- A dissimulate presentation of histoid Hansen's disease in the form of erythema nodosum leprosum. [Case Reports]
- IJInt J Mycobacteriol 2019 Apr-Jun; 8(2):208-210
- Hansen's disease is a chronic infectious granulomatous disease with varied clinical presentation. Histoid Hansen's disease is an important emerging lepromatous subset of Hansen's disease known to mim…
Hansen's disease is a chronic infectious granulomatous disease with varied clinical presentation. Histoid Hansen's disease is an important emerging lepromatous subset of Hansen's disease known to mimic varied dermatoses. Occurrence of reactions, especially erythema nodosum leprosum (ENL), is rare in this form of leprosy. We report a case of Histoid Hansen's disease with initial presentation of ENL while undergoing management for infertility.
- Down regulation of RANTES in pleural site is associated with inhibition of antigen specific response in tuberculosis. [Journal Article]
- TTuberculosis (Edinb) 2019 Apr 25
- Tuberculosis is the most common infectious reason for death and a major cause of pleural effusion globally. To understand the role of chemokines in trafficking of cells during TB pleurisy, we studied…
Tuberculosis is the most common infectious reason for death and a major cause of pleural effusion globally. To understand the role of chemokines in trafficking of cells during TB pleurisy, we studied the responses to MTB, Ag85A in cells from pleural fluids and peripheral blood. Patients with TB pleural effusions, malignant effusions and asymptomatic healthy controls were enrolled. High expression (p < 0.05) of IP-10, MCP-1, MIG, IL-8, IFN-γ and IL-23 were observed in pleural fluids of TB patients compared to their plasma where expression of RANTES was significantly higher (p < 0.05). On specific stimulation of PFMCs with Ag85A, expression of RANTES was significantly lower in TB compared to NTB patients. We also observed increased expression of T regs and PD1 on CD8+T cells in PFMC of TB patients. Though some of the inflammatory chemokine/cytokines were up-regulated in pleura of TB patients, antigenic stimulation failed to induce them indicating poor antigenic responses at the site. Low expression of RANTES might be a reason for decreased trafficking of cells to the site and dissemination of infection into pleural site. The pattern of RANTES expression in pleural fluid vs serum is interesting. The observations necessitate further studies to investigate the levels of RANTES for its potential biological relevance in TB immunity and its use as a biomarker for diagnosis of pleural TB.
- [Orientation of primary care in actions to control leprosy: factors relating to professionals]. [Journal Article]
- GSGac Sanit 2019 May 01
- CONCLUSIONS: Professional experience in the Family Health Strategy and leprosy care is crucial for the service to be a provider of control actions oriented according to the essential and derived attributes of primary health care. Brazil has made progress in reducing the incidence of leprosy; however, it is necessary to increase the effectiveness of health surveillance, as a means of early detection and training of professionals.
- Dose-dependent thalidomide induced bradycardia in young erythema nodosum leprosum patient. [Journal Article]
- IJIndian J Pharmacol 2019 Jan-Feb; 51(1):72-74
- The distressing consequences of immunology in leprosy is the lepra reaction. Erythema nodosum leprosum(ENL) in special cases need to be managed with capsule thalidomide in varying doses. We report su…
The distressing consequences of immunology in leprosy is the lepra reaction. Erythema nodosum leprosum(ENL) in special cases need to be managed with capsule thalidomide in varying doses. We report such a case of bradycardia in thalidomide dose dependent manner in a young ENL male.
- Transforming Growth Factor-β Suppresses Interleukin (IL)-2 and IL-1β Production in HIV-Tuberculosis Co-Infection. [Journal Article]
- JIJ Interferon Cytokine Res 2019; 39(6):355-363
- Interleukin (IL)-1β and IL-2 play important roles in protective immune responses against Mycobacterium tuberculosis (Mtb) infection. Information on the factors that regulate the production of these c…
Interleukin (IL)-1β and IL-2 play important roles in protective immune responses against Mycobacterium tuberculosis (Mtb) infection. Information on the factors that regulate the production of these cytokines in the context of human immunodeficiency virus and latent tuberculosis infection (LTBI) or active tuberculosis (TB) disease is limited. In this study, we compared the production of these cytokines by peripheral blood mononuclear cells (PBMCs) from HIV- and HIV+ individuals with latent and active Tuberculosis infection in response to Mtb Antigen 85A. PBMCs from HIV+ LTBI+ and HIV+ active TB patients produced low IL-1β, IL-2 but high transforming growth factor beta (TGF-β) compared to healthy controls. CD4+ T cells from HIV patients expressed low retinoic acid-related orphan receptor gamma (RORγ), and high suppressors of cytokine signaling-3 (SOCS-3). Active TB infection in HIV+ individuals further inhibited antigen-specific IL-1β and IL-2 production compared with those with LTBI. Neutralization of TGF-β restored IL-1β and IL-2 levels and lowered SOCS-3 production by CD4+ T cells. We hypothesize that high TGF-β in HIV patients could be a reason for defective Mtb-specific IL-1β, IL-2 production and activation of latent TB in HIV. Coupling anti-TGF-β antibodies with antiretroviral therapy treatment might increase T cell function to boost the immune system for effective clearance of Mtb.
