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1.
J Immunol Res ; 2019: 3405103, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31781675

RESUMEN

Leprosy reactions are acute immunological events that occur during the evolution of chronic infectious disease causing neural damage and disabilities. A study using blood samples of 17 leprosy reaction patients and 17 reaction-free was carried out by means of associations between antigens, receptors, and expression of cytokines, using path analysis providing new insights into the immunological mechanisms involved in triggering leprosy reactions. Toll-like receptors (TLR) such as TLR1 and TLR2, presented balanced expression in the reaction-free multibacillary (MB) group (TLR1: 1.01 ± 0.23, TLR2: 1.22 ± 0.18; p = 0.267). On the other hand, downgrading type 1 reaction (T1R) (TLR1: 1.24 ± 0.17, TLR2: 2.88 ± 0.37; p = 0.002) and erythema nodosum leprosum (ENL) (TLR1: 1.93 ± 0.17, TLR2: 2.81 ± 0.15; p = 0.004) revealed an unbalance in relation to the expression of these receptors. When the path analysis was approached, it was noted that interleukin 10 (IL-10) expression showed a dependence relation with phenolic glycolipid I (PGL-I) in downgrading T1R (direct effect = 0.503 > residual effect = 0.364), whereas in ENL, such relationship occurred with lipoarabinomannan (LAM) (direct effect = 0.778 > residual effect = 0.280). On the contrary, in the reaction-free leprosy group, interferon-gamma (IFN-γ) levels were dependent on the association between TLR2 and TLR1 (0.8735). The high TLR2 expression associated with IL-10 levels, in the leprosy reaction groups, may be hypothetically related to the formation of TLR2/2 homodimers and/or TLR2/6 heterodimers linked to evasion mechanisms in downgrading reactions and pathophysiology of ENL.


Asunto(s)
Eritema Nudoso/etiología , Regulación de la Expresión Génica , Interferón gamma/genética , Interleucina-10/genética , Lepra/etiología , Receptor Toll-Like 1/genética , Receptor Toll-Like 2/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores , Susceptibilidad a Enfermedades , Eritema Nudoso/diagnóstico , Eritema Nudoso/epidemiología , Eritema Nudoso/metabolismo , Femenino , Humanos , Interferón gamma/metabolismo , Interleucina-10/metabolismo , Lepra/diagnóstico , Lepra/epidemiología , Lepra/metabolismo , Masculino , Persona de Mediana Edad , Modelos Biológicos , Unión Proteica , Transducción de Señal , Receptor Toll-Like 1/metabolismo , Receptor Toll-Like 2/metabolismo , Adulto Joven
2.
BMC Infect Dis ; 19(1): 455, 2019 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-31117984

RESUMEN

BACKGROUND: Leprosy typically manifests with skin and peripheral nerve involvement. Musculoskeletal complaints are the third most common, and can be the sole presenting manifestation. They range from arthralgia/arthritis in reactional states to full mimics of systemic rheumatic diseases. Remitting Seronegative Symmetrical Synovitis with Pitting Oedema syndrome has only been described once in a patient with already diagnosed Leprosy. CASE REPORT: A 68-year-old male, from an endemic region of familial amyloid polyneuropathy, presented with an inaugural Remitting Seronegative Symmetrical Synovitis with Pitting Oedema like syndrome, more that 20 years after travelling to Leprosy endemic areas. Arthritis would resurface whenever oral prednisone was tapered, so methotrexate was started, controlling the complaints. Only one year later, after the appearance of peripheral neuropathy and skin lesions, it was possible to diagnose Leprosy, through the identification of Mycobacterium leprae bacilli in a peripheral nerve biopsy. CONCLUSION: This report is an example of the heterogeneity of manifestations of Leprosy, namely rheumatic, and the challenge of diagnosing it when typical complaints are absent. It is also a reminder that this disease should be considered whenever a patient with a combination of skin/neurologic/rheumatic complaints has travelled to endemic countries in the past.


Asunto(s)
Edema/diagnóstico , Lepra/etiología , Mycobacterium leprae/aislamiento & purificación , Sinovitis/diagnóstico , Anciano , Antibacterianos , Artritis/tratamiento farmacológico , Artritis/etiología , Edema/etiología , Humanos , Lepra/tratamiento farmacológico , Lepra/microbiología , Masculino , Mycobacterium leprae/patogenicidad , Prednisona/administración & dosificación , Prednisona/uso terapéutico , Piel/microbiología , Piel/patología , Síndrome , Sinovitis/etiología
3.
BMC Infect Dis ; 19(1): 460, 2019 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-31118048

