C3C3C2" rowSpan="3" vAlign="middle" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Bands           NC&nbsp;</font></p>         </td>         <td bgColor="#C3C3C2" colSpan="4" vAlign="top">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">Molecular           weight&nbsp;</font></p>         </td>       </tr>       <tr>         <td bgColor="#C3C3C2" colSpan="2" vAlign="top">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">SE&nbsp;</font></p>         </td>         <td bgColor="#C3C3C2" colSpan="2" vAlign="top">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">ST&nbsp;</font></p>         </td>       </tr>       <tr>         <td bgColor="#c3c3c2" vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Upper&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Lower&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Upper&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Lower&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">1&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">132&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">112&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">207&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">165&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">2&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">112&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">96&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">165&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">127&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">3&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">96&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">76&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">127&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">96&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">4&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">76&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">62&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">96&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">85&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">5&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">62&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">51&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">85&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">72&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">6&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">51&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">47&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">72&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">59&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">7&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">47&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">45&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">59&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">53&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">8&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">45&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">41&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">53&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">44&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">9&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">41&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">38&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">44&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">39&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">10&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">38&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">36&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">39&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">30&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">11&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">36&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">33&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">30&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">25&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">12&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">33&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">30&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">25&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">19&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">13&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">30&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">29&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">19&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">16&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">14&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">29&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">27&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">16&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">13&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">15&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">27&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">25&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">13&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">10&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">16&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">25&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">22&nbsp;</font></p>         </td>         <td vAlign="top" width="121"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="121"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">17&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">22&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">20&nbsp;</font></p>         </td>         <td vAlign="top" width="121"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="121"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">18&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">20&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">18&nbsp;</font></p>         </td>         <td vAlign="top" width="121"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="121"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">19&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">18&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">17&nbsp;</font></p>         </td>         <td vAlign="top" width="121"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="121"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">20&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">17&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">15&nbsp;</font></p>         </td>         <td vAlign="top" width="121"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="121"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>       </tr>     </tbody>   </table>   </center> </div>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Cell proliferation assays</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> A standard microtest procedure was employed. Briefly, mononuclear cells  were separated from heparinized blood by centrifugation over Ficoll-Hypaque,  washed three times, and cultured in triplicate for crude antigens and in  quadruplicate for semi purified antigens, in plastic microtiter plates,  at a 2 &#215; 10<FONT COLOR="#1f1a17"><SUP>5</SUP> cells/well concentration. The medium used was RPMI-1640 (Grand  Island Biological Company) supplemented with 50 &#181;g/mL gentamycin and 10%  autologous serum. After seven days of exposure to the antigen(s), 0.5 &#181;Ci  of [<SUP>3</SUP>H] thymidine was added to each well 18 hours before harvesting onto  glass fiber strips and counting by liquid scintillation. As control, particles  of nitrocellulose (NC) without protein, obtained from the same blot as  the bands, were added to 10 wells with mononuclear cells.&nbsp;</FONT> </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Evaluation of regulation induced by </FONT> </B><FONT COLOR="#1f1a17" face="Verdana"> <I><B>T. cruzi</B></I><B> antigen</B>&nbsp; </FONT></font></P>     ]]></body>
