Current approaches and future directions in the treatment of leprosy

Worobec, Sophie M.

doi:10.2147/rrtm.s27395

Cited by 18 publications

(20 citation statements)

References 38 publications

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“…One alternative regimen recommended by WHO since 1998 is the provision of single dose combination of rifampicine (600 mg), ofloxacine (400 mg), and minocycline (100 mg) (ROM)for PB type leprosy patients with single lesion [7,8]. A study in Brazil also found that patients treated with MDT MB compared to ROM for 24 months showed the same results in terms of reductions in Bacterial Index (BI), and improvement in clinical and histopathological features [9].…”

Section: Introductionmentioning

confidence: 99%

Interleukin-12 and Interleukin-4 Levels of Multibacillary Leprosy Patients Before and After Rifampicine Ofloxacine Minocycline Combined Therapy

Budhiani¹

2017

AJCEM

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Abstract:Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which is an obligate intracellular bacteria. This study aims to determine the interleukin-12 and interleukin-4 levels of multibacillary leprosy patients before and after Rifampicine Ofloxacine Minocycline (ROM) combined therapy for three months. The research used an analytic observational design with the prospective cohort study pre and post treatment method. The samples were taken at the polyclinic of Skin Treatment Central Public hospital and Ibnu Sina hospital. Samples examination was conducted in the NECHRI laboratory, Hasanuddin University Teaching hospital. The samples were ten new patients of MB type leprosy. Blood samples were taken before and after the ROM therapy for three months. The levels of interleukin-12 and interleukin-4 were assessed using the ELISA technique. The results shows that there is no significant change in the levels of interleukin-12 and interleukin-4 in the patients of multibacillary leprosy before and after ROM therapy for three months.

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Section: Introductionmentioning

confidence: 99%

Interleukin-12 and Interleukin-4 Levels of Multibacillary Leprosy Patients Before and After Rifampicine Ofloxacine Minocycline Combined Therapy

Budhiani¹

2017

AJCEM

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“…In most cases, diagnosis of leprosy can be made by finding one of the three cardinal signs of leprosy: loss of sensation in a hypopigmented or erythematous skin lession; thickening or enlargement of the peripheral nerve accompanied by loss of sensation and/ or muscle weakness in the affected nerve; or positive slit skin smear (1,2).…”

Section: Introductionmentioning

confidence: 99%

“…Alternative regimen recommended by the WHO is a single dose of rifampicin (600 mg), ofloxacin (400 mg), and minocycline (100 mg) (ROM) for PB leprosy patients with single lesion (2). Ofloxacin and minocycline are significantly more potent than dapsone and clofazimine against M. leprae and when combined with rifampicin provide a potent bactericidal activity that could kill 98% M. leprae in the first administration (7).…”

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confidence: 99%

Alternative Leprosy Treatment Using Rifampicin Ofloxacin Minocycline (ROM) Regimen – Two Case Reports

Widjaja

Djawad

Amin

et al. 2019

Serbian Journal of Dermatology and Venereology

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Introduction. Leprosy is a disease that predominantly affects the skin and peripheral nerves, resulting in neuropathy and associated long-term consequences, including deformities and disabilities. According to the WHO classification, there are two categories of leprosy, paucibacillary (PB) and multibacillary (MB). The standard treatment for leprosy employs the use of WHO MDT (Multi Drug Treatment) regimen, despite its multiple downsides such as clofazimine-induced pigmentation, dapsone-induced haematological adverse effects, poor compliance due to long therapy duration, drug resistance, and relapse. Multiple studies and case reports using ROM regimen have reported satisfactory results. Nevertheless, there are still insufficient data to elucidate the optimum dosage and duration of ROM regimen as an alternative treatment for leprosy. Previous experience from our institution revealed that ROM regimen given three times weekly resulted in a satisfactory outcome. Case Reports. We report two cases of leprosy treated with ROM regimen from our institution. The first case was PB leprosy in a 64-year-old male who presented with a single scaly plaque with erythematous edge on the right popliteal fossa. Sensibility examination showed hypoesthesia with no peripheral nerve enlargement. Histopathological examination confirmed Borderline Tuberculoid leprosy. ROM regimen was started three times weekly for 6 weeks and the patient showed significant clinical improvement at the end of the treatment with no reaction or relapse until after 6 months after treatment. The second case was MB leprosy in a 24-year-old male patient with clawed hand on the 3rd-5th phalanges of the right hand and a hypoesthetic erythematous plaque on the forehead. Histopathology examination confirmed Borderline leprosy. The patients received ROM therapy 3 times a week with significant clinical improvement after 12 weeks. Conclusion. ROM regimen given three times weekly for 6 weeks in PB leprosy and 12 weeks in MB leprosy resulted in a significant clinical improvement. Thus, ROM regimen could be a more effective, safer, faster alternative treatment for leprosy.

