Reaction in Leprosy: Acute Phase Reactant Response During and After Remission

Abstract

Sera from 25 patients with type 1 (Lepra), upgrading and downgrading, and type 2 (erythema nodosum leprosum [ENL]) reactions were assayed, during the reaction and after its clinical remission, for changes in levels of alpha-1-antitrypsin (A1A) and C-reactive protein (CRP). The results were compared with those from normal healthy adults and patients of leprosy without history and/or clinical evidence of reaction. The A1A levels correlated better with changes in status of type 1 reaction; whereas CRP levels correlated well with alterations in type 2 reactions and were definitely superior to A1A in this situation for monitoring the course of these episodes.

Leprosy: pathogenesis updated

“…The efficacy of sulfones was initially attributed to their bactericidal effect. Hypothetically, sulfones may promote lysosomal phospholipase activity in “Mitsuda‐negative macrophages.” 39−103 An antioxidant role has also been suggested .96−100 The abnormality may reside within the mitochondria (oxidative phosphorylation) and lead to excessive release of free radicals; consequently, depression of phospholipases may result. In lepromatous leprosy, the sulfone mechanism of action may be as follows.…”

“…11). All of these cytokines may induce a type 2 leprosy reaction (ENL), 68−77 and if circulating complexes exist, a leukocytoclastic vasculitis type 3 reaction (Lucio phenomenon) may occur .78−80 …”

“…11). All of these cytokines may induce a type 2 leprosy reaction (ENL), [68][69][70][71][72][73][74][75][76][77] and if circulating complexes exist, a leukocytoclastic vasculitis type 3 reaction (Lucio phenomenon) may occur. [78][79][80] In lepromatous leprosy, the NAPCs may relate to MHC-I and stimulate CD8ϩ T lymphocytes (Tc-s), which accelerate the death of lepra cells.…”