Analysis of the myeloid-derived suppressor cells and annexin A1 in multibacillary leprosy and reactional episodes

Background Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Patients have distinct clinical forms, and the host´s immunological response regulate those manifestations. In this work, the presence of the myeloid-derived suppressor cell and the regulatory protein annexin A1 is described in patients with multibacillary leprosy and with type 1 and 2 reactions. Methods Patients were submitted to skin biopsy for histopathological analysis to obtain a bacilloscopic index. Immunofluorescence was used to detect myeloid-derived suppressor cells and annexin A1. Results The data demonstrated that the presence of granulocytic and monocytic myeloid-derived suppressor cells in leprosy patients. A high number of monocytic myeloid-derived suppressor cells were observed in lepromatous leprosy and type 2 reactional patients. The presence of annexin A1 was observed in all myeloid-derived suppressor cells. In particular, the monocytic myeloid-derived suppressor cell in the lepromatous patients has higher levels of this protein when compared to the reactional patients. This data suggest that the higher expression of this protein may be related to regulatory response against a severe infection, contributing to anergic response. In type 1 reactional patients, the expression of annexin A1 was reduced. Conclusions Myeloid-derived suppressor cell are present in leprosy patients and annexin A1 might be regulated the host response against Mycobacterium leprae.

RELATIONSHIP BETWEEN SERUM LEVELS OF IMMUNOGLOBULIN M-ANTI PHENOLIC GLYCOLIPID 1 AND IMMUNOGLOBULIN G-ANTI PHENOLIC GLYCOLIPID 1 WITH BACTERIA INDEX VALUES IN MULTIBACILLARY LEPROSY

Objective: This study aims to determine the relationship of serum levels of anti-phenolic glycolipid (PGL-1), immunoglobulin M (IgM), and anti-PGL-1 immunoglobulin G (IgG) with bacterial index (BI) values in multibacillary (MB) leprosy. Methods: This study was an observational study with a cross-sectional design. A total of 30 study samples were examined for a Slit Skin Smear and examined serum levels of IgM and IgG Anti PGL-1 antibodies by ELISA method. Results: The results showed the higher the BI value, the serum levels of IgM anti-PGL-1 and IgG anti-PGL-1 increased. Conclusion: There was a significant relationship between IgM anti-PGL-1 with BI value in MB leprosy (p<0.05), but there was no significant relationship between IgG anti-PGL-1 with BI value in MB leprosy (p>0.05). IgM anti-PGL-1 has more role in increasing the value of BI in MB leprosy.

Changes in B Cell Pool of Patients With Multibacillary Leprosy: Diminished Memory B Cell and Enhanced Mature B in Peripheral Blood

Despite being treatable, leprosy still represents a major public health problem, and many mechanisms that drive leprosy immunopathogenesis still need to be elucidated. B cells play important roles in immune defense, being classified in different subgroups that present distinct roles in the immune response. Here, the profile of B cell subpopulations in peripheral blood of patients with paucibacillary (TT/BT), multibacillary (LL/BL) and erythema nodosum leprosum was analyzed. B cell subpopulations (memory, transition, plasmablasts, and mature B cells) and levels of IgG were analyzed by flow cytometry and ELISA, respectively. It was observed that Mycobacterium leprae infection can alter the proportions of B cell subpopulations (increase of mature and decrease of memory B cells) in patients affected by leprosy. This modulation is associated with an increase in total IgG and the patient’s clinical condition. Circulating B cells may be acting in the modulation of the immune response in patients with various forms of leprosy, which may reflect the patient’s ability to respond to M. leprae.

