Profile of Trypanosoma cruzi Reactivity in a Population at High Risk for Endemic Pemphigus Foliaceus (Fogo Selvagem)

Joaquim X. Sousa Jr. Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Luis A. Diaz Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Donald P. Eaton Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Günter Hans-Filho Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Elder Lanzani de Freitas Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Livia Delgado Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Ligia Maria F. Ichimura Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Flávia Cristaldi Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Renata Orlandi Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Norival Kesper Jr. Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Eufrosina S. Umezawa Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Evandro A. Rivitti Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Valeria Aoki Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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The Cooperative Group on Fogo Selvagem Research Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil; Department of Dermatology, University of North Carolina at Chapel Hill, North Carolina; Wildlife Conservation Society, Campo Grande, MS, Brazil; Federal University of Mato Grosso do Sul, Brazil; Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil

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Fogo Selvagem (FS) is an autoimmune bullous disease with pathogenic IgG autoantibodies recognizing desmoglein 1 (Dsg1), a desmosomal glycoprotein. In certain settlements of Brazil, a high prevalence of FS (3%) is reported, suggesting environmental factors as triggers of the autoimmune response. Healthy individuals from endemic areas recognize nonpathogenic epitopes of Dsg1, and exposure to hematophagous insects is a risk factor for FS. Fogo selvagem and Chagas disease share some geographic sites, and anti-Dsg1 has been detected in Chagas patients. Indeterminate Chagas disease was identified in a Brazilian Amerindian population of high risk for FS. In counterpart, none of the FS patients living in the same geographic region showed reactivity against Trypanosoma cruzi. The profile of anti-Dsg1 antibodies showed positive results in 15 of 40 FS sera and in 33 of 150 sera from healthy individuals from endemic FS sites, and no cross-reactivity between Chagas disease and FS was observed.

Author Notes

* Address correspondence to Valeria Aoki, Av. Dr. Enéas de Carvalho Aguiar 255, Sala 3016, Departamento de Dermatologia-Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, CEP 05403-002. E-mail: valeria.aoki@gmail.com

Financial support: This work was partially supported by a National Institute of Health grant-NIAMSD 5 R01 AR032599-29 (LAD).

Authors' addresses: Joaquim X. Sousa Jr., Elder Lanzani de Freitas, Livia Delgado, Ligia Maria F. Ichimura, Flávia Cristaldi, Renata Orlandi, Evandro A. Rivitti, and Valeria Aoki, Departamento de Dermatologia-Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, E-mails: jxsj@yahoo.com, elderlanzanifreitas@yahoo.com.br/, paralivi@hotmail.com, liichi01@hotmail.com, flaviacristaldi@bol.com.br, re_orlandi@hotmail.com/, evandro.rivitti@gmail.com, and valeria.aoki@gmail.com. Luis A. Diaz, Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, E-mail: ldiaz@med.unc.edu. Donald P. Eaton, Wildlife Conservation Society, Campo Grande, MS, Brazil, E-mail: ksadeaton@yahoo.com. Günter Hans-Filho, Department of Dermatology, Federal University of Mato Grosso do Sul, Campo Grande, Brazil, E-mail: ghansfilho@hotmail.com. Norival Kesper Jr. and Eufrosina S. Umezawa, Instituto de Medicina Tropical, University of São Paulo Medical School, São Paulo, Brazil, E-mails: nkesper@usp.br and eumezawa@usp.br.

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