RESUMEN

BACKGROUND: The multidrug therapy (MDT) for leprosy treatment adopted by Brazil in the 1990s was important for reducing leprosy in the country; however, recurrent cases remained problematic. Mechanisms involved in leprosy recurrence are heterogeneous and can be sorted into three groups: insufficient therapy, bacillary persistence and new infections. This study aimed to analyse the time interval of leprosy recurrence in relation to the therapeutic scheme in the state of Acre. The hypotheses were as follows: 1) treatments (a) rifampicin, ofloxacin and minocycline (ROM) and (b) dapsone (DDS) have a short leprosy recurrence time, 2) treatments based on MDT have a long leprosy recurrence time, 3) there is a dose-response relationship between MDT and the time interval between leprosy episodes. METHODS: This retrospective cohort study included 201 patients with a second episode of clinical leprosy at the reference centers for leprosy control in the state of Acre. Exposure was the type of therapeutic scheme as follows: 1) ROM, 2) DDS, 3) MDT0-9 doses, 4) MDT10-19 doses, 5) MDT20-29 doses, and 6) MDT30+ doses. Outcome was the time interval between release from treatment and a diagnosis of a recurrent leprosy case. Incidence rate ratios and relative risk Poisson regressions adjusted by age and sex were calculated with 95% confidence intervals. RESULTS: The 201 patients studied during this retrospective follow-up resulted in a total of 224 cases of recurrent leprosy. Incidence rate ratios within this therapeutic scheme were as follows: 3.3 (2.39, 4.2; ROM/MDT30+), 1.12 (0.33, 1.92; DDS/MDT30+), 2.17 (1.39, 2.94; MDT0-9/MDT30+), 1.94 (1.13, 2.75; MDT10-19/MDT30+) and 1.26 (0.47, 2.05; MDT20-29/MDT30+). Relative risk Poisson regressions showed a protective effect of MDT30+ in comparison with ROM (0.22; 0.07, 0.72), MDT0-9 (0.42; 0.21, 0.85), and MDT10-19 (0.44; 0.21, 0.92). No differences among MDT30+ and DDS (0.71; 0.36, 1.41) and MDT20-29 (0.76; 0.38, 1.49) were observed. CONCLUSIONS: New infection is an important-yet neglected-mechanism in leprosy recurrence in the state of Acre and can challenge the leprosy elimination plan in Brazil. MDT with few doses might be associated with leprosy recurrence due to insufficient therapy or bacillary persistence.


Asunto(s)
Leprostáticos/uso terapéutico , Lepra/tratamiento farmacológico , Lepra/etiología , Adulto , Brasil/epidemiología , Estudios de Cohortes , Dapsona/uso terapéutico , Quimioterapia Combinada , Femenino , Humanos , Lepra/epidemiología , Masculino , Persona de Mediana Edad , Minociclina/uso terapéutico , Ofloxacino/uso terapéutico , Recurrencia , Estudios Retrospectivos , Rifampin/uso terapéutico , Factores de Tiempo , Resultado del Tratamiento
5.
s.l; s.n; 2019. 10 p. tab, mapas, graf.
No convencional en Inglés | Sec. Est. Saúde SP, HANSEN, SESSP-ILSLPROD, Sec. Est. Saúde SP, SESSP-ILSLACERVO, Sec. Est. Saúde SP | ID: biblio-1099450

RESUMEN

BACKGROUND: The multidrug therapy (MDT) for leprosy treatment adopted by Brazil in the 1990s was important for reducing leprosy in the country; however, recurrent cases remained problematic. Mechanisms involved in leprosy recurrence are heterogeneous and can be sorted into three groups insufficient therapy, bacillary persistence and new infections. This study aimed to analyse the time interval of leprosy recurrence in relation to the therapeutic scheme in the state of Acre. The hypotheses were as follows 1) treatments (a) rifampicin, ofloxacin and minocycline (ROM) and (b) dapsone (DDS) have a short leprosy recurrence time, 2) treatments based on MDT have a long leprosy recurrence time, 3) there is a dose-response relationship between MDT and the time interval between leprosy episodes. METHODS: This retrospective cohort study included 201 patients with a second episode of clinical leprosy at the reference centers for leprosy control in the state of Acre. Exposure was the type of therapeutic scheme as follows 1) ROM, 2) DDS, 3) MDT0-9 doses, 4) MDT10-19 doses, 5) MDT20-29 doses, and 6) MDT30+ doses. Outcome was the time interval between release from treatment and a diagnosis of a recurrent leprosy case. Incidence rate ratios and relative risk Poisson regressions adjusted by age and sex were calculated with 95% confidence intervals. RESULTS: The 201 patients studied during this retrospective follow-up resulted in a total of 224 cases of recurrent leprosy. Incidence rate ratios within this therapeutic scheme were as follows 3.3 (2.39, 4.2; ROM/MDT30+), 1.12 (0.33, 1.92; DDS/MDT30+), 2.17 (1.39, 2.94; MDT0-9/MDT30+), 1.94 (1.13, 2.75; MDT10-19/MDT30+) and 1.26 (0.47, 2.05; MDT20-29/MDT30+). Relative risk Poisson regressions showed a protective effect of MDT30+ in comparison with ROM (0.22; 0.07, 0.72), MDT0-9 (0.42; 0.21, 0.85), and MDT10-19 (0.44; 0.21, 0.92). No differences among MDT30+ and DDS (0.71; 0.36, 1.41) and MDT20-29 (0.76; 0.38, 1.49) were observed. CONCLUSIONS: New infection is an important-yet neglected-mechanism in leprosy recurrence in the state of Acre and can challenge the leprosy elimination plan in Brazil. MDT with few doses might be associated with leprosy recurrence due to insufficient therapy or bacillary persistence.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Rifampin/uso terapéutico , Factores de Tiempo , Ofloxacino/uso terapéutico , Estudios de Cohortes , Resultado del Tratamiento , Dapsona/uso terapéutico , Quimioterapia Combinada , Leprostáticos/uso terapéutico , Lepra/etiología , Lepra/tratamiento farmacológico , Lepra/epidemiología , Minociclina/uso terapéutico
6.
Belo Horizonte; s.n; 2019. 127 p. ilus, tab, graf.
Tesis en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1021993