<body><![CDATA[<P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> To evaluate the regulation elicited by parasite antigens, mixtures of antigens  or nitrocellulose particles from Western blots and soluble PPD were used  at the same concentrations as for the cell proliferation assay.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The percentage of down-regulation (DR) or up-regulation (UR) was calculated  as follows:&nbsp; </FONT></P>     <P ALIGN="justify"><img border="0" src="/img/fbpe/ic/v47n3/art06ec1.gif" width="452" height="67"></P>     
<P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Regulation was evaluated only in patients with a significant proliferation  to PPD (SE: INF 13; CDM 9. ST: INF 13; CDM 13).&nbsp; </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Data analysis. Criteria used to define proliferation or regulation induced  by NC adsorbed antigen as relevant</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Proliferation: Any band that gave a CPM greater than the mean plus two  standard deviations of the CPM induced by NC alone.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Regulation: any regulation equal to or smaller than -10 (Down-regulation),  or equal to or greater than 10 (Up-regulation) was considered significant.  Only patients with a significant proliferation to PPD were included in  this analysis.&nbsp; </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Statistical analysis</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The following parameters were used to compare the regulation induced by  bands of the sub cellular fractions:&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Mean regulation: Average of significant up or down regulation to the band.&nbsp; </FONT></P>     ]]></body>
<body><![CDATA[<P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Frequency of relevant up or down-regulation: percentage of patients with  significant regulation to each band.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The frequency of responses to crude antigens was evaluated using a Chi  square test.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> To compare down-regulation or up-regulation mean values, the relevant proliferation  (CPM) means induced by each band, and the percentage of patients with positive  proliferation or suppression, we used the paired Wilcoxon signed-rank test.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The response of individual bands was compared using a non-parametric test  (Mann-Whitney).&nbsp; </FONT></P>     <P ALIGN="justify"> <B><FONT COLOR="#1f1a17" size="2" face="Verdana"> RESULTS&nbsp; </FONT></B> </P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Evaluation of NC particles</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The T-cell blot technique (23) was received with great interest when published.  However, due to the variability of the data obtained it has not been widely  used. Most NC particles obtained using the original methodology have a  diameter larger than 2.4 &#181;m (<a href="#TABLE II">Table II</a>). The sizes of particles affect their  sedimentation and the interaction with antigen presenting cells. Therefore,  the quality and the amount of antigen present in each aliquot, dispensed  to stimulate mononuclear cells, may vary.&nbsp; </FONT></P> <basefont>     <p align="center"><font face="Verdana" size="2"><b><font color="#1f1a17"><a name="TABLE II">TABLE II</a></font></b></font></p>     <p align="center"><font face="Verdana" size="2"><font color="#1f1a17" face="Verdana">EVALUATION OF NC PARTICLES PRODUCED BY THE TECHNIQUE OF ABOUD ZEID AND AS MODIFIED BY AUTHORS&nbsp;</font></font></p>     <div align="center">       ]]></body>
<body><![CDATA[<center>   <table width="570" border="1" cellspacing="1">     <tbody>       <tr>         <td bgColor="#c3c3c2" rowSpan="2" vAlign="top" width="184">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Technique&nbsp;</font></p>         </td>         <td bgColor="#C3C3C2" colSpan="3" vAlign="top">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Diameter           of NC particles&nbsp;</font></p>         </td>       </tr>       <tr>         <td bgColor="#c3c3c2" vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">&nbsp;&lt;           2.4 µm&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">2.4-5.0           µm&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">&gt;           5.0 µm&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="184">               <p align="left"><font color="#1f1a17" size="2" face="Verdana">Aboud           Zeid (n = 9)&nbsp;</font></p>         </td>         <td vAlign="top" width="140"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="140"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="140"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>       </tr>       <tr>         <td vAlign="top" width="184">               <p align="left"><font color="#1f1a17" size="2" face="Verdana">&nbsp;&nbsp;&nbsp;&nbsp;Mean&nbsp;</font></p>         </td>         <td vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">9.0%&nbsp;</font></p>         </td>         <td vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">50.6%&nbsp;</font></p>         </td>         <td vAlign="top" width="140">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">36.1%&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="184">               <p align="left"><font color="#1f1a17" size="2" face="Verdana">&nbsp;&nbsp;&nbsp;&nbsp;Standard           Deviation&nbsp;</font></p>         </td>         <td vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">6.3&nbsp;</font></p>         </td>         <td vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">30.8&nbsp;</font></p>         </td>         <td vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">31.1&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="184">               <p align="left"><font color="#1f1a17" size="2" face="Verdana">Modification           (n = 64)&nbsp;</font></p>         </td>         <td vAlign="top" width="140"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="140"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="140"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>       </tr>       <tr>         <td vAlign="top" width="184">               <p align="left"><font color="#1f1a17" size="2" face="Verdana">&nbsp;&nbsp;&nbsp;&nbsp;Mean&nbsp;</font></p>         </td>         <td vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">92.0%&nbsp;</font></p>         </td>         <td vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">6.2%&nbsp;</font></p>         </td>         <td vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">1.8%&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="184">               ]]></body>
