BACKGROUND: Tumor necrosis factor-alpha (TNF) is an important mediator of immunologic responses to chronic infections. METHOD: Sera from 25 patients with acute reactions (6 with type 1 upgrading, 8 with type 1 downgrading, and 11 with type 2 reaction) were assayed for TNF before treatment and after clinical remission of the acute episode. The results were compared with serum TNF levels in healthy controls and fresh pauci- and multibacillary leprosy patients. RESULTS: TNF levels in acute reactions were higher than in the control groups (significant only in upgrading reaction). In type 1 reaction, serum TNF concentrations fell to approximately the levels of the control patients following treatment and clinical remission. In type 2 reaction, however, levels of TNF were seen to rise further (became statistically significant) as a result of therapy induced clinical remission. CONCLUSIONS: The rise in TNF-alpha level in reactions in leprosy is significant and indicates its active role in immunopathogenesis. The corresponding decline in TNF-alpha levels seen following regression of type 1 (lepra) reactions was not observed in the case of type 2 (ENL) reaction. This probably reflects the enhancement of cellular immunity in such cases and/or an attempt by the immunologic process to overcome specific inhibitors.
BACKGROUND:Tumor necrosis factor-alpha (TNF) is an important mediator of immunologic responses to chronic infections. METHOD: Sera from 25 patients with acute reactions (6 with type 1 upgrading, 8 with type 1 downgrading, and 11 with type 2 reaction) were assayed for TNF before treatment and after clinical remission of the acute episode. The results were compared with serum TNF levels in healthy controls and fresh pauci- and multibacillary leprosypatients. RESULTS:TNF levels in acute reactions were higher than in the control groups (significant only in upgrading reaction). In type 1 reaction, serum TNF concentrations fell to approximately the levels of the control patients following treatment and clinical remission. In type 2 reaction, however, levels of TNF were seen to rise further (became statistically significant) as a result of therapy induced clinical remission. CONCLUSIONS: The rise in TNF-alpha level in reactions in leprosy is significant and indicates its active role in immunopathogenesis. The corresponding decline in TNF-alpha levels seen following regression of type 1 (lepra) reactions was not observed in the case of type 2 (ENL) reaction. This probably reflects the enhancement of cellular immunity in such cases and/or an attempt by the immunologic process to overcome specific inhibitors.
Authors: W Cairns S Smith; Peter G Nicholls; Loretta Das; Pramila Barkataki; Sujai Suneetha; Lavanya Suneetha; Rupendra Jadhav; P S S Sundar Rao; Einar P Wilder-Smith; Diana N J Lockwood; Wim H van Brakel Journal: PLoS Negl Trop Dis Date: 2009-08-11
Authors: Mariane M Stefani; Jackeline G Guerra; Ana Lucia M Sousa; Mauricio B Costa; Maria Leide W Oliveira; Celina T Martelli; David M Scollard Journal: BMC Infect Dis Date: 2009-05-27 Impact factor: 3.090
Authors: José Augusto da Costa Nery; Fred Bernardes Filho; Juliana Quintanilha; Alice Miranda Machado; Soraya de Souza Chantre Oliveira; Anna Maria Sales Journal: An Bras Dermatol Date: 2013 Sep-Oct Impact factor: 1.896