RESUMEN

A hanseníase é uma doença infectocontagiosa, causada pelo bacilo Mycobacterium leprae, com sintomatologia dermatoneurológica. Várias estratégias têm sido adotadas para o controle da hanseníase, porém o diagnóstico da hanseníase é essencialmente clínico. O desafio atual é identificar biomarcadores que possibilitem a identificação de parâmetros imunológicos de infecção subclínica e, em última análise, o diagnóstico precoce da hanseníase em indivíduos infectados e assintomáticos, para realização de imunoprofilaxia de forma oportuna quebrando, assim, a cadeia de transmissão do bacilo. Aprofundar nas diferenças entre casos índice multibacilares e seus contatos domiciliares foi a estratégia deste estudo, através da avaliação conjunta de parâmetros imunológicos gerais e específicos. Objetivo: o objetivo deste trabalho foi avaliar o perfil da resposta imune inata e adaptativa de casos multibacilares de hanseníase e seus contatos domiciliares para a identificação de parâmetros imunológicos de infecção subclínica. Metodologia: Para mensurar a expressão de moléculas de superfície foi realizada imunofenotipagem por citometria de fluxo. Para dosar os níveis de citocinas e quimiocinas séricas as foi utilizada a técnica de Cytometric Bead Array (CBA). Os níveis de IgM anti PGL-1 de foram mensurados pela técnica de ELISA. Resultados: Os níveis de IgM/IgG anti PGL-1, de linfócitos ativados T CD4+ e CD8+ e a frequência de monócitos circulantes estavam mais elevados em casos índice em relação aos seus contatos. A frequência de linfócitos T estava menor em casos índice MB. A distância imunológica entre casos e contatos domiciliares não foi significativa quando se avaliou em conjunto todos os parâmetros imunológicos. Conclusão: Nós inferimos, a partir dos parâmetros diferencialmente expressos em casos índice MB e contatos domiciliares, que a elevação da resposta humoral específica, o maior nível de ativação de linfócitos (com provável proliferação e diferenciação em células T efetoras e/ou de memória), a maior frequência de monócitos em trânsito no sangue periférico, podem ser opções de biomarcadores preditores de infecção subclínica em contatos domiciliares.(AU)


Leprosy is an infectious disease caused by the bacillus Mycobacterium leprae, with dermatoneurological symptoms. Several strategies have been adopted for leprosy control, but the diagnosis of leprosy is essentially clinical. The current challenge is to identify biomarkers that enable the identification of immunological parameters of subclinical infection and, ultimately, the early diagnosis of leprosy in infected and asymptomatic individuals, to perform immunoprophylaxis in a timely manner, thus breaking the bacillus transmission chain. Deepening the differences between multibacillary index cases and their household contacts was the strategy of this study, through the joint evaluation of general and specific immunological parameters. Objective: The aim of this study was to evaluate the profile of the innate and adaptive immune response of multibacillary leprosy cases and their household contacts for the identification of immunological parameters of subclinical infection. Methodology: To measure the expression of surface molecules, immunophenotyping was performed by flow cytometry. To measure serum cytokine and chemokine levels, the Cytometric Bead Array (CBA) technique was used. Anti-PGL-1 IgM/IgG levels were measured by ELISA. Results: Anti-PGL-1 IgM/IgG levels, CD4 + and CD8 + activated T lymphocytes and the frequency of circulating monocytes were higher in index cases compared to their contacts. The frequency of T lymphocytes was lower in MB index cases. The immunological distance between cases and home contacts was not significant when all immunological parameters were evaluated together. Conclusion: We infer from the differentially expressed parameters in MB index cases and household contacts that the elevation of specific humoral response, the highest level of lymphocyte activation (with probable proliferation and differentiation in effector and / or memory T cells), the higher frequency of peripheral blood transit monocytes, may be predictive biomarker options for subclinical infection in household contacts.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Biomarcadores , Lepra/diagnóstico , Lepra/epidemiología , Salud de la Familia , Encuestas y Cuestionarios , Inmunidad Mucosa , Tesis Académica , Infecciones Asintomáticas , Lepra/etiología
7.
Immunol Lett ; 200: 55-65, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-30006101

