scholarly journals Methotrexate Treatment for Type 1 (Reversal) Leprosy Reactions

2007 ◽  
Vol 45 (1) ◽  
pp. e7-e9 ◽  
Author(s):  
G. Biosca ◽  
S. Casallo ◽  
R. Lopez-Velez
Keyword(s):  
Leprosy Reactions ◽  
Methotrexate Treatment

Longitudinal Immune Responses and Gene Expression Profiles in Type 1 Leprosy Reactions

2013 ◽  
Vol 34 (2) ◽  
pp. 245-255 ◽  
Author(s):  
Annemieke Geluk ◽  
Krista E. van Meijgaarden ◽  
Louis Wilson ◽  
Kidist Bobosha ◽  
Jolien J. van der Ploeg-van Schip ◽  
...  
Keyword(s):  
Gene Expression ◽  
Immune Responses ◽  
Expression Profiles ◽  
Gene Expression Profiles ◽  
Leprosy Reactions

scholarly journals Leprosy Reactions: Clinical and Therapeutic Profile of Patients Registered at a Dermatology Reference Center in Brazil

10.3823/2534 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Danielle Oliveira De Sousa ◽  
Karolyne Moura Rique De Oliveira ◽  
Deborah Marques Centeno ◽  
Carolina Ribeiro Mainardi ◽  
Jean Carlos Alves de Lima Souza ◽  
...  
Keyword(s):  
Metropolitan Region ◽  
Multidrug Therapy ◽  
Inclusion Criteria ◽  
Neural Damage ◽  
Leprosy Reactions ◽  
Protective Sensation ◽  
The City ◽  
Therapeutic Profile

Introduction: During the course of leprosy, 10 to 50% of individuals can be surprised by reaction states, which are immune system reactions of the patient to Mycobacterium leprae. Leprosy reactions constitute the main cause of nerve damage and disability caused by leprosy. Objective:To analyze the clinical and therapeutic profile of patients with leprosy reactions registered in a Dermatology Service in the city of Belém-PA. Methods:This is a cross-seccional, descriptive study. It was investigated through analysis of medical records, 52 patients who fit the established inclusion criteria. Data were collected in july and august 2016. Results: It was found a predominance of men, from the metropolitan region. The clinical form most common of Leprosy was Borderline, and the leprosy reaction type 1. The most of reactions occurred right after the introduction of multidrug therapy,and more than a half of patients with type 1 reaction showed edema of limbs. Regarding the type 2, fever and general symptoms were the most common, present in all cases. The frequency of neural damage was evident, showing reduction of motor force level andloss of protective sensation. Conclusion: Early diagnosis and appropriate therapeutic management of reactive events is critical to the prevention of disabilities.

scholarly journals Longitudinal immune profiles in type 1 leprosy reactions in Bangladesh, Brazil, Ethiopia and Nepal

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Saraswoti Khadge ◽  
Sayera Banu ◽  
Kidist Bobosha ◽  
Jolien J. van der Ploeg-van Schip ◽  
Isabela M. Goulart ◽  
...  
Keyword(s):  
Leprosy Reactions

scholarly journals Exploratory urinary metabolomics of type 1 leprosy reactions

2016 ◽  
Vol 45 ◽  
pp. 46-52 ◽  
Author(s):  
Oleg. A. Mayboroda ◽  
Anouk van Hooij ◽  
Rico Derks ◽  
Susan J.F. van den Eeden ◽  
Karin Dijkman ◽  
...  
Keyword(s):  
Leprosy Reactions

scholarly journals Host-Related Laboratory Parameters for Leprosy Reactions

2021 ◽  
Vol 8 ◽  
Author(s):  
Yuqian Luo ◽  
Mitsuo Kiriya ◽  
Kazunari Tanigawa ◽  
Akira Kawashima ◽  
Yasuhiro Nakamura ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Clinical Symptoms ◽  
Type I ◽  
Leprosy Reactions ◽  
Erythema Nodosum Leprosum ◽  
Precise Diagnosis ◽  
Reversal Reaction

Leprosy reactions are acute inflammatory episodes that complicate the course of a Mycobacterium leprae infection and are the major cause of leprosy-associated pathology. Two types of leprosy reactions with relatively distinct pathogenesis and clinical features can occur: type 1 reaction, also known as reversal reaction, and type 2 reaction, also known as erythema nodosum leprosum. These acute nerve-destructive immune exacerbations often cause irreversible disabilities and deformities, especially when diagnosis is delayed. However, there is no diagnostic test to detect or predict leprosy reactions before the onset of clinical symptoms. Identification of biomarkers for leprosy reactions, which impede the development of symptoms or correlate with early-onset, will allow precise diagnosis and timely interventions to greatly improve the patients' quality of life. Here, we review the progress of research aimed at identifying biomarkers for leprosy reactions, including its correlation with not only immunity but also genetics, transcripts, and metabolites, providing an understanding of the immune dysfunction and inflammation that underly the pathogenesis of leprosy reactions. Nevertheless, no biomarkers that can reliably predict the subsequent occurrence of leprosy reactions from non-reactional patients and distinguish type I reaction from type II have yet been found.

scholarly journals Differential Expression of IFN-γ, IL-10, TLR1, and TLR2 and Their Potential Effects on Downgrading Leprosy Reaction and Erythema Nodosum Leprosum

