Markers of leprosy, reactions in skin and nerves
Although effective antibiotics are available to treat the mycobacterial infection Mycobacterium leprae, which affects skin and peripheral nerves, a key part of the disease process is the accompanying inflammation.
Although effective antibiotics are available to treat the mycobacterial infection Mycobacterium leprae, which affects skin and peripheral nerves, a key part of the disease process is the accompanying inflammation. This can worsen after starting antibacterial treatment with episodes of immune mediated inflammatory reactions. When they occur these reactions are associated with worsening of the nerve damage. In this cohort study 303 newly diagnosed multibacillary leprosy patients were recruited with the aim to identify risk factors for an inflammatory reaction and the accompanying nerve damage. The researchers took skin and nerve biopsies and used light microscopic and immunohistochemical techniques to define which molecules and mediators of inflammation were present.They found high levels of the cytokines Tumour Necrosis Factor alpha (TNF-alpha), Transforming Growth Factor beta (TGF-beta) and inducible Nitric Oxide Synthase (iNOS) in biopsies from patients with reactions. They also found high levels of bacteria and inflammation in the nerves. Thereby showing that it is necessary to further determine which other molecules are present and to explore ways of switching off the production of these pro-inflammatory molecules to lessen the nerve damage caused by the disease.