RESUMEN

BACKGROUND: Leprosy reactions appear episodically in leprosy patients, which lead to high inflammation, morbidity and peripheral nerve damage. The role of Th17 cell has been well studied in leprosy reactions but the role of γδ or unconventional T cells which is an other major source of IL-17 in many diseases, not studied in leprosy reactional episodes. OBJECTIVE: The aim of the present study to elucidate the role of γδ T cells in leprosy reactions. METHODOLOGY: A total of 40 untreated non-reaction and reactions patients were recruited. PBMCs were isolated and stimulated with M. leprae sonicated antigen (MLSA) for 48 h and immuno-phenotyping was done using flow cytometry. Moreover, γδ T cells were isolated by Magnetic beads technology and mRNA expression of IL-17, IFN-γ, TGF-ß and FOXP3 were analyzed by real-time PCR (qPCR) and cytokine was estimated in the culture supernatant by ELISA. RESULTS: γδ T cells were significantly increased in both Reversal reaction (RR) and Erythema nodosum leprosum (ENL) reaction patients. These cells produced significant amount of IL-17 and IFN-γ. Furthermore, CD3+TCRγδ+ T cells expressed transient FOXP3 with a low amount of TGF-ß in both reactions as compared to stable patients. Moreover, low TGF-ß producing TCR-γδ cells were associated with low phosphorylation of STAT5A. CONCLUSION: This study will add to our understanding of the immunological features that mediate and regulate the pathogenesis of leprosy and may helpful to reduce the immuno-pathogenesis of leprosy reaction by targeting these cells.


Asunto(s)
Inflamación/etiología , Inflamación/metabolismo , Lepra/etiología , Lepra/metabolismo , Receptores de Antígenos de Linfocitos T gamma-delta/metabolismo , Subgrupos de Linfocitos T/inmunología , Subgrupos de Linfocitos T/metabolismo , Antígenos de Superficie/metabolismo , Biomarcadores , Citocinas/metabolismo , Expresión Génica , Humanos , Inmunofenotipificación , Inflamación/patología , Lepra/patología , Fosforilación , Factor de Transcripción STAT3/metabolismo , Factor de Transcripción STAT5/metabolismo , Linfocitos T Reguladores/inmunología , Linfocitos T Reguladores/metabolismo
8.
Front Immunol ; 9: 939, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29867937

RESUMEN

Neurotrophins are a family of proteins that regulate different aspects of biological development and neural function and are of great importance in neuroplasticity. This group of proteins has multiple functions in neuronal cells, as well as in other cellular populations. Nerve growth factor (NGF) is a neurotrophin that is endogenously produced during development and maturation by multiple cell types, including neurons, Schwann cells, oligodendrocytes, lymphocytes, mast cells, macrophages, keratinocytes, and fibroblasts. These cells produce proNGF, which is transformed by proteolytic cleavage into the biologically active NGF in the endoplasmic reticulum. The present review describes the role of NGF in the pathogenesis of leprosy and its correlations with different clinical forms of the disease and with the phenomena of regeneration and neural injury observed during infection. We discuss the involvement of NGF in the induction of neural damage and the pathophysiology of pain associated with peripheral neuropathy in leprosy. We also discuss the roles of immune factors in the evolution of this pathological process. Finally, we highlight avenues of investigation for future research to broaden our understanding of the role of NGF in the pathogenesis of leprosy. Our analysis of the literature indicates that NGF plays an important role in the evolution and outcome of Mycobacterium leprae infection. The findings described here highlight an important area of investigation, as leprosy is one of the main causes of infection in the peripheral nervous system.