2019 ◽  
Vol 2019 ◽  
pp. 1-14
Author(s):  
Douglas Eulálio Antunes ◽  
Isabela Maria Bernardes Goulart ◽  
Mayara Ingrid Sousa Lima ◽  
Patrícia Terra Alves ◽  
Paula Cristina Brígido Tavares ◽  
...  
Keyword(s):  
Path Analysis ◽  
Erythema Nodosum ◽  
Interleukin 10 ◽  
Dependence Relation ◽  
Tlr2 Expression ◽  
Leprosy Reactions ◽  
Erythema Nodosum Leprosum ◽  
Immunological Mechanisms ◽  
Ifn Γ

Leprosy reactions are acute immunological events that occur during the evolution of chronic infectious disease causing neural damage and disabilities. A study using blood samples of 17 leprosy reaction patients and 17 reaction-free was carried out by means of associations between antigens, receptors, and expression of cytokines, using path analysis providing new insights into the immunological mechanisms involved in triggering leprosy reactions. Toll-like receptors (TLR) such as TLR1 and TLR2, presented balanced expression in the reaction-free multibacillary (MB) group (TLR1: 1.01±0.23, TLR2: 1.22±0.18; p=0.267). On the other hand, downgrading type 1 reaction (T1R) (TLR1: 1.24±0.17, TLR2: 2.88±0.37; p=0.002) and erythema nodosum leprosum (ENL) (TLR1: 1.93±0.17, TLR2: 2.81±0.15; p=0.004) revealed an unbalance in relation to the expression of these receptors. When the path analysis was approached, it was noted that interleukin 10 (IL-10) expression showed a dependence relation with phenolic glycolipid I (PGL-I) in downgrading T1R (direct effect=0.503>residual effect=0.364), whereas in ENL, such relationship occurred with lipoarabinomannan (LAM) (direct effect=0.778>residual effect=0.280). On the contrary, in the reaction-free leprosy group, interferon-gamma (IFN-γ) levels were dependent on the association between TLR2 and TLR1 (0.8735). The high TLR2 expression associated with IL-10 levels, in the leprosy reaction groups, may be hypothetically related to the formation of TLR2/2 homodimers and/or TLR2/6 heterodimers linked to evasion mechanisms in downgrading reactions and pathophysiology of ENL.

scholarly journals Serum uric acid levels during leprosy reaction episodes

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1799 ◽  
Author(s):  
Yvelise T. Morato-Conceicao ◽  
Eduardo R. Alves-Junior ◽  
Talita A. Arruda ◽  
Jose C. Lopes ◽  
Cor J.F. Fontes
Keyword(s):  
Oxidative Stress ◽  
Uric Acid ◽  
Immune Deficiency Syndrome ◽  
Skin Lesions ◽  
Control Group ◽  
Enhanced Production ◽  
Leprosy Reactions ◽  
Leprosy Patients

Background.Leprosy reactions are acute inflammatory episodes that occur mainly in the multibacillary forms of the disease. The reactions are classified as type 1 (reverse reaction) or type 2 (erythema nodosum leprosum). Leprosy-associated oxidative stress has been widely demonstrated. Several recent studies have shown uric acid (UA) to have antioxidative effects under pathologic conditions. The objective of this study was to assess serum levels of UA in patients with leprosy reactions, with the aim of monitoring their levels before and after treatment, compared with levels in leprosy patients without reactions.Methods.The study included patients aged 18–69 years assisted at a leprosy treatment reference center in the Central Region of Brazil. Patients who were pregnant; were using immunosuppressant drugs or immunobiologicals; or had an autoimmune disease, human immunodeficiency virus infection, acquired immune deficiency syndrome, or tuberculosis were excluded. Upon recruitment, all individuals were clinically assessed for skin lesions and neural or systemic impairment. Some patients had already completed treatment for leprosy, while others were still undergoing treatment or had initiated treatment after being admitted. The treatment of the reactional episode was started only after the initial evaluation. Laboratory assessments were performed upon admission (baseline) and at approximately 30 and 60 days (time points 1 and 2, respectively).Results.A total of 123 leprosy patients were recruited between June 2012 and June 2015; among them, 56, 42, and 25 presented with type 1, type 2, and no reactions, respectively. Serum UA levels were significantly reduced in patients with type 2 leprosy reactions compared with patients in the control group and remained lower in the two subsequent assessments, after initiation of anti-reaction treatments, with similar values to those recorded before the treatment.Discussion.The decreased serum UA levels in patients with type 2 leprosy reactions might be due to the consumption of UA to neutralize the enhanced production of oxygen- and nitrogen-reactive species that occurs during type 2 reactions. The maintenance of the reduced levels in the follow-up assessments may indicate persistence of oxidative stress in the initial post-treatment stages, despite improved clinical conditions. The results of this study suggest that serum UA may play an antioxidative role during type 2 leprosy reactions.

Clinical Pearls

2016 ◽  
Vol 20 (5) ◽  
pp. 484-485 ◽  
Author(s):  
Jane Wu ◽  
Andrea K. Boggild
Keyword(s):  
Corticosteroid Therapy ◽  
Mycobacterium Leprae ◽  
Nerve Damage ◽  
Leprosy Reactions

Leprosy reactions are acute inflammatory episodes that occur in the setting of Mycobacterium leprae infection. Precipitants of reactions can be pharmacologic and nonpharmacologic. Both type 1 and type 2 reactions typically occur before and during leprosy treatment but may also occur after treatment has been completed. Reactions cause morbidity due to nerve damage, and prompt corticosteroid therapy is warranted to minimize nerve damage due to reactions.

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