<body><![CDATA[<p align="left"><font color="#1f1a17" size="2" face="Verdana">&nbsp;&nbsp;&nbsp;&nbsp;Standard           Deviation&nbsp;</font></p>         </td>         <td vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">4.9&nbsp;</font></p>         </td>         <td vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">3.8&nbsp;</font></p>         </td>         <td vAlign="top" width="140">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">1.9&nbsp;</font></p>         </td>       </tr>     </tbody>   </table>   </center> </div>     <p align="justify"><font color="#1f1a17" face="Verdana" size="1">n = sample size.&nbsp;</font></p>     <div align="center">       <center>   <table width="570" border="1" cellspacing="1">     <tbody>       <tr>         <td bgColor="#c3c3c2" rowSpan="2" vAlign="top" width="120">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">NC           batch&nbsp;</font></p>         </td>         <td bgColor="#C3C3C2" colSpan="3" vAlign="top" width="434">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Proliferation           induced by NC adsorbed with PPD and particulated&nbsp;</font></p>         </td>       </tr>       <tr>         <td bgColor="#c3c3c2" vAlign="top" width="154">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Control&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="133">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">I&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="135">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">II&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="120">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">1&nbsp;</font></p>         </td>         <td vAlign="top" width="154">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">220&nbsp;</font></p>         </td>         <td vAlign="top" width="133">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">400&nbsp;</font></p>         </td>         <td vAlign="top" width="135">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">&nbsp;800&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="120">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">2&nbsp;</font></p>         </td>         <td vAlign="top" width="154">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">150&nbsp;</font></p>         </td>         <td vAlign="top" width="133">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">300&nbsp;</font></p>         </td>         <td vAlign="top" width="135">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">1000&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="120">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">3&nbsp;</font></p>         </td>         <td vAlign="top" width="154">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">180&nbsp;</font></p>         </td>         <td vAlign="top" width="133">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">250&nbsp;</font></p>         </td>         <td vAlign="top" width="135">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">&nbsp;840&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="120">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">4&nbsp;</font></p>         </td>         <td vAlign="top" width="154">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">270&nbsp;</font></p>         </td>         <td vAlign="top" width="133">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">760&nbsp;</font></p>         </td>         <td vAlign="top" width="135">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">&nbsp;900&nbsp;</font></p>         </td>       </tr>     </tbody>   </table>   </center> </div>     <p align="justify"><font color="#1f1a17" face="Verdana" size="1">Control: NC particles without antigen. &nbsp;&nbsp;&nbsp;I: NC particles produced as described by Abou Zeid <i>et al. </i>(23). &nbsp;&nbsp; II: NC particles produced by the modified technique.&nbsp;</font></p>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> These considerations suggested that the variability of this technique could  be minimized if we could produce smaller and more homogeneous NC particles.  With this in mind, and after trying different procedures, we found that  NC particles were smaller and more homogeneous when carbonate buffer was  delivered as a continuous flow, instead of drop wise. With this simple  modification, most NC particles produced had a diameter of less than 2.4  &#181;m (<a href="#TABLE II">Table&nbsp;II</a>). When different batches of NC particles were evaluated (<a href="#TABLE II">Table II</a>), it was obvious that the NC particles, prepared as described by Abou  Zeid <I>et al.</I> (23), induced a highly variable proliferative response of mononuclear  cells (mean CPM 427; SD 230.3). On the contrary, with our modification,  the NC particles induced a more intense response with low variability (mean  CPM 885; SD 86.9).&nbsp; </FONT></P>     ]]></body>
<body><![CDATA[<P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Analysis of the response of patients to crude antigens</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Proliferation. </FONT> </B><FONT COLOR="#1f1a17" face="Verdana"> The proliferative response to crude antigens was evaluated  with antigen A, the standard <I>T. cruzi</I> antigen used in our laboratory, and  soluble subcellular fractions of epimastigotes and trypomastigotes adsorbed  to NC. The proliferative response induced by antigen A was significantly  higher in CDM than in INF (<a href="#TABLE III">Table III</a>). The CPM induced by the sub cellular  fractions (SE and ST) were similar and, as with antigen A, higher in CDM  than in INF. Nevertheless, in most cases they were lower than the proliferation  induced by antigen A in the same patient. The intensity of the proliferation  induced by an antigen is directly related to its concentration and immunogeneicity.&nbsp; </FONT></font></P> <basefont>     <p align="center"><font face="Verdana" size="2"><b><font color="#1f1a17"><a name="TABLE III">TABLE III</a></font></b></font></p>     <p align="center"><font face="Verdana" size="2"><font color="#1f1a17" face="Verdana">MEAN PROLIFERATION INDUCED BY <i>Trypanosoma cruzi </i>CRUDE ANTIGENS&nbsp;</font></font></p>     <div align="center">       <center>   <table width="570" border="1" cellspacing="1">     <tbody>       <tr>         <td bgColor="#c3c3c2" rowSpan="2" vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Groups&nbsp;</font></p>         </td>         <td bgColor="#C3C3C2" colSpan="3" vAlign="top">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Antigens&nbsp;</font></p>         </td>       </tr>       <tr>         <td bgColor="#c3c3c2" vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">A&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">SE&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="151">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">ST&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">CDM&nbsp;</font></p>         </td>         <td vAlign="top" width="151"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="151"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="151"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>       </tr>       <tr>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">CPM&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">22754*&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">4183+&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">5568!