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“…Leprosy reaction is caused by patient's immunological dynamic response to M. leprae which could happen before, during, and after MDT administration. 2 This reaction is an acute episode of the disease with constitutional symptoms, activation, sometimes accompanied with new skin efflorescence. Two types of leprosy reaction are type 1, known as reversal reaction (RR), caused by acute changes in cellu lar immun ity, and type 2 reaction known as eritema nodosum leprosum (ENL), caused by humoral immun ity process.…”

Section: Introductionmentioning

confidence: 99%

Distribution Of CD4+RORg-T Th17 And CD25+ FOXP3+ Treg In Leprosy Patient With Reversal Reaction

Yuniati

Riawan

Widasmara

et al. 2017

J. Biomed. Transl. Res.

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Background: One of the most common difficulties found in leprosy management is how to manage leprosy reaction, even though MDT has proven to be effective for the patients. Reversal reaction is associated with cell mediated immunity (CMI), consists of T-helper (Th) 1 and Th2 activities. Moreover, subset of CD4+ Th17 and CD25+ FOXP3 Treg were known to have an important role in leprosy’s natural history. Prior study showed a decreasing number of CD25+ FOXP3 Treg and increasing number of CD4+ Th17 in type II reversal reaction (ENL). However, the distribution of Th17 and Treg in type I reversal reaction (RR) has not yet been identified.Objective: To compare the distribution of CD4+ Th17 and CD25+ FOXP3 Treg between RR and ENL patient groups.Method: A total of 50 samples, consisted of 27 samples of reversal reaction (RR) and 23 samples of ENL, were collected. Observation of CD4+ RORg-T Th17 and CD25+ FOXP3 Treg were conducted with immunohistochemistry staining technique using anti FOX-P3 and anti RORg-T. Expression of CD4+ ROR-g Th17 and CD25+ FOXP3 Treg in percentage were analyzed using T-test.Result: There is a significant difference in mean CD4+ ROR-g Th17 and IL17 cell distribution for RR patient group (14.96% and 10.72%) compared with ENL (9.12% and 4.28%). No significant difference were found between mean CD25+ FOXP3 Treg and TGF-β cell distribution in RR patient group (6.12% and 5.44%) compared with ENL group (6.16% and 5.96%).Conclusion: There is a significant increment od CD+RORg-T Th17 and IL17 in RR patients group compared with ENL patients group. however, the distribution of CD25+ FOXP3+ Treg and TGF beta in RR has no significant difference campared with ENL.

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Current approaches and future directions in the treatment of leprosy

Cited by 18 publications

References 38 publications

Interleukin-12 and Interleukin-4 Levels of Multibacillary Leprosy Patients Before and After Rifampicine Ofloxacine Minocycline Combined Therapy

Interleukin-12 and Interleukin-4 Levels of Multibacillary Leprosy Patients Before and After Rifampicine Ofloxacine Minocycline Combined Therapy

Alternative Leprosy Treatment Using Rifampicin Ofloxacin Minocycline (ROM) Regimen – Two Case Reports

Distribution Of CD4+RORg-T Th17 And CD25+ FOXP3+ Treg In Leprosy Patient With Reversal Reaction

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