scholarly journals Leprosy patients: neurotrophic factors and axonal markers in skin lesions

2012 ◽  
Vol 70 (4) ◽  
pp. 281-286 ◽  
Author(s):  
Letícia Baccaro Michellin ◽  
Jaison Antonio Barreto ◽  
Lúcia Helena Soares Camargo Marciano ◽  
Flavio Alves Lara ◽  
Maria Esther Salles Nogueira ◽  
...  
Keyword(s):  
Neurotrophic Factors ◽  
Skin Lesions ◽  
Clinical Parameters ◽  
Pgp 9.5 ◽  
Peripheral Nerve Damage ◽  
Leprosy Patients ◽  
Nociceptive Fibers ◽  
Neural Impairment ◽  
Multibacillary Leprosy

Neurotrophins are growth factors with crucial roles in neural pathophysiology. These mediators functionally modulate nociceptive fibers, and changes in neurotrophins expression have been correlated with early loss of nociception in leprosy. This study investigated the expression of NGF, BDNF, and NT3 in dermal nerves of leprosy patients. Characterization of Remak bundles was achieved by p75NTR, and axonal markers NF-L and PGP 9.5 immunostaining. Clinical parameters of neural impairment have been evaluated by Semmes-Wenstein monofilaments. Our findings demonstrated decrease of NGF in borderline leprosy, when compared to control specimens. Similar results were observed in PGP 9.5 expression (borderline: p<0.001 and lepromatous: p<0.05) and NF-L (lepromatous: p<0.05), suggesting advanced Remak bundles degeneration in multibacillary leprosy. It has also been observed positive correlation between p75NTR and PGP 9.5, indicating association between Schwann cells and axons in Remak bundles. Present data indicate that neurotrophins imbalance may participate in the establishment of peripheral nerve damage.

scholarly journals Powerful Bactericidal Activity of Moxifloxacin in Human Leprosy

2008 ◽  
Vol 52 (9) ◽  
pp. 3113-3117 ◽  
Author(s):  
Fe Eleanor F. Pardillo ◽  
Jasmin Burgos ◽  
Tranquilino T. Fajardo ◽  
Eduardo Dela Cruz ◽  
Rodolfo M. Abalos ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Bactericidal Activity ◽  
Mycobacterium Leprae ◽  
Skin Lesions ◽  
Definite Improvement ◽  
Highly Effective ◽  
Leprosy Patients ◽  
Multibacillary Leprosy

ABSTRACT In a clinical trial of moxifloxacin in eight multibacillary leprosy patients, moxifloxacin proved highly effective. In all trial patients, a single 400-mg dose of moxifloxacin resulted in significant killing (P ≤ 0.006) of Mycobacterium leprae, ranging from 82% to 99%, with a mean of 91%. In all instances, no viable bacilli were detected with an additional 3 weeks of daily therapy, this observed rapid bactericidal activity being matched previously only by rifampin. On moxifloxacin therapy, skin lesions cleared exceedingly rapidly with definite improvement observed consistently after eight doses and progressive resolution continuing for the 56 days of the trial. Side effects, toxicities, and laboratory abnormalities were mild, not requiring discontinuation of therapy.

MO224VCAM-1 LEVELS ASSOCIATED WITH ALBUMINURIA IN MULTIBACILLARY LEPROSY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Louise Donadello Tessarolo ◽  
Gdayllon Cavalcante Meneses ◽  
Gabriela Freire Bezerra ◽  
Geraldo Bezerra da Silva Junior ◽  
Elizabeth De Francesco Daher ◽  
...  
Keyword(s):  
Clinical Care ◽  
Epidemiological Data ◽  
Skin Lesions ◽  
Cross Sectional Study ◽  
Vascular Involvement ◽  
Clinical Aspects ◽  
Cross Sectional ◽  
Leprosy Patients ◽  
Duration Of Disease ◽  
Multibacillary Leprosy