&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">SEM&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">5875&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">1596&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">1326&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="151">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">n&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">15&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">13&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">17&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">INF&nbsp;</font></p>         </td>         <td vAlign="top" width="151"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="151"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="151"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>       </tr>       <tr>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">CPM&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">11377&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">2945&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">2825&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">SEM&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">&nbsp;5316&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">1283&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">&nbsp;929&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">n&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">18&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">15&nbsp;</font></p>         </td>         <td vAlign="top" width="151">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">18&nbsp;</font></p>         </td>       </tr>     </tbody>   </table>   </center> </div>     <p align="justify"><font color="#1f1a17" face="Verdana" size="1">SEM = Standard Error of the mean. &nbsp;* P = 0,0053 When compared with CPM INF. &nbsp;&nbsp;+ P = 0,0197 When compared with CPM INF. &nbsp;! P = 0,0394 When compared with CPM INF.&nbsp;</font></p>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The amount of antigen A was selected based on previous experiments, where  optimal proliferation, in most patients, was observed at this concentration.  However, the soluble antigens of epimastigotes and trypomastigotes were  used adsorbed to NC and the concentration of protein in each band was different.  Furthermore, the stimulation induced by an antigen depends on its immunogenicity  and not on a given concentration of proteins. To normalize the data and  to be able to compare the proliferation induced by each band, the NC particles  used to evaluate each experimental group were:&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> 1.&nbsp;Produced from the same Western blot.&nbsp;</FONT></P>     ]]></body>
<body><![CDATA[<P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> 2.&nbsp;The gel was loaded with the higher concentration of protein compatible  with an adequate separation of bands.&nbsp;</FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> If the antigen was evenly adsorbed to NC, the amount of protein added to  each well was 1 <FONT COLOR="#1f1a17">mg; a low concentration for a crude antigen. Thus, it is  obvious that antigens adsorbed to NC might have induced suboptimal stimulation  of mononuclear cells. Therefore, it does not seem adequate to compare neither  the CPM nor the stimulation index obtained with antigen A with the ones  obtained with antigens adsorbed to NC. Accordingly, we compared the frequency  of patients with relevant proliferation for antigen A, with the frequency  of patients with CPM greater than the mean value of the CPM induced by  NC alone plus two standard deviations of the mean.&nbsp;</FONT> </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> As shown in <a href="#TABLE IV"> Table IV</a>, the frequency of relevant proliferation induced by  crude antigens was lower in INF. This difference only was statistically  significant when SE was used as antigen (p = 0.018). With ST the frequency  of patients with significant proliferation was lower than with A, but it  was not statistically significant (p = 0.1642).&nbsp; </FONT></P> <basefont>     <p align="center"><font color="#1f1a17" face="Verdana" size="2"><b><a name="TABLE IV">TABLE IV</a></b></font></p>     <p align="center"><font color="#1f1a17" face="Verdana" size="2">PERCENTAGE OF PATIENTS WITH A SIGNIFICANT PROLIFERATION TO CRUDE ANTIGENS&nbsp;</font></p>     <div align="center">       <center>   <table width="560" border="1" cellspacing="1">     <tbody>       <tr>         <td bgColor="#c3c3c2" rowSpan="2" vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Antigens&nbsp;</font></p>         </td>         <td bgColor="#C3C3C2" colSpan="2" vAlign="top">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Experimental           Groups&nbsp;</font></p>         </td>       </tr>       <tr>         <td bgColor="#c3c3c2" vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">&nbsp;CDM&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="202">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">&nbsp;INF&nbsp;</font></p>         </td>       </tr>       <tr>         <td rowSpan="2" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">A&nbsp;</font></p>         </td>         <td vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">91.7&nbsp;</font></p>         </td>         <td vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">75.0&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(11/12)&nbsp;</font></p>         </td>         <td vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(12/16)&nbsp;</font></p>         </td>       </tr>       <tr>         <td rowSpan="2" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">SE&nbsp;</font></p>         </td>         <td vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">83.3&nbsp;</font></p>         </td>         <td vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">33.3&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(10/12)&nbsp;</font></p>         </td>         <td vAlign="top" width="202">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">(5/15)&nbsp;</font></p>         </td>       </tr>       <tr>         <td rowSpan="2" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">ST&nbsp;</font></p>         </td>         <td vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">76.5&nbsp;</font></p>         </td>         <td vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">50.0&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(13/17)&nbsp;</font></p>         </td>         <td vAlign="top" width="202">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(9/18)&nbsp;</font></p>         </td>       </tr>     </tbody>   </table>   </center> </div>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Regulation</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> We have demonstrated that <I>T. cruzi</I><B> </B>antigens<B> </B>elicit<B> </B>a bystander regulation  of the proliferative response to PPD of mononuclear cells obtained from  Chagasic patients. Our previous study (14) showed that 71% of INF patients  had a down-regulation lower than -10 when their mononuclear cells were  stimulated simultaneously with PPD and tetanus toxoid. Based on this finding  we defined as a significant down-regulation any value equal or lower than  -10, and as a significant up-regulation any value equal or higher than  10.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Since the evaluation is based on the PPD generated proliferative response,  only PPD positive patients were included.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The intensity of the down-regulation of the response to PPD, induced by  SE as well as ST was higher in CDM although not significantly different (<a href="#TABLE V">Table V</a>). It could be presumed that the diminished proliferation is the  consequence of sequestration of PPD in the NC. If this argument is correct,  all antigens adsorbed to NC should induce down regulation. However, with  soluble antigen of epimastigotes only 44 percent of CDM had down-regulation  while 44 percent had up-regulation. Similar data were obtained with trypomastigote  antigens.&nbsp; </FONT></P> <basefont>     ]]></body>
