Oral coinfection can stress peripheral lymphocyte to inflammatory activity in leprosy

Abstract

Introduction: This study evaluated the intracellular profile of interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-10 (IL-10) and interferon-γ (IFN-γ) in peripheral blood mononuclear cells (PBMCs) from leprosy patients based on oral infections presence to determine whether these coinfections could be associated with pro-inflammatory activity in leprosy. Methods: Leprosy patients regardless of clinical form and specific leprosy treatment (n=38) were divided into two groups: Group I -leprosy patients with oral infections (n=19), and Group II -leprosy patients without oral infections (n=19). Non-leprosy patients presenting oral infections were assigned to the control Group (n=10). Intracellular IL-2, IL-4, IL-10 and IFN-γ production was evaluated by flow cytometry (FACS) before and 7 days after controlling the oral infection in the Group I, before and 7 days after dental prophylaxis in the Group II, and during oral infection process in control Group. Results: Low percentages of CD3+ lymphocytes bearing IL-2, IL-10 and IFN-γ were observed in the Group I and Group II at baseline and 7 days after therapy or prophylaxis compared to controls. Group I showed reduced percentages of IL-4 at baseline and 7 days after therapy compared to controls, or at baseline of Group II, and the Group II showed reduced percentages of CD3 + cells bearing IL-4 compared to control. An increase of the percentages of CD3 + cells bearing IL-4 was observed in the Group I after the oral infections treatment. Conclusions: The occurrence of oral infections favors the intracellular cytokines expression and, probably, the inflammatory reaction operating as a stimulatory signal triggering the leprosy reactions.

Inflammatory Mediators of Leprosy Reactional Episodes and Dental Infections: A Systematic Review

“…Studies published in the past 5 years have addressed the possible relationship between the occurrence of reactional episodes and dental infections [ 11 – 14 ]. The oral health conditions in individuals with leprosy are poor, that is, high rates of caries and periodontal disease (PD) [ 15 – 20 ], with little involvement of dentists to control these diseases [ 11 , 21 ].…”

“…The release of cytokines in response to oral bacteria is among the mechanisms underlying the systemic effects of periodontitis [ 30 , 31 ]. Motta et al [ 12 – 14 ] investigated the role of dental infections in the triggering, maintenance, or exacerbation of reactive episodes and emphasized the possible role of IL-6, IL-10, and IL-1 in these events. However, there is need for additional studies to understand this possible interaction.…”

The oral cavity in leprosy: what clinicians need to know

“…Low percentages of CD3+ lymphocytes bearing IL‐2, IL‐10, and IFN‐ γ were detected in LP patients with oral infections, whereas reduced percentages of IL‐4 and IFN‐ γ were observed in LP patients without oral infections. Nevertheless, LP patients showed high percentages of CD3 + cells bearing IL‐4, regardless of the presence of oral infections (Motta et al , ). We concluded that oral infections favor the expression of intracellular cytokines and probably induce the inflammatory reaction, acting as a trigger for the reactional episodes in leprosy.…”

Oral health conditions in leprosy cases in hyperendemic area of the Brazilian Amazon

“…One of the most critically undervalued issues within the comprehensive care plan for leprosy is oral health 5 , 6 . In addition to the possibility of oral lesions secondary to the disease, poor oral health status represents a potential risk factor for propagated disease transmission, and above all, the occurrence of leprosy reactional episodes 7 .…”