Abstract Background and Aims Leprosy may present important renal and endothelial abnormalities, and this can worse patients’ prognosis. However, renal and vascular involvement in these patients has been poor investigated. The aim of this study was to investigate if higher systemic endothelial biomarkers levels are associated with renal abnormalities and clinical aspects of leprosy. Method This is a cross-sectional study with leprosy patients before initiation of multidrug therapy enrolled in January 2017 to December 2018 in Fortaleza, northeast Brazil. Leprosy-associated clinical and epidemiological data were collected. Two groups were constructed: Paucibacillary (PB) and Multibacillary (MB) for comparisons. Serum and urine samples were obtained for laboratory analysis. In urine the following parameters were evaluated: creatinine, proteinuria and albuminuria. In serum the endothelial biomarkers were evaluated: VCAM-1 and ICAM-1, using ELISA assay. Results A total of 101 leprosy patients were included, with mean age of 48±15 years, and 71 (70%) were male. The multibacillary form occurred in 81 cases (80%), where 22 had a Virchowian form. VCAM-1 was elevated in MB group and was correlated with the bacteriological index (skin smear) (r = 0.372, p &lt;0.01), duration of disease symptoms (r = 0.234, p = 0.04), and number of skin lesions ( r = 0.331, p &lt;0.001). Moreover, in MB patients who presented albuminuria &gt;15 mg/g of creatinine, VCAM-1 showed a significant correlation (r = 0.341, p &lt;0.05) with increased albuminuria and improve the correlation with number of skin lesions (r = 0.653, p=0.003). Conclusion Multibacillary leprosy patients present high systemic levels of VCAM-1, associated with leprosy clinical features and increased albuminuria, an important marker of kidney disease progression. Further prospective studies are necessary to establish a cause-effect relation and evaluate the preventive role of these biomarkers, aiming to improve clinical care.

scholarly journals Characterization of MicroRNA Expression Profiles and Identification of Potential Biomarkers in Leprosy

2017 ◽  
Vol 55 (5) ◽  
pp. 1516-1525 ◽  
Author(s):  
Karina T. O. S. Jorge ◽  
Renan P. Souza ◽  
Marieta T. A. Assis ◽  
Marcelo G. Araújo ◽  
Massimo Locati ◽  
...  
Keyword(s):  
Expression Profiles ◽  
Principal Component ◽  
Skin Lesions ◽  
Lepromatous Leprosy ◽  
Diagnostic Potential ◽  
Reverse Transcription Quantitative Pcr ◽  
Leprosy Patients ◽  
Healthy Control ◽  
Validation Experiments

ABSTRACT Leprosy is an important cause of disability in the developing world. Early diagnosis is essential to allow for cure and to interrupt transmission of this infection. MicroRNAs (miRNAs) are important factors for host-pathogen interaction and they have been identified as biomarkers for various infectious diseases. The expression profile of 377 microRNAs were analyzed by TaqMan low-density array (TLDA) in skin lesions of tuberculoid and lepromatous leprosy patients as well as skin specimens from healthy controls. In a second step, 16 microRNAs were selected for validation experiments with reverse transcription-quantitative PCR (qRT-PCR) in skin samples from new individuals. Principal-component analysis followed by logistic regression model and receiver operating characteristic (ROC) curve analyses were performed to evaluate the diagnostic potential of selected miRNAs. Four patterns of differential expression were identified in the TLDA experiment, suggesting a diagnostic potential of miRNAs in leprosy. After validation experiments, a combination of four miRNAs (miR-101, miR-196b, miR-27b, and miR-29c) was revealed as able to discriminate between healthy control and leprosy patients with 80% sensitivity and 91% specificity. This set of miRNAs was also able to discriminate between lepromatous and tuberculoid patients with a sensitivity of 83% and 80% specificity. In this work, it was possible to identify a set of miRNAs with good diagnostic potential for leprosy.

Leprosy in a Chimpanzee: Morphology of the Skin Lesions and Characterization of the Organism

1978 ◽  
Vol 15 (3) ◽  
pp. 339-346 ◽  
Author(s):  
J. R. Leininger ◽  
K. J. Donham ◽  
M. J. Rubino
Keyword(s):  
Bovine Leukemia Virus ◽  
Leukemia Virus ◽  
Mycobacterium Leprae ◽  
Skin Lesions ◽  
Clear Zone ◽  
Infiltrating Cells ◽  
Leprosy Patients ◽  
Microscopic Features ◽  
Acid Fast Staining

