What is new in the pathogenesis and management of erythema nodosum leprosum

Bhat, Ramesh M; Vaidya, Tanvi

doi:10.4103/idoj.idoj_561_19

Cited by 32 publications

(60 citation statements)

References 82 publications

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“…Our previous study with Luminex technology has also found that IL-8 cytokine expression is elevated in leprosy patients upon stimulation with M. leprae antigen ML2044 (Chen et al, 2019), which confirms our findings at the transcriptomic level in this study. Thus, our finding of increased IL-8 mRNA/gene expression in the blood from leprosy patients is consistent with a potential role for this chemokine in the pathogenesis of erythema nodosum leprosum in leprosy (Negera, et al, 2018;Bhat and Vaidya, 2020). CCL2 (C-C motif chemokine ligand 2) is a chemokine ligand involved in immune regulation and inflammatory responses (Fang et al, 2015).…”

Section: Discussionsupporting

confidence: 84%

Transcriptomic Analysis of Mycobacterium leprae-Stimulated Response in Peripheral Blood Mononuclear Cells Reveal Potential Biomarkers for Early Diagnosis of Leprosy

Yuan

Liu

You

et al. 2021

Front. Cell. Infect. Microbiol.

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We aimed to identify an unique host transcriptional signature in peripheral blood mononuclear cells (PBMCs) in response to Mycobacterium leprae antigens to distinguish between patients with leprosy and non-leprosy controls for early diagnosis of the disease. Sixteen individuals were enrolled in the discovery cohort [eight patients with leprosy, comprising four multibacillary (MB) and four paucibacillary (PB); and eight non-leprosy controls, comprising four healthy house contacts (HHCs) and four endemic controls (ECs)]. The differences in the transcriptome response of PBMCs to M. leprae sonicate antigen were evaluated between leprosy patients and non-leprosy controls, and 12 differentially expressed genes (CCL2/MCP-1, IL-8, JAKM, ATP, ND1, SERP, FLJ10489, LINC00659, LOC34487, LOC101928143, MIR22, and NCF1C) were identified. The accuracy of the 12 differentially expressed genes was further validated for the diagnosis of leprosy using real-time quantitative PCR in 82 individuals (13 MB, 10 PB, 37 HHCs, and 22 ECs) in the validation cohort. We found that a 5 gene signature set IL-8, CCL2/MCP-1, SERP, LINC00659 and FLJ10489 had a suitable performance in discriminating leprosy from ECs. In addition, elevated expression of IL-8, CCL2/MCP-1, SERP and LINC00659 was associated with MB diagnosis compared with ECs, whereas increased expression of IL-8, CCL2/MCP-1, SERP and FLJ10489 was found to be useful biomarkers for PB diagnosis from ECs. Moreover, we found decreased expression of NCF1C among leprosy patients could distinguish leprosy from HHCs, whereas higher expression of CCL2 among MB than PB could distinguish different leprosy patients. In conclusion, among the 12 candidate host genes identified, a three gene signature IL-8, CCL2/MCP-1, and SERP showed the best performance in distinguishing leprosy patients from healthy controls. These findings may have implications for developing a rapid blood-based test for early diagnosis of leprosy.

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Section: Discussionsupporting

confidence: 84%

Transcriptomic Analysis of Mycobacterium leprae-Stimulated Response in Peripheral Blood Mononuclear Cells Reveal Potential Biomarkers for Early Diagnosis of Leprosy

Yuan

Liu

You

et al. 2021

Front. Cell. Infect. Microbiol.

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“…Treatment can be done with thalidomide (100–400 mg/per day), an immunomodulator derived from glutamic acid, and a potent selective inhibitor of TNF-α, in association with corticosteroids (1 mg/kg/day) for cases of neuritis, epididymo-orchitis, iridocyclitis, glomerulonephritis. Pentoxifylline (800–1200 mg/day) and clofazimine (300 mg/day, an anti-inflammatory dose) have been shown to help stabilize refractory reactions [1] , [11] .…”

Section: Discussionmentioning

confidence: 99%

“…Type 2 leprosy reaction, or erythema nodosum leprosum (ENL), is previously described in the literature as an immune response mediated by immune complexes that cause neutrophilic vasculitis [1] , [2] . Recent studies discussing the role of immune complexes in the pathogenesis of the disease reaction are still uncertain [3] .…”

Section: Introductionmentioning

confidence: 99%

“…Among the risk factors related to its development are lepromatous leprosy and multibacillary disease, pregnancy, and lactation [7] . Some authors also relate an increased risk of developing reactions with the presence of other infections after vaccinations, some medications, and other factors [1] , [2] . The possibility of a Sars-cov-2 infection during the pandemic is an additional concern for leprosy centers, especially due to the possible increased risk for a type 2 leprosy reaction [8] .…”

Section: Introductionmentioning

confidence: 99%

“…Clinical manifestations may include fever, asthenia, cutaneous and subcutaneous erythematous nodules, arthritis, synovitis, lymphadenopathy, neuritis, iridocyclitis, epididymo-orchitis, hepatitis, glomerulonephritis, among others [1] , [2] .…”

Section: Introductionmentioning

confidence: 99%

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Type 2 leprosy reaction presenting as a monoarthritis post multidrug therapy

Goulart

Santana

Costa

et al. 2022

IDCases

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Type 2 leprosy reaction, or erythema nodosum leprosum (ENL), involves a complex interaction between the host's immune system and Mycobacterium leprae . It may occur before, during, or after treatment and have a variable clinical presentation involving different body systems, such as skin, osteoarticular, kidneys, and others. Thus, the differential diagnosis, depending on its clinical presentation, can be broad and challenging. The authors report a case of a severe monoarthritis during a type 2 reaction after the multidrug therapy (MDT) was discharged and the investigation of the differential diagnoses.

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Generalized Erythematous Edematous Plaques and Nodules

Tiwary

2022

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What is new in the pathogenesis and management of erythema nodosum leprosum

Cited by 32 publications

References 82 publications

Transcriptomic Analysis of Mycobacterium leprae-Stimulated Response in Peripheral Blood Mononuclear Cells Reveal Potential Biomarkers for Early Diagnosis of Leprosy

Transcriptomic Analysis of Mycobacterium leprae-Stimulated Response in Peripheral Blood Mononuclear Cells Reveal Potential Biomarkers for Early Diagnosis of Leprosy

Type 2 leprosy reaction presenting as a monoarthritis post multidrug therapy

Generalized Erythematous Edematous Plaques and Nodules

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