Asunto(s)
Lepra/etiología , Lepra/metabolismo , Factor de Crecimiento Nervioso/metabolismo , Animales , Autoinmunidad , Regulación de la Expresión Génica , Humanos , Sistema Inmunológico/inmunología , Sistema Inmunológico/metabolismo , Inmunomodulación , Lepra/patología , Factor de Crecimiento Nervioso/genética , Transducción de Señal
9.
Trop Med Int Health ; 23(7): 748-757, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29704447

RESUMEN

OBJECTIVE: To analyse the spatial distribution of the incidence of leprosy and identify areas at risk for occurrences of hyper-endemic disease in Northeastern Brazil. METHODS: Ecological study using municipalities as the analysis unit. Data on new cases of leprosy came from the Health Hazard Notification System (SINAN). This study focused on Pernambuco and covered the years 2005 to 2014. Indicators for monitoring were calculated per 100 000 inhabitants. The local empirical Bayes method was used to minimise rate variance, and spatial autocorrelation maps were used for spatial pattern analysis (box maps and Moran maps). RESULTS: A total of 28 895 new cases were registered in the study period. The average incidence was 21.88/100 000; the global Moran's I index was 0.36 (P < 0.01), thus indicating the existence of spatial dependence; and the Moran map identified 20 municipalities with high priority for attention. The average incidence rate among individuals under 15 years of age was 8.78/100 000; the global Moran's I index showed the presence of positive spatial autocorrelation (0.43; P < 0.01), and the Moran map showed a main cluster of 15 hyper-endemic municipalities. The average rate of grade 2 physical disability at the time of diagnosis was 1.12/100 000; the global Moran index presented a positive spatial association (0.17; P < 0.01); and the Moran map located clusters of municipalities (high-high) in three mesoregions. CONCLUSION: Application of different spatial analysis methods made it possible to locate areas that would not have been identified by epidemiological indicators alone.


Asunto(s)
Enfermedades Endémicas , Lepra/epidemiología , Adolescente , Brasil/epidemiología , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Lepra/etiología , Masculino , Factores de Riesgo , Análisis Espacio-Temporal
10.
Rev Saude Publica ; 51: 70, 2017 Jul 20.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-28746575

RESUMEN

OBJECTIVE: To identify the socioeconomic, demographic, operational, and health service-related factors associated with the occurrence of leprosy in a hyperendemic State in North Brazil. METHODS: This is an ecological study based on secondary data from the Sistema de Informações de Agravos de Notificação in municipalities of the State of Tocantins from 2001 to 2012. Units of analysis were the 139 municipalities of the State. Negative binomial log linear regression models were used to estimate incidence rate ratios. RESULTS: In bivariate analysis, the incidence rate ratios were significantly higher for municipalities with higher income ratio of the poorest 20.0% (1.47; 95%CI 1.19-1.81) and better Municipal Human Development Index (1.53; 95%CI 1.14-2.06). In multivariate analysis, the incidence rate ratios were significantly higher in municipalities with higher proportion of immigrants (1.31; 95%CI 1.11-1.55) and higher proportion of households with waste collection (1.37; 95%CI 1.11-1.69). There was a significant reduction in the incidence rate ratio with increased coverage of the Bolsa Família Program (0.98; 95%CI 0.96-0.99). CONCLUSIONS: Control programs need to focus on activities in municipalities of greater social vulnerability with intersectoral investment for the improvement of the living conditions of the population. OBJETIVO: Identificar fatores socioeconômicos, demográficos, operacionais e de serviços de saúde associados à ocorrência da hanseníase em um estado hiperendêmico do norte do Brasil. MÉTODOS: Estudo ecológico com dados secundários do Sistema de Informações de Agravos de Notificação em municípios do estado do Tocantins de 2001 a 2012. As unidades de análise foram os 139 municípios do estado. Modelos de regressão log linear binomial negativa foram utilizados para estimar as razões de taxas de incidência. RESULTADOS: Na análise bivariada, a razão de taxa de incidência foi significativamente maior para os municípios com maior razão de renda dos 20,0% mais pobres (1,47; IC95% 1,19-1,81) e melhor Índice de Desenvolvimento Humano Municipal (1,53; IC95% 1,14-2,06). Na múltipla, a razão de taxa de incidência foi significativamente superior em municípios com maior concentração de imigrantes (1,31; IC95% 1,11-1,55) e proporção de domicílios com coleta de lixo (1,37; IC95% 1,11-1,69). Houve redução significativa da razão de taxa de incidência com o aumento da cobertura do programa bolsa família (0,98; IC95% 0,96-0,99). CONCLUSÕES: Os programas de controle precisam focar as atividades em municípios de maior vulnerabilidade social com investimentos intersetoriais para a melhoria das condições de vida da população.