Microscopic features of lepromatoid lesions in a chimpanzee inoculated with bovine leukemia virus consisted of diffuse dermal infiltrations of foamy histiocytes, except for a subepidermal “clear zone” devoid of infiltrating cells. Acid-fast organisms were in histiocytes, dermal nerves and a branch of the left radial nerve. The organisms were more intensely acid-fast with the Fite-Faraco than with the Ziehl-Neelsen stain. The organisms did not oxidize 3,4-dihydroxyphenylalanine (dopa) to indole but their acid-fast staining quality was removed by pretreatment with pyridine. Human leprosy patients, inoculated simultaneously with chimpanzee and human lepromin, reacted similarly to both lepromins. Organisms, when inoculated into mouse footpads, multiplied in 6 months to a quantity that was compatible with their identification as Mycobacterium leprae.

scholarly journals Ulcers in leprosy patients, an unrecognized clinical manifestation: a report of 8 cases

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Denis Miyashiro ◽  
Carolina Cardona ◽  
Neusa Yuriko Sakai Valente ◽  
João Avancini ◽  
Gil Benard ◽  
...  
Keyword(s):  
Venous Insufficiency ◽  
Delayed Diagnosis ◽  
Specific Treatment ◽  
Skin Lesions ◽  
Lower Limbs ◽  
Skin Ulcers ◽  
Wide Range ◽  
Leprosy Patients ◽  
Mean Time ◽  
Multibacillary Leprosy

Abstract Background Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae. It is a polymorphic disease with a wide range of cutaneous and neural manifestations. Ulcer is not a common feature in leprosy patients, except during reactional states, Lucio’s phenomenon (LP), or secondary to neuropathies. Cases presentation We report eight patients with multibacillary leprosy who presented specific skin ulcers as part of their main leprosy manifestation. Ulcers were mostly present on lower limbs (eight patients), followed by the upper limbs (three patients), and the abdomen (one patient). Mean time from onset of skin ulcers to diagnosis of leprosy was 17.4 months: all patients were either misdiagnosed or had delayed diagnosis, with seven of them presenting grade 2 disability by the time of the diagnosis. Reactional states, LP or neuropathy as potential causes of ulcers were ruled out. Biopsy of the ulcer was available in seven patients: histopathology showed mild to moderate lympho-histiocytic infiltrate with vacuolized histiocytes and intact isolated and grouped acid-fast bacilli. Eosinophils, vasculitis, vasculopathy or signs of chronic venous insufficiency were not observed. Skin lesions improved rapidly after multidrug therapy, without any concomitant specific treatment for ulcers. Conclusions This series of cases highlights the importance of recognizing ulcers as a specific cutaneous manifestation of leprosy, allowing diagnosis and treatment of the disease, and therefore avoiding development of disabilities and persistence of the transmission chain of M. leprae.

scholarly journals COVID-19, leprosy, and neutrophils

2021 ◽  
Vol 15 (1) ◽  
pp. e0009019
Author(s):  
Veronica Schmitz ◽  
Jéssica Brandão dos Santos
Keyword(s):  
Healthcare Services ◽  
Neutrophil Extracellular Trap ◽  
Public Health Systems ◽  
Peripheral Nerve Damage ◽  
Erythema Nodosum Leprosum ◽  
Immune Mediated ◽  
Leprosy Patients ◽  
Patients Experience ◽  
Multibacillary Leprosy ◽  
Local Healthcare

Coronavirus Disease 2019 (COVID-19), a disease caused by the betacoronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has only recently emerged, while Mycobacterium leprae, the etiological agent of leprosy, has endured for more than 2,000 years. As soon as the initial reports of COVID-19 became public, several entities, including the Brazilian Leprosy Society, warned about the possible impact of COVID-19 on leprosy patients. It has been verified that COVID-19 carriers can be either asymptomatic or present varying degrees of severe respiratory failure in association with cytokine storm and death, among other diseases. Severe COVID-19 patients show increased numbers of neutrophils and serum neutrophil extracellular trap (NET) markers, in addition to alterations in the neutrophil-to-lymphocyte ratio (NLR). The absence of antiviral drugs and the speed of COVID-19 transmission have had a major impact on public health systems worldwide, leading to the almost total collapse of many national and local healthcare services. Leprosy, an infectious neurological and dermatological illness, is widely considered to be the most frequent cause of physical disabilities globally. The chronic clinical course of the disease may be interrupted by acute inflammatory episodes, named leprosy reactions. These serious immunological complications, characterized by cytokine storms, are responsible for amplifying peripheral nerve damage. From 30% to 40% of all multibacillary leprosy (MB) patients experience erythema nodosum leprosum (ENL), a neutrophilic immune-mediated condition. ENL patients often present these same COVID-19-like symptoms, including high levels of serum NET markers, altered NLR, and neutrophilia. Moreover, the consequences of a M. leprae–SARS-CoV-2 coinfection have yet to be fully investigated. The goal of the present viewpoint is to describe some of the similarities that may be found between COVID-19 and leprosy disease in the context of neutrophilic biology.