<body><![CDATA[<p align="center"><font face="Verdana" size="2"><b><font color="#1f1a17"><a name="TABLE V">TABLE V</a></font></b></font></p>     <p align="center"><font face="Verdana" size="2"><font color="#1f1a17" face="Verdana">REGULATION INDUCED BY SUBCELLULAR FRACTIONS&nbsp;</font></font></p>     <div align="center">       <center>   <table width="570" border="1" cellspacing="1">     <tbody>       <tr>         <td bgColor="#c3c3c2" rowSpan="2" vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">Regulation&nbsp;</font></p>         </td>         <td bgColor="#C3C3C2" colSpan="2" vAlign="top">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">SE&nbsp;</font></p>         </td>         <td bgColor="#C3C3C2" colSpan="2" vAlign="top">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">ST&nbsp;</font></p>         </td>       </tr>       <tr>         <td bgColor="#c3c3c2" vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">CDM&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">INF&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">CDM&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="121">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">INF&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">DR&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">–66.0&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">–48.2&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">–66.6&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">–55.3&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">%DR&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">44.4&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">84.6&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">81.3&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">76.9&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(4/9)&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(11/13)&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(13/16)&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(10/13)&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">UR&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">40.4&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">21.0&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">151.4&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">86.2&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="2" face="Verdana">%UR&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">44.4&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">15.4&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">6.3&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">23.1&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="121"><font face="Verdana" size="2">&nbsp;&nbsp;</font></td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(4/9)&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(2/16)&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(1/16)&nbsp;</font></p>         </td>         <td vAlign="top" width="121">               <p align="center"><font color="#1f1a17" size="2" face="Verdana">(3/13)&nbsp;</font></p>         </td>       </tr>     </tbody>   </table>   </center> </div>     <p align="justify"><font color="#1f1a17" face="Verdana" size="1">DR: Average down-regulation of patients with significant down-regulation. &nbsp;&nbsp;&nbsp;UR: Average up-regulation of patients with significant up-regulation. % DR: percentage of patients with a significant down-regulation. &nbsp;&nbsp;&nbsp;% UR: percentage of patients with a significant up-regulation.&nbsp;</font></p>     ]]></body>
<body><![CDATA[<P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The frequency of patients with SE induced down-regulation was higher in  INF than in CDM patients. On the other hand, the percentage of patients  with down-regulation with ST was similar in both experimental groups.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> An important aspect of the assay is that it reveals, besides the down-regulation,  the presence of up-regulation or synergism. With SE, the values of up-regulation  were similar in both experimental groups. The intensity of the up-regulation  in INF was higher with ST than with SE. Furthermore, with ST only one CDM  had a relevant up-regulation, while three INF had a significant up-regulation.  Because the sample size of patients with up-regulation was small, no reliable  statistics could be performed. However, the data obtained with crude antigens  from the infective stage of the parasite suggest presence of considerable  differences in the regulation of the immune response to the infective form  of <I>Trypanosoma cruzi</I>.&nbsp; </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Analysis of the response to semi purified antigens</FONT></B><FONT COLOR="#1f1a17" face="Verdana">&nbsp;</FONT></font></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Proliferation</FONT></B><FONT COLOR="#1f1a17" face="Verdana"><B>. </B>In order to identify the antigens that stimulate and/or  regulate the mononuclear cell response we studied the response of mononuclear  cells to soluble antigen semi purified by electrophoresis. The protein  pattern is more complex in SE than in ST. In SE 20 bands were identified,  and 15 in ST (<a href="#TABLE I">Table I</a>).&nbsp;</FONT></font></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The analysis of patients with significant proliferation to SE, bands (<a href="#f1">Fig. 1A</a>) shows that bands between 29.8 and 61.6 kDa (B5 to B12 with the exception  of B9) gave higher CPM in INF, and bands between 17.2 and 29.8 kDa (B13  to B19) in CDM. With ST (<a href="#f1">Fig 1B</a>), the pattern observed with SE was reversed;  bands between 59 and 127 kDa (B3 to B6) were more active in CDM. These  observations suggest that besides the complexity of the protein pattern,  these sub cellular fractions have fundamental differences in their antigenic  composition.&nbsp; </FONT></P>     <p ALIGN="center"><a name="f1"><img border="0" src="/img/fbpe/ic/v47n3/art06img01.gif" width="578" height="640"></a>     
<P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The frequency of positive responses to most SE and ST bands (<a href="#TABLE VI">Table VI</a>)  was low. Consequently, due to the sample size, any inference concerning  the intensity of the positive response to each band will have a large margin  of error. However, comparing the frequency of significant proliferation  elicited by each band, we can assess if one experimental group responds  more to one or both sub cellular fractions. The frequency of relevant proliferation (<a href="#TABLE VI">Table VI</a>) was significantly higher in CDM (SE p = 0.0158; ST p&nbsp;= 0.0002).  Bands 3, 5 and 6 of ST, that gave significant proliferation in an important  percentage of CDM, also had high CPM (<a href="#f1">Fig. 1b</a>), suggesting that they might  be of importance in the host-parasite relationship.&nbsp; </FONT></P> <basefont>     <p align="center"><font face="Verdana" size="2"><b><font color="#1f1a17"><a name="TABLE VI">TABLE VI</a></font></b></font></p>     <p align="center"><font face="Verdana" size="2"><font color="#1f1a17" face="Verdana">PERCENTAGE OF PATIENTS WITH RELEVANT PROLIFERATION INDUCED BY CRUDE SE OR ST ANTIGENS AND THEIR WESTERN BLOT BANDS&nbsp;</font></font></p>     <div align="center">       ]]></body>
