Avaliação do uso da timomodulina em gatos naturalmente infectados com esporotricose cutânea disseminada

Abstract

Sporotrichosis is one of the most important mycoses for the feline species, both for its implications for the cat and for its zoonotic potential. The most successful referenced therapeutic guideline is the association of itraconazole (ITL) with potassium iodide (KI). Specifically about sporotrichosis, feline species are known to have failures in innate immunity and formation of ringworm-controlling granulomas. Thus, the use of immunomodulators such as thymomodulin may be determinant in the prognosis of these patients. The aim of this thesis was to evaluate, through a prospective clinical study, the therapeutic potential of thymomodulin in cats with disseminated cutaneous sporotrichosis, as well as to investigate possible prognostic predictors of sporotrichosis in this population. During the development of the thesis, four articles were developed that resulted in the fulfillment of the proposed objectives. The first article came from the study of a clinical case of immunomodulator-treated sporotrichosis. Article 2 was a review on immunomodulators used in cats, and finally the last article presented a prospective study evaluating and comparing conventional treatment for sporotrichosis with conventional treatment plus the immunomodulatory drug timomodulin. In the first article, 5mg / kg of ITL-associated timomodulin (100mg / cat) and KI (5mg / kg) were used in feline with sporotrichosis and after 65 days complete remission of the lesions was observed. In the third study the animals were segregated into two groups: G1 treated with ITL (100mg / cat), KI (5mg / kg) once daily associated with thymomodulin (4mg / kg) and G2 ITL (100mg / cat) cat and KI (5mg / kg) once a day. The cats were submitted to clinical, hematological and biochemical evaluation at three moments: before the beginning of treatment (M0), after 5 to 7 weeks of treatment (M1) and after 13 to 15 weeks of treatment (M2). The clinical evaluation involved monitoring the body condition score (ECC) and the evolution of the lesions during the treatment, being classified as clinical cure when there was complete remission of the lesions, stabilization when there was no improvement or worsening, and clinical deterioration when there was an increase in the condition. number or size of lesions. For hematological and biochemical evaluation, blood samples were collected for blood count and biochemical tests: alanine aminotransferase, alkaline phosphatase, urea and creatinine. At the end of the study, G1 had a significantly higher survival rate (93.6%) than G2 (53%) (p <0.02). In addition, patients in G1 showed earlier improvement in clinical parameters than G2. especially related to remission of extra-cutaneous signs and ECC progress, both factors being associated with better prognosis (p <0.02). The combination oftimomodulin with itraconazole and potassium iodide improved the prognosis of cats with disseminated cutaneous sporotrichosis and had no additional side effects.