Asunto(s)
Enfermedades Endémicas/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Lepra/epidemiología , Brasil/epidemiología , Ciudades , Composición Familiar , Disparidades en Atención de Salud , Humanos , Lepra/etiología , Enfermedades Desatendidas/epidemiología , Valores de Referencia , Factores de Riesgo , Factores Socioeconómicos
11.
Microb Pathog ; 104: 116-124, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28088473

RESUMEN

Leprosy triggers a complex relationship between the pathogen and host immune response. Endothelium plays an important role in this immune response by directly influencing cell migration to infected tissues. The objective of this work is to investigate the possible role of endothelium in M. leprae infection, correlating the characteristics of endothelial markers with the expression pattern of cytokines. Thirty-six skin biopsy samples were cut into 5-µm thick sections and stained with hematoxylin-eosin and Ziehl-Neelsen for morphological analysis and then submitted to immunohistochemical analysis using monoclonal antibodies against ICAM-1, ICAM-2, VCAM-1, and VLA-4. Immunostaining for ICAM-1 showed a significantly larger number of stained endothelial cells in the tuberculoid leprosy (9.92 ± 1.11 cells/mm2) when compared to lepromatous samples (5.87 ± 1.01 cells/mm2) and ICAM-2 revealed no significant difference in the number of endothelial cells expressing this marker between the tuberculoid (13.21 ± 1.27 cells/mm2) and lepromatous leprosy (14.3 ± 1.02 cells/mm2). VCAM-1-immunostained showed 18.28 ± 1.46/mm2 cells in tuberculoid leprosy and 10.67 ± 1.25 cells/mm2 in the lepromatous leprosy. VLA-4 exhibited 22.46 ± 1.38 cells/mm2 in the tuberculoid leprosy 16.04 ± 1.56 cells/mm2 in the lepromatous leprosy. Samples with characteristics of the tuberculoid leprosy exhibited a larger number of cells stained with ICAM-1, VCAM-1 and VLA-4, demonstrating the importance of these molecules in the migration and selection of cells that reach the inflamed tissue.


Asunto(s)
Moléculas de Adhesión Celular/metabolismo , Endotelio Vascular/metabolismo , Lepra/etiología , Lepra/metabolismo , Antígenos CD/genética , Antígenos CD/metabolismo , Moléculas de Adhesión Celular/genética , Expresión Génica , Humanos , Integrina alfa4beta1/genética , Integrina alfa4beta1/metabolismo , Molécula 1 de Adhesión Intercelular/genética , Molécula 1 de Adhesión Intercelular/metabolismo , Lepra/patología , Piel/metabolismo , Piel/microbiología , Piel/patología , Molécula 1 de Adhesión Celular Vascular/genética , Molécula 1 de Adhesión Celular Vascular/metabolismo
12.
Pract Neurol ; 17(2): 135-139, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27941127

RESUMEN

A 60-year-old Nigerian man, who had lived in Europe for 30 years but had returned home frequently, presented with right frontalis muscle weakness and right ulnar nerve palsy, without skin lesions. Neurophysiology showed a generalised neuropathy with demyelinating features. Blood tests were positive for HIV, with a normal CD4 count. There was nerve thickening both clinically and on MRI. Nerve biopsy showed chronic endoneuritis and perineuritis (indicating leprosy) without visible mycobacteria. His neuropathy continued to deteriorate (lepra reaction) before starting treatment with WHO multidrug therapy, highly active antiretroviral therapy and corticosteroids. There are 10 new cases of leprosy diagnosed annually in the UK. Coinfection with HIV is rare but paradoxically does not usually adversely affect the outcome of leprosy or change treatment. However, permanent nerve damage in leprosy is common despite optimal therapy. Leprosy should be considered in patients from endemic areas who present with mononeuritis multiplex.


Asunto(s)
Infecciones por VIH/complicaciones , Lepra/etiología , Biopsia , Complejo CD3/metabolismo , Infecciones por VIH/diagnóstico , Humanos , Lepra/diagnóstico por imagen , Lepra/virología , Linfocitos/metabolismo , Linfocitos/patología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso Periférico/etiología , Enfermedades del Sistema Nervioso Periférico/virología
13.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-LISBR1.1-35134

RESUMEN

A Biblioteca Virtual em Saúde Hanseníase, criada em 2007 por iniciativa do Instituto Lauro de Souza Lima, em cooperação com a BIREME/OPAS/OMS e com o respaldo das instituições nacionais e internacionais com maior expertise na área, é uma BVS temática cujo objetivo é reunir, organizar e disseminar a produção científica produzida, colaborando com ações no desenvolvimento de estudos e pesquisa que contribuam para a preservação da história, prevenção e tratamento da Hanseníase


Asunto(s)
Lepra , Bibliotecas Digitales , Células Germinales Embrionarias , Investigación , Lepra/diagnóstico , Lepra/etiología , Lepra/epidemiología , Lepra/mortalidad , Lepra/prevención & control , Lepra/rehabilitación , Lepra/transmisión
14.
Recurso de Internet en Inglés, Español, Portugués | LIS - Localizador de Información en Salud | ID: lis-LISBR1.1-35126