<body><![CDATA[<center>   <table width="580" border="1" cellspacing="1">     <tbody>       <tr>         <td bgColor="#c3c3c2" rowSpan="2" vAlign="top" width="43">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">Group&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" rowSpan="2" vAlign="top" width="38">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">Crude           SE&nbsp;</font></p>         </td>         <td bgColor="#C3C3C2" colSpan="20" vAlign="top" width="536">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">&nbsp;SE           Bands&nbsp;</font></p>         </td>       </tr>       <tr>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">1&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">2&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">3&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">4&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">5&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">6&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="1" face="Verdana">7&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">8&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">9&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">10&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">12&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">13&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">14&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">15&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">16&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="1" face="Verdana">17&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">18&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="23">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">19&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="25">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">20&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="43">               <p align="left"><font color="#1f1a17" size="1" face="Verdana">CDM&nbsp;</font></p>         </td>         <td vAlign="top" width="38">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">83&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">18&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">29&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">35&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">12&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="1" face="Verdana">35&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">29&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">35&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">29&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">29&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">35&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">29&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">24&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">24&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">18&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="1" face="Verdana">29&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">18&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">29&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">12&nbsp;</font></p>         </td>         <td vAlign="top" width="23">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">12&nbsp;</font></p>         </td>         <td vAlign="top" width="25">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">18&nbsp;</font></p>         </td>       </tr>       <tr>         <td vAlign="top" width="43">               <p align="left"><font color="#1f1a17" size="1" face="Verdana">INF&nbsp;</font></p>         </td>         <td vAlign="top" width="38">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">33&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">44&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="1" face="Verdana">28&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">17&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">22&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">22&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">28&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">17&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">17&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">17&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">17&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="1" face="Verdana">22&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">17&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">22&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">&nbsp;0&nbsp;</font></p>         </td>         <td vAlign="top" width="23">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">33&nbsp;</font></p>         </td>         <td vAlign="top" width="25">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">17&nbsp;</font></p>         </td>       </tr>       <tr>         <td bgColor="#c3c3c2" rowSpan="2" vAlign="top" width="43">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">Group&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" rowSpan="2" vAlign="top" width="38">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">Crude           ST&nbsp;</font></p>         </td>         <td bgColor="#C3C3C2" colSpan="20" vAlign="top" width="536">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="1" face="Verdana">&nbsp;ST           Bands&nbsp;</font></p>         </td>       </tr>       <tr>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">1&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">2&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">3&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">4&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">5&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">6&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">7&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">8&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">9&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="1" face="Verdana">10&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">12&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">13&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">14&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">15&nbsp;</font></p>         </td>         <td bgColor="#c3c3c2" vAlign="top" width="21">&nbsp;</td>         <td bgColor="#c3c3c2" vAlign="top" width="21">&nbsp;</td>         <td bgColor="#c3c3c2" vAlign="top" width="21">&nbsp;</td>         <td bgColor="#c3c3c2" vAlign="top" width="23">&nbsp;</td>         <td bgColor="#c3c3c2" vAlign="top" width="25">&nbsp;</td>       </tr>       <tr>         <td vAlign="top" width="43">               <p align="left"><font color="#1f1a17" size="1" face="Verdana">CDM&nbsp;</font></p>         </td>         <td vAlign="top" width="38">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">76&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">24&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">18&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="1" face="Verdana">41&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">24&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">59&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">29&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">41&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">24&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">29&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">12&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">18&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">6&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="1" face="Verdana">35&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">18&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">18&nbsp;</font></p>         </td>         <td vAlign="top" width="21"><font face="Verdana" size="1">&nbsp;</font></td>         <td vAlign="top" width="21"><font face="Verdana" size="1">&nbsp;</font></td>         <td vAlign="top" width="21"><font face="Verdana" size="1">&nbsp;</font></td>         <td vAlign="top" width="23"><font face="Verdana" size="1">&nbsp;</font></td>         <td vAlign="top" width="25"><font face="Verdana" size="1">&nbsp;</font></td>       </tr>       <tr>         <td vAlign="top" width="43">               <p align="left"><font color="#1f1a17" size="1" face="Verdana">INF&nbsp;</font></p>         </td>         <td vAlign="top" width="38">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">50&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">16&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">5&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">26&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">26&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               ]]></body>
<body><![CDATA[<p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">21&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">&nbsp;5&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">&nbsp;5&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">5&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td vAlign="top" width="21">               <p align="center"><font color="#1f1a17" size="1" face="Verdana">11&nbsp;</font></p>         </td>         <td vAlign="top" width="21"><font face="Verdana" size="1">&nbsp;</font></td>         <td vAlign="top" width="21"><font face="Verdana" size="1">&nbsp;</font></td>         <td vAlign="top" width="21"><font face="Verdana" size="1">&nbsp;</font></td>         <td vAlign="top" width="23"><font face="Verdana" size="1">&nbsp;</font></td>         <td vAlign="top" width="25"><font face="Verdana" size="1">&nbsp;</font></td>       </tr>     </tbody>   </table>   </center> </div>     ]]></body>
<body><![CDATA[<p align="justify"><font color="#1f1a17" face="Verdana" size="1">SE: Soluble Epimastigote antigens. &nbsp;&nbsp;&nbsp;ST: Soluble Trypomastigote antigens.&nbsp;</font></p>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> These results confirm that the immunogeneicity of soluble antigens of <I>T.  cruzi</I> is low. However, several of the bands induced proliferation with  a frequency not much lower to the one observed with crude soluble antigens (<a href="#TABLE VI">Table VI</a>).&nbsp; </FONT></P>     <P ALIGN="justify"><font size="2"> <B><FONT COLOR="#1f1a17" face="Verdana"> Regulation. </FONT></B><FONT COLOR="#1f1a17" face="Verdana"> <B> </B>As shown in <a href="#f2"> Fig. 2</a>, the down-regulation mean of most bands,  either of SE or of ST, was higher in INF (SE p&nbsp;= 0.0021; ST p = 0.0028).  However, the frequency of down-regulation elicited by bands of both sub  cellular fractions was higher in CDM than in INF (<a href="#TABLE VII">Table VII</a>). This difference  was statistically significant for ST (p = 0.0009) and SE (p = 0.014).&nbsp; </FONT></font></P>     <P ALIGN="center"><a name="f2"><img border="0" src="/img/fbpe/ic/v47n3/art06img02.gif" width="577" height="678"></a></P>     
<p align="center"><font face="Verdana"><b><font color="#1f1a17" size="2"><a name="TABLE VII">TABLE VII</a></font></b></font></p>     <p align="center"><font face="Verdana"><font color="#1f1a17" size="2">PERCENTAGE OF PATIENTS WITH RELEVAN TPROLIFERATION INDUCED BY CRUDE SE OR ST ANTIGENS AND THEIR WESTERN BLOT BANDS&nbsp;</font></font></p>     <p align="center"><img border="0" src="/img/fbpe/ic/v47n3/art06tab7.gif" width="580" height="221"></p>     
<p align="justify"><font color="#1f1a17" face="Verdana" size="1">SE: Soluble Epimastigote antigens. &nbsp;&nbsp;&nbsp;ST: Soluble Trypomastigote antigens.&nbsp;</font></p>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> An interesting aspect was that more than 80% CDM had significant suppression  with most ST bands. Six of them (B1, B4 to B7, and B9) induced down-regulation  in 100% CDM. But, in a contrasting manner, band 3 induced relevant proliferation  in 41% of CDM (mean CPM 1250), band 4 in 24% (mean CPM 1000), band 5 in  59% (mean CPM 2500) and band 6 in 29% (mean CPM 1250), suggesting that  the proliferating mononuclear cells might be the ones that will modulate  negatively the immune response&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The up-regulation of the PPD proliferative response was more intense in  INF with both sub cellular fractions (SE p&nbsp;=&nbsp;0.026; ST p = 0.0052). As shown  in <a href="#f2"> Fig.&nbsp;2,</a> the up-regulation induced by SE bands was higher than the up-regulation  elicited by ST bands.&nbsp; </FONT></P>     ]]></body>
<body><![CDATA[<P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The frequency of patients with relevant up-regulation (<a href="#TABLE VII">Table VII</a>) was significantly  higher in INF for SE (p = 0.0075) and ST (p = 0.0015). The difference of  up-regulation frequency in INF and CDM was more pronounced with ST bands (<a href="#f2">Fig 2B</a>). Bands 6, 7, 10, 13 and 15 of SE (<a href="#f2">Fig 2A</a>) and bands 1, 3 to 10,  and 15 of ST (<a href="#TABLE VII">Table VII</a>) did not induce relevant up-regulation in any of  the CDM studied. In INF only bands 2 and 4 of ST did not induce relevant  up-regulation.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The observation that the UR with most bands was higher in INF and bands  that induce DR in one hundred percent of CDM (bands 5 to 10 and 15) in  INF induce UR in more than 31% of the INF (5-31%; 6-31%; 7-38%; 8-31%;  9-38%; 10-31% and 15-23%) suggest the presence of some interaction or balance,  between up and down-regulation, in INF that is lost in CDM.&nbsp; </FONT></P>     <P ALIGN="justify"> <B><FONT COLOR="#1f1a17" size="2" face="Verdana"> DISCUSSION&nbsp; </FONT></B> </P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Our modification of the technique described by Aboud Zeid <I>et al.</I> had two  fundamental effects: the NC particles generated had a size consistently  similar to microorganisms (2.4 &#181;m), and induced a more reproducible proliferation.  In our opinion this is due to the fact that the size of NC particles is  more homogeneous and APC can internalize them easily. This should induce  a more reproducible stimulation of lymphocytes as shown by our evaluation.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The proliferation elicited by soluble epimastigote antigens is less intense  than the proliferation elicited by antigen A, and the proportion of patients  with relevant proliferation is smaller in INF (33%) than in CDM (83.3%).  These values are similar to those reported with a similar antigen (INF  27%; CDM 72.5%) by De Titto <I>et al</I>. (6), corroborating the validity of the  results obtained with the antigens adsorbed to NC.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Using a similar technology Gazzinelli <I>et al</I>. (27) evaluated the proliferation  induced by fragments of NC from Western blots of soluble epimastigote antigens.  