A clinicoepidemiological study of familial leprosy

: Hansen’s disease (also known as leprosy) is an infection caused by Mycobacterium leprae which can affect the skin, mucous membranes and nerves. It is known to spread among and infect family members. There are very few published studies pertaining to family leprosy conducted in India and worldwide. : To find the prevalence of familial leprosy and to know the clinicoepidemiological patterns of these cases.: Observational study.: This was a descriptive study conducted for a period of five years from 2013-2018. The study population included all new documented cases of leprosy visiting our out-patient department during the study period. All the patients were diagnosed as leprosy on histopathological confirmation or by the presence of cardinal signs of leprosy according to the world health organization (WHO) definition. The data collected was analysed by simple descriptive statistics. Permission to conduct the study was taken from institutional ethical committee. Consent was taken from index case and family members.: A total of 302 new leprosy cases with 18 index cases (n=18) whose family members were affected, accounting for the prevalence of 5.96 %. Total number of family members with documented leprosy (old or newly detected) was 26. So, the total number of leprosy cases were 44 (index cases + family members). Out of the 18 families, 4 families had more than one person who was affected. 8 cases (18.18%) of Childhood leprosy were noted. Among the index cases 4 cases (22%) of paucibacillary leprosy were seen and 14 cases (78%) of multibacillary leprosy was seen. Among the family members, 18 cases of paucibacillary leprosy were seen and 8 cases of multibacillary leprosy were seen. Conjugal leprosy was seen in 10 families accounting for the prevalence of 3.31%. : Our study intends to emphasize the importance of examining the close contacts of a case of leprosy, especially the family members in whom the incidence of leprosy could be very high. By way of identifying leprosy cases early in its course we may be able to prevent deformities to a great extent.

Profil Dehabilitasi Pasien Kusta di Rumah Sakit Kusta Alverno Singkawang: Studi Pendahuluan

Abstrak Kusta dapat menyebabkan disabilitas permanen yang memengaruhi fisik dan psikis pasien. Stigmadiri dan stigma sosial menyebabkan pasien mengalami dehabilitasi yang dapat menurunkan kualitashidup penyandangnya. Penelitian ini merupakan studi pendahuluan yang bertujuan untuk mendapatkanprofil dehabilitasi pasien kusta termasuk orang yang pernah mengalami kusta (OYPMK). Penelitian inimenggunakan metode potong lintang untuk menilai profil dehabilitasi pasien kusta dan OYPMK menggunakanskala dehabilitasi Anandaraj di RS Kusta Alverno Singkawang, bulan Juli 2019. Delapan puluh delapan subjekdiikutkan dalam penelitian ini. Analisis data dilakukan menggunakan uji Mann Whitney untuk menilai hubungantipe kusta dan derajat dehabilitasi, serta uji Kruskal Wallis untuk melihat hubungan antara reaksi kusta danderajat disabilitas terhadap skala dehabilitasi. Analisis dilakukan menggunakan perangkat lunak SPSS formac. Subjek terbanyak adalah laki-laki, usia produktif, bekerja sebagai petani, berpenghasilan kurang dari 1,5juta per bulan, tidak bersekolah, sudah menikah, etnis Tionghoa, tinggal di dalam rumah yang padat, memilikikeluarga serumah yang menderita kusta, terdiagnosis kusta tipe multibasiler, pernah mengalami reaksi dantelah menyelesaikan pengobatan. Dari penelitian ini didapatkan bahwa tipe kusta dan disabilitas derajat noldan dua berhubungan dengan skala dehabilitasi Anandaraj (p<0.05). Stigma terhadap kusta hingga kinimerupakan masalah yang belum dapat diatasi. Stigma dan disabilitas akibat kusta berperan penting terhadapkejadian dehabilitasi yang menyebabkan penurunan kualitas hidup pasien kusta dan OYPMK. Kata kunci: Anandaraj, dehabilitasi, kusta, Singkawang. Dehabilitation Profile of Leprosy Patients in Alverno Singkawang Hospital: a Preliminary Study Abstract Leprosy causes permanent disability that affects both physical and psychological aspect of the patient.Self-stigma and social stigma cause dehabilitation; therefore, reducing the quality of life of the patients. Thisresearch is a preliminary study to assess the dehabilitation profile of leprosy patients, including people whohave had leprosy (OYPMK). A cross-sectional method was used to assess the dehabilitation scale of leprosypatients in Alverno Leprosy Hospital, Singkawang, using the Anandaraj dehabilitation scale. Eighty-eightsubjects were included in the analysis. Mann-Whitney test was done to analyze the association betweentype of leprosy and dehabilitation scale, and Kruskal Wallis test was done to analyze the association betweenleprosy reaction and grade of disability with dehabilitation scale. Most subjects are male, productive age,farmers, less than 1.5 million wages per month, uneducated, married, Chinese ethnicity, living in a crowdedhouse, had a family with leprosy, diagnosed with multibacillary leprosy, had an episode of leprosy reaction danreleased from treatment. Type of leprosy and WHO disability grade 0 and 2 are related to the dehabilitationscale. Leprosy stigmatization is still a worrisome problem. Together with the disability, stigmatization affectsthe dehabilitation scale of leprosy patients leading to reduced quality of life. Keywords: Anandaraj, dehabilitation, leprosy, Singkawang.