RESUMEN

Reúne documentos que aborda a etiologia da hanseníase


Asunto(s)
Lepra , Lepra/etiología , Células Germinales Embrionarias , Investigación
15.
Fontilles, Rev. leprol ; 30(2): 159-177, mayo-ago. 2015. ilus, tab
Artículo en Español | IBECS | ID: ibc-144141

RESUMEN

Resulta fundamental revisar y comprender la importancia relativa de los factores percibidos por los afectados de lepra como obstáculos que les impiden completar el número de dosis requeridas en el tiempo necesario para optimizar la adherencia a la multiterapia (MDT). Objetivo: Para explorar los factores personales, familiares, sociales, comunitarios, de actitud, prácticos, geográficos, culturales y tradicionales que pueden influenciar la adherencia al tratamiento, se llevó a cabo un estudio en dos fases identificando los temas mediante grupos focales y la correspondiente clasificación de los mismos. Métodos: Mediante una entrevista con lista de comprobación se recopilaron las perspectivas de 895 encuestados (320 afectados por lepra que no pudieron completar el tratamiento, 302 de sus “cabezas de familia” y 273 de sus miembros comunitarios) en cuatro estados de la India, p. ej. Andhra Pradesh (Salur), Chhattisgarh (Chandkhuri), Maharashtra (Kothara) y Uttar Pradesh (Barabanki). Resultados: Los hallazgos sugieren que percibir cambios positivos en sus síntomas, así como no percibir mejoría puede conllevar a no completar la MDT. Los problemas con la planificación y el gasto del transporte también son temas clave. Un mejor control de las expectativas de las personas afectadas por lepra y la reducción de la carga del tratamiento también pueden ser estrategias importantes. La importancia del estigma y la pobreza se percibieron a través de varios temas, ninguno de los cuales fue particularmente clasificado como muy prioritario. Conclusiones: La naturaleza y diversidad de los temas percibidos por los encuestados en cada una de las regiones, sugiere que los determinantes de adherencia son complejos y multifactoriales. Se recomiendan más planteamientos comunitarios con una mejor coordinación


To maximise successful completion of multi-drug therapy (MDT) and optimise treatment outcomes for people with leprosy, it is vital to understand the relative importance of perceived factors which prevent them from completing the required number of doses in time. Objective: To explore personal, family, social, community, attitudinal, practical, geographical, cultural and traditional factors which may influence adherence to treatment, a two-phase study was undertaken comprising issue identification via focus groups, and a ranking exercise via individual interview. Study Design: The perspectives of 895 respondents (320 people affected by leprosy who were not able to complete treatment, 302 of their ‘operational heads of family’, and 273 of their nearby community members) across four states of India namely i.e. Andhra Pradesh (Salur), Chhattisgarh (Chandkhuri), Maharashtra (Kothara) and Uttar Pradesh (Barabanki) were collected, using a checklist interview method. Results: Findings suggest that seeing positive changes in their symptoms as well as not seeing improvement can lead to non-completion of MDT. Problems with scheduling and travel expenses were also key issues. Better management of the expectations of people affected by leprosy and reducing the burden of treatment may be important strategies. The importance of stigma and poverty were noted through a number of issues, none of which were particularly highly ranked. Conclusions: The nature and diversity of perceived issues identified across respondent type and particularly region, suggest that the determinants of adherence are complex and multi-factorial. More community based approaches with greater coordination at the community level are recommended


Asunto(s)
Femenino , Humanos , Masculino , Lepra/diagnóstico , Lepra/prevención & control , Lepra/terapia , Terapéutica/psicología , Terapéutica/estadística & datos numéricos , Terapéutica/tendencias , Lepra/etnología , Lepra/etiología , Terapéutica , Terapéutica/economía
16.
PLoS Negl Trop Dis ; 9(5): e0003766, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25965879

RESUMEN

BACKGROUND: Food shortage was associated with leprosy in two recent studies investigating the relation between socioeconomic factors and leprosy. Inadequate intake of nutrients due to food shortage may affect the immune system and influence the progression of infection to clinical leprosy. We aimed to identify possible differences in dietary intake between recently diagnosed leprosy patients and control subjects. METHODS: In a leprosy endemic area of Bangladesh, newly diagnosed leprosy patients and control subjects were interviewed about their socioeconomic situation, health and diet. Dietary intakes were recorded with a 24-hour recall, from which a Dietary Diversity Score (DDS) was calculated. Body Mass Index (BMI) was calculated and Household Food Insecurity Access Scale (HFIAS) was filled out for every participant. Using logistic regression, a univariate, block wise multivariate, and an integrated analysis were carried out. RESULTS: 52 leprosy cases and 100 control subjects were included. Food shortage was more common, dietary diversity was lower and household food insecurity was higher in the patient group. Patients consumed significantly less items from the DDS food groups 'Meat and fish' and 'Other fruits and vegetables.' Lower food expenditure per capita, lower BMI, lower DDS and absence of household food stocks are the main factors associated with an increased risk of having leprosy. CONCLUSION: Low income families have only little money to spend on food and consequently have a low intake of highly nutritious non-rice foods such as meat, fish, milk, eggs, fruits and vegetables. Development of clinical leprosy could be explained by deficiencies of the nutrients that these foods normally provide.