scholarly journals On Using a Mobile Application to Support Teledermatology: A Case Study in an Underprivileged Area in Colombia

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Juan Pablo Sáenz ◽  
Mónica Paola Novoa ◽  
Darío Correal ◽  
Bell Raj Eapen
Keyword(s):  
Rural Areas ◽  
Mobile Applications ◽  
Mobile Application ◽  
Correct Diagnosis ◽  
Skin Lesions ◽  
Healthcare Personnel ◽  
Combined Use ◽  
Forest Regions ◽  
The Face

Background. The use of mobile applications in dermatology to support remote diagnosis is gaining acceptance, particularly in rural areas, where dermatology services are commonly managed by healthcare personnel with no specialty training. Moreover, ontologies—sets of concepts that represent knowledge in a given domain—are increasingly being used to support medical diagnosis. A specific case is ONTODerm: an ontology to aid dermatological diagnosis. However, there is little information on the combined use of mobile applications and ontologies as support solutions in dermatology. Objective. Assessing the reliability of ONTODerm as a tool to support remote dermatological diagnosis when used together with a mobile dermatological application in underprivileged areas. Methods. A mobile application that allows characterization of skin lesions was developed, and the information about the lesions was sent to ONTODerm. An exploratory study was conducted in a remote area without access to a dermatologist. A total of 64 dermatological queries were recorded in the application and consulted with ONTODerm. Later, an experienced dermatologist evaluated the characterization and diagnosis of each query to determine the accuracy of the system. Results. The results showed that the probability of obtaining a correct diagnosis was between 64.4% and 85.6% with a confidence interval of 95%. A higher accuracy rate was obtained when the skin lesion occurred on the face or when its border was categorized as poorly demarcated. Conclusions. This study demonstrates the implementation of a teledermatology strategy based on mobile applications and domain ontology-driven knowledge base to provide timely assistance to healthcare professionals. This approach was found to be pertinent in the Colombian rural context, particularly in forest regions, where dermatology specialists are not available. The results of this article do not represent a final validation of the proposed approach; they suggest how the ontology can be improved to effectively support medical staff in marginalized regions.

HISTOPATHOLOGICAL EVALUATION OF WHO CLASSIFIED MULTIBACILLARY LEPROSY CASES IN A TERTIARY CARE CENTRE, SOUTH KERALA

2021 ◽  
pp. 32-34
Author(s):  
Anita Sanker ◽  
G Nandakumar ◽  
Swapna Balkrishnan
Keyword(s):  
Immune Response ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Newly Diagnosed ◽  
Epithelioid Cells ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Leprosy Patients ◽  
Epidermal Atrophy ◽  
Multibacillary Leprosy

There are signicant differences in the histopathology of leprosy lesions which is inuenced by the host immune response to Mycobacterium leprae. Objective - To nd the histopathological changes in newly diagnosed multibacillary leprosy(MB) cases registered in the skin department Government Medical College, Thiruvananthapuram. Method- skin biopsy performed in 40 multibacillary leprosy cases and histopathological ndings were evaluated. 70% showed epidermal atrophy. Granulomas, composed of sheets of foamy macro Results- phages, lymphocytes and epithelioid cells, were seen in 21 cases & twenty two cases were AFB positive. Eight cases each were lepromatous, borderline tuberculoid, mid boderline, borderline lepromatous types. Conclusion- Presence of 60% cases of borderline leprosy indicates the unstable immune response in leprosy patients. Majority were either borderline lepromatous or lepromatous showing the infective nature of multibacillary leprosy. Histopathological examination with Fite- Foroco staining is a crucial method and the gold standard for accurate diagnosis and typing of leprosy.

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