- Zentral eingedellte Läsionen bei einer de novo histoiden Lepra. [Letter]
- JDJ Dtsch Dermatol Ges 2019; 17(3):333-335
- Does histoid leprosy represent a locally hyperimmune variant of lepromatous leprosy? [Journal Article]
- QJMQJM 2019 Jun 01; 112(6):429-435
- CONCLUSIONS: Ours is the first study comparing normal and lesional skin in histoid leprosy. Though the histoid lesions appear to have a derivation from lepromatous leprosy, the local histologic and clinical alterations may be a result of heightened local immunity or reactive local modifying factors.
- Brain and Spinal Cord Lesions in Leprosy: A Magnetic Resonance Imaging-Based Study. [Journal Article]
- AJAm J Trop Med Hyg 2019; 100(4):921-931
- Neurotropism and infiltration by Mycobacterium leprae of peripheral nerves causing neuropathy are well established, but reports of central nervous system (CNS) damage are exceptional. We report CNS m…
Neurotropism and infiltration by Mycobacterium leprae of peripheral nerves causing neuropathy are well established, but reports of central nervous system (CNS) damage are exceptional. We report CNS magnetic resonance imaging (MRI) abnormalities of the brain and spinal cord as well as lesions in nerve roots and plexus in leprosy patients. Eight patients aged between 17 and 41 years underwent detailed clinical, histopathological, and MRI evaluation. All had prominent sensory-motor deficits with hypopigmented and hypo/anesthetic skin patches and thickened peripheral nerves. All demonstrated M. Leprae DNA in affected peripheral nerve tissue. All received multidrug therapy (MDT). Two patients had brainstem lesions with enhancing facial nuclei and nerves, and one patient had a lesion in the nucleus ambiguus. Two patients had enhancing spinal cord lesions. Follow-up MRI performed in four cases showed resolution of brainstem and cord lesions after starting on MDT. Thickened brachial and lumbosacral plexus nerves were observed in six and two patients, respectively, which partially resolved on follow-up MRI in the two cases who had reimaging. The site and side of the MRI lesions corresponded with the location and side of neurological deficits. This precise clinico-radiological correlation of proximal lesions could be explained by an immune reaction in the gray matter corresponding to the involved peripheral nerves, retrograde axonal and gray matter changes, or infection of the CNS and plexus by lepra bacilli. Further study of the CNS in patients with leprous neuropathy is needed to establish the exact nature of these CNS MRI findings.
- Active and latent tuberculosis among inmates in La Esperanza prison in Guaduas, Colombia. [Journal Article]
- PlosPLoS One 2019; 14(1):e0209895
- CONCLUSIONS: The prevalence of LTBI and TB was higher in prison than in the general population. Molecular genotyping suggests that TB in this prison is mainly caused by strains imported by inmates or endogenous reactivation.
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- Association of a PD-L2 Gene Polymorphism with Chronic Lymphatic Filariasis in a South Indian Cohort. [Journal Article]
- AJAm J Trop Med Hyg 2019; 100(2):344-350
- Lymphatic filariasis (LF) is a parasitic infection, caused by three closely related nematodes, namely Wuchereria bancrofti, Brugia malayi, and Brugia timori. Previously, we have shown that lysate fro…
Lymphatic filariasis (LF) is a parasitic infection, caused by three closely related nematodes, namely Wuchereria bancrofti, Brugia malayi, and Brugia timori. Previously, we have shown that lysate from B. malayi microfilariae induces the expression of interleukin (IL)-10 and programmed death-ligand (PD-L) 1 on monocytes, which lead to inhibition of CD4+ T-cell responses. In this study, we investigated associations of IL-10 and programmed cell death (PD)-1 pathway gene polymorphisms with clinical manifestation in LF. We evaluated the frequency of alleles and genotypes of IL-10 (rs3024496, rs1800872), IL-10RA (rs3135932), IL-10RB (rs2834167), PD-1 (rs2227982, rs10204525), PD-L1 (rs4143815), PD-L2 (rs7854413), and single-nucleotide polymorphisms (SNPs) in 103 patients with chronic pathology (CP), such as elephantiasis or hydrocele and 106 endemic normal (EN) individuals from a South Indian population living in an area endemic for LF. Deviations from the Hardy-Weinberg equilibrium were tested, and we found a significant difference between the frequency of polymorphisms in PD-L2 (rs7854413; P < 0.001) and IL-10RB (rs2834167; P = 0.012) between the CP and the EN group, whereas there were no significant differences found among IL-10, IL-10RA, PD-1, and PD-L1 SNPs. A multivariate analysis showed that the existence of a CC genotype in PD-L2 SNP rs7854413 is associated with a higher risk of developing CP (OR: 2.942; 95% confidence interval [CI]: 0.957-9.046; P = 0.06). Altogether, these data indicate that a genetically determined individual difference in a non-synonymous missense SNP of PD-L2 might influence the susceptibility to CP.