However, their approach was different from ours. First, there are technical  differences with respect to the preparation of crude antigens and the processing  of Western Blots. Second, they did not evaluate the response to soluble  trypomastigote antigens nor did they analyze the regulation induced by  these antigens.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Contrary to our results these authors observe higher values of proliferation.  This dissimilarity could be due to differences in the preparation and processing  of antigens. On the other hand, they reported an important proliferation  in the range of 43 to 57 kDa in both of their experimental groups (equivalent  to our INF and CDM groups). Our data show that SE bands 3 to 6, enclosing  the range from 43 to 57 kDa, also induced a important proliferation in  CDM. In their study, two of 8 INF (24%) and one of 7 (14.3%) INF patients  did not respond to any of the fractions evaluated. Our results also show  that three of 18 (16.7%) INF, and two of 17 (11.8%) CDM did not respond  to any of the SE bands. However, the frequency of patients that did not  respond to any of the ST bands was significantly higher (p = 0.0096) in  INF (55.6%) than in CDM (5.9%). This observation, together with the difference  in response of INF and CDM to the different bands, reveals a difference  in the intensity and pattern of response of INF and CDM, to antigens of  the circulating form of the parasite, not evident with antigens of the  culture form of the parasite.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> It is important to underline that the average proliferative response, as  well as the frequency of response to trypomastigote antigens of INF was  lower, which indicates an association between the intensity of the response  to these antigens and the presence of pathology. In this context, it is  relevant to note that ST band 5 (72 to 84 kDa) induced proliferation with  high frequency (59%) in CDM.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> Down-regulation may play an important role in the persistence of chronic  infection and in the development or control of immunopathology. Several  authors have reported suppression in experimental models (8, 10-13, 28,  29). Morato <I>et al.<B> </B></I>(7) reported experimental findings in Chagas patients  that suggest the presence of suppression. Kierazenbaum <I>et al.</I> (30)<B> </B>demonstrated  the presence of molecules, spontaneously released by trypomastigotes (termed  Trypanosomal Suppressive Factor) that inhibit lymphocyte proliferation.  In accordance with this, our results show that most epimastigote or trypomastigote  antigens induce significant down-regulation. SE and ST bands gave a higher  average down regulation in INF, but the frequency of relevant down regulation  was higher in CDM for both antigens. Only one SE band, B17, induced down-regulation  in all CDM patients. With ST, B1, B4 to B7 and B9 induced down-regulation  in 100% CDM. On the basis of these differences, we postulate that regulation  of the cell-mediated immune response to the parasite might affect different  effector functions, such as control of parasitemia or induction of immunopathology,  in the different patient groups.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> It is reasonable to assume that the presence of significant proliferation  should be associated with low or no down-regulation. However, in agreement  with our previous data (14) we did not find an inverse correlation between  proliferation and down-regulation.&nbsp; </FONT></P>     ]]></body>
<body><![CDATA[<P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> The presence in INF of higher frequency and intensity of up-regulation  with trypomastigote antigens suggests that in INF the response to parasite  antigens is more efficient.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> On the other hand our data support the notion that antigens or elements  that induce down regulation of the immune response coexist with antigens  that elicit an effector immune response; being prevalent the down regulation.  The above conclusion is supported by data obtained by Hansen <I>et al. </I>(31),  showing that the crude flagellar epimastigote antigen, previously reported  as inducing protection against experimental infection (22) can be separated  by affinity chromatography into two fractions with opposite immunological  properties. The non-retained material induced important splenocyte proliferation.  In contrast, ligand bound material inhibited the proliferation elicited  by Concavalin A, as well as the proliferation induced by the non-retained  material.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> It is important to emphasize the importance of our observations for the  formulation of a possible vaccine for Chagas&#146; disease. In order to be effective,  it will be necessary to identify and purify antigens that preferentially  induce a protective response and eliminate those that stimulate suppression.  Unfortunately, our data indicate that most antigens present in crude <I>T.  cruzi</I> antigenic preparations induce down-regulation, more frequently than  proliferation.&nbsp; </FONT></P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> In conclusion, we have shown that most SE and ST semi purified antigens  induce <I>in vitro </I>a significant down-regulation of the immune response and  little proliferation. Furthermore, the bands that induce higher proliferation  or down-regulation are different in INF and CDM. The difference of the  data obtained in INF and CDM patients suggests that the response to these  antigens varies according to the clinical status of Chagas&#146; disease patients.&nbsp; </FONT></P>     <P ALIGN="justify"> <B><FONT COLOR="#1f1a17" size="2" face="Verdana"> ACKNOWLEDGEMENTS&nbsp; </FONT></B> </P>     <P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> This work was supported by FONACIT proyecto G2000001530, FONACIT LAB-200  0001639 y Consejo de Desarrollo Cientifico y tecnol&#243;gico de la UCV. We  thank Maria Eugenia Gallinotto and Dr. Marian Ulrich for critically reading  the manuscript&nbsp; </FONT></P>     <P ALIGN="justify"> <B><FONT COLOR="#1f1a17" size="2" face="Verdana"> REFERENCES&nbsp; </FONT></B> </P>     <!-- ref --><P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> 1.&nbsp;<B>WHO.</B> XIII Programme Reports. 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Mol Biochem Parasitol 1998; 92:133-145.</FONT>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=1138631&pid=S0535-5133200600030000600030&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --><!-- ref --><P ALIGN="justify"><FONT COLOR="#1f1a17" size="2" face="Verdana"> 31.&nbsp;<B>Hansen DS, Alievi G, Segura E, Carlomagno M, Morein B, Villacres-Eriksson  M. </B>The flagellar fraction (FF) of <I>Trypanosoma cruzi</I> depleted of an immunosuppressive  antigen enhances protection to infection and elicit spontaneous T cell  response. Parasite Immunol 1996; 18:607-615.&nbsp;</FONT>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=1138632&pid=S0535-5133200600030000600031&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --><p ALIGN="justify"><font color="#1f1a17" face="Verdana" size="2">Corresponding autor: Walter Mosca. Instituto de Biomedicina, Apartado 4043. Caracas 101OA, Venezuela. Telephone 58-2-8604636; 8604630. Fax: 58-2-8611258. E-mail: Wmosca@telcel.net.ve&nbsp;</font></p>      ]]></body>
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