Asunto(s)
Dieta , Lepra/etiología , Adolescente , Adulto , Anciano , Bangladesh , Índice de Masa Corporal , Estudios de Casos y Controles , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Socioeconómicos
17.
Microbes Infect ; 17(4): 247-57, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25576930

RESUMEN

Autoantibodies against various components of host are known to occur in leprosy. Nerve damage is the primary cause of disability associated with leprosy. The aim of this study was to detect the level of autoantibodies and lympho-proliferative response against myelin basic protein (MBP) in leprosy patients (LPs) and their correlation with clinical phenotypes of LPs. Further, probable role of molecular mimicry in nerve damage of LPs was investigated. We observed significantly high level of anti-MBP antibodies in LPs across the spectrum and a positive significant correlation between the level of anti-MBP antibodies and the number of nerves involved in LPs. We report here that 4 B cell epitopes of myelin A1 and Mycobacterium leprae proteins, 50S ribosomal L2 and lysyl tRNA synthetase are cross-reactive. Further, M. leprae sonicated antigen hyperimmunization was responsible for induction of autoantibody response in mice which could be adoptively transferred to naive mice. For the first time our findings suggest the role of molecular mimicry in nerve damage in leprosy.


Asunto(s)
Enfermedades Desmielinizantes/microbiología , Lepra/microbiología , Lisina-ARNt Ligasa/fisiología , Imitación Molecular/fisiología , Mycobacterium leprae/patogenicidad , Proteína Básica de Mielina/fisiología , Proteínas Ribosómicas/fisiología , Animales , Enfermedades Desmielinizantes/complicaciones , Enfermedades Desmielinizantes/etiología , Humanos , Lepra/complicaciones , Lepra/etiología , Ratones , Ratones Endogámicos BALB C/sangre , Conejos
18.
Clin Dermatol ; 33(1): 3-7, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25432805

RESUMEN

Leprosy is a chronic infectious disease caused by a close relative of Mycobacterium tuberculosis: Mycobacterium leprae. There have been various beliefs in its etiology with two main concepts emerging: anticontagion and contagion. From ancient times through the early Middle Ages, the miasmatic theory of leprosy was the main anticontagion view. The development of histopathologic and cytologic studies in the second half of the 19th century provided a starting point to explain the etiology of leprosy bacteriologically.


Asunto(s)
Enfermedades Transmisibles/historia , Predisposición Genética a la Enfermedad/historia , Lepra/etiología , Lepra/historia , Femenino , Historia del Siglo XVII , Historia del Siglo XVIII , Historia del Siglo XIX , Humanos , Masculino , Mycobacterium leprae/aislamiento & purificación
19.
New York; Elsevier; 2015. 127 p. ilus, tab, graf, mapas.
No convencional en Inglés | Sec. Est. Saúde SP, HANSEN, SESSP-ILSLPROD, Sec. Est. Saúde SP, SESSP-ILSLACERVO, Sec. Est. Saúde SP | ID: biblio-1048207
20.
In. Virmond, Marcos da Cunha Lopes; Grzybowski, Andrzej. Clinics in Dermatology: Leprosy: 1. New York, Elsevier, 2015. p.3-7, ilus.
No convencional en Inglés | Sec. Est. Saúde SP, HANSEN, SESSP-ILSLPROD, Sec. Est. Saúde SP, SESSP-ILSLACERVO, Sec. Est. Saúde SP | ID: biblio-1048260

RESUMEN

Leprosy is a chronic infectious disease caused by a close relative of Mycobacterium tuberculosis: Mycobacterium leprae. There have been various beliefs in its etiology with two main concepts emerging: anticontagion and contagion. From ancient times through the early Middle Ages, the miasmatic theory of leprosy was the main anticontagion view. The development of histopathologic and cytologic studies in the second half of the 19th century provided a starting point to explain the etiology of leprosy bacteriologically.


Asunto(s)
Humanos , Masculino , Femenino , Historia del Siglo XVII , Historia del Siglo XVIII , Historia del Siglo XIX , Enfermedades Transmisibles/historia , Predisposición Genética a la Enfermedad/historia , Lepra/etiología , Lepra/historia , Mycobacterium leprae/aislamiento & purificación
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