Altered composition and functional profile of high-density lipoprotein in leprosy patients.

The changes in host lipid metabolism during leprosy have been correlated to fatty acid alterations in serum and with high-density lipoprotein (HDL) dysfunctionality. This is most evident in multibacillary leprosy patients (Mb), who present an accumulation of host lipids in Schwann cells and macrophages. This accumulation in host peripheral tissues should be withdrawn by HDL, but it is unclear why this lipoprotein from Mb patients loses this function. To investigate HDL metabolism changes during the course of leprosy, HDL composition and functionality of Mb, Pb patients (paucibacillary) pre- or post-multidrug therapy (MDT) and HC (healthy controls) were analyzed. Mb pre-MDT patients presented lower levels of HDL-cholesterol compared to HC. Moreover, Ultra Performance Liquid Chromatography-Mass Spectrometry lipidomics of HDL showed an altered lipid profile of Mb pre-MDT compared to HC and Pb patients. In functional tests, HDL from Mb pre-MDT patients showed impaired anti-inflammatory and anti-oxidative stress activities and a lower cholesterol acceptor capacity compared to other groups. Mb pre-MDT showed lower concentrations of ApoA-I (apolipoprotein A-I), the major HDL protein, when compared to HC, with a post-MDT recovery. Changes in ApoA-I expression could also be observed in M. leprae-infected hepatic cells. The presence of bacilli in the liver of a Mb patient, along with cell damage, indicated hepatic involvement during leprosy, which may reflect on ApoA-I expression. Together, altered compositional and functional profiles observed on HDL of Mb patients can explain metabolic and physiological changes observed in Mb leprosy, contributing to a better understanding of its pathogenesis.

Hanseníase multibacilar: índices baciloscópios e viabilidade do M. leprae após 24 doses da PQT/OMS / Multivacillar leprosy: bacilloscopic index and viability of M. leprae after 24 doses of multidrug therapy: worlld health organization (MDT/WHO)

A técnica de inoculação no coxim plantar de camundongos (técnica de Shepard) possibilita a verificação da resistência aos quimioterápicos e a viabilidade do M. Leprae. O objetivo era avaliar por meio da técnica de Shepard a viabilidade do M. leprae em material de biópsia cutânea proveniente de pacientes hansenianos multibacilares. Biópsias cutâneas e esfregaços de linfas cutâneas em 21 pacientes hansenianos multibacilares após 24 doses do esquema poliquimioterápico (PQT/OMS). A comparação dos resultados dos índices baciloscópico e morfológico entre as duas amostras demonstrou valores significativamente maiores nos índices baciloscópicos das biópsias cutâneas. A concentração do M.Leprae 12 meses após a inoculação mostrou valores inferiores ao referido como padrão de multiplicação, sugerindo que a população bacilar nas biópsias cutâneas de pacientes hansenianos multibacilares após 24 doses da PQT/OMS pode ser considerada não viável