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Diop MM, Fall L, Dioussé P, Mané I, Zoubi H, Badiane F, Puchner K, Doucoure A, Cissé M, Almairac L, Kasang C. High transmission of leprosy among inhabitants in two former isolated leprosy villages in Senegal. LEPROSY REV 2021. [DOI: 10.47276/lr.92.1.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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2
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Abstract
Leprosy is a disease caused by Mycobacterium leprae (ML) with diverse clinical manifestations, which are strongly correlated with the host's immune response. Skin lesions may be accompanied by peripheral neural damage, leading to sensory and motor losses, as well as deformities of the hands and feet. Both innate and acquired immune responses are involved, but the disease has been classically described along a Th1/Th2 spectrum, where the Th1 pole corresponds to the most limited presentations and the Th2 to the most disseminated ones. We discuss this dichotomy in the light of current knowledge of cytokines, Th subpopulations and regulatory T cells taking part in each leprosy presentation. Leprosy reactions are associated with an increase in inflammatory activity both in limited and disseminated presentations, leading to a worsening of previous symptoms or the development of new symptoms. Despite the efforts of many research groups around the world, there is still no adequate serological test for diagnosis in endemic areas, hindering the eradication of leprosy in these regions.
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Affiliation(s)
| | - Maria Angela Bianconcini Trindade
- Departamento de Patologia, University of Sao Paulo, São Paulo, Brazil.,Imunodermatologia, Universidade de São Paulo Hospital das Clínicas, São Paulo, Brazil
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3
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Maymone MBC, Laughter M, Venkatesh S, Dacso MM, Rao PN, Stryjewska BM, Hugh J, Dellavalle RP, Dunnick CA. Leprosy: Clinical aspects and diagnostic techniques. J Am Acad Dermatol 2020; 83:1-14. [PMID: 32229279 DOI: 10.1016/j.jaad.2019.12.080] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 11/26/2019] [Accepted: 12/11/2019] [Indexed: 01/27/2023]
Abstract
Leprosy, also known as Hansen's disease, is a curable infectious disease that remains endemic in >140 countries around the world. Despite being declared "eliminated" as a global public health problem by the World Health Organization in the year 2000, approximately 200,000 new cases were reported worldwide in 2017. Widespread migration may bring leprosy to nonendemic areas, such as North America. In addition, there are areas in the United States where autochthonous (person-to-person) transmission of leprosy is being reported among Americans without a history of foreign exposure. In the first article in this continuing medical education series, we review leprosy epidemiology, transmission, classification, clinical features, and diagnostic challenges.
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Affiliation(s)
- Mayra B C Maymone
- Department of Dermatology, University of Colorado School of Medicine, Denver, Colorado
| | - Melissa Laughter
- Department of Dermatology, University of Colorado School of Medicine, Denver, Colorado
| | - Samantha Venkatesh
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Mara M Dacso
- National Hansen's (Leprosy) Disease Program, Baton Rouge, Louisiana; University of Texas Southwestern Medical Center, Dallas, Texas
| | - P Narasimha Rao
- Special Interest Group on Leprosy, Indian Association of Dermatologists, Venereologists and Leprologists, Hyderabad, India
| | | | - Jeremy Hugh
- Department of Dermatology, University of Colorado School of Medicine, Denver, Colorado
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado School of Medicine, Denver, Colorado
| | - Cory A Dunnick
- Department of Dermatology, University of Colorado School of Medicine, Denver, Colorado.
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4
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Fairley JK, Ferreira JA, de Oliveira ALG, de Filippis T, de Faria Grossi MA, Chaves LP, Caldeira LN, Dos Santos PS, Costa RR, Diniz MC, Duarte CS, Bomjardim Pôrto LA, Suchdev PS, Negrão-Corrêa DA, do Carmo Magalhães F, Peixoto Moreira JM, de Melo Freire Júnior A, Cerqueira MC, Kitron U, Lyon S. The Burden of Helminth Coinfections and Micronutrient Deficiencies in Patients with and without Leprosy Reactions: A Pilot Study in Minas Gerais, Brazil. Am J Trop Med Hyg 2020; 101:1058-1065. [PMID: 31549606 DOI: 10.4269/ajtmh.18-0502] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Leprosy reactions are immune-mediated complications occurring in up to 50% of patients. The immune consequences of helminth infections and micronutrient deficiencies suggest a potential role in type 1 reactions (T1R) or type 2 reactions (T2R). We conducted a case-control study in Minas Gerais, Brazil, to evaluate whether comorbidities and other factors are associated with reactions in patients with multibacillary leprosy. Stool and serum were tested for helminth infections. Deficiencies of vitamin A, D, and iron were measured using serum retinol, 25-hydroxyvitamin D, and ferritin, respectively. Logistic regression models identified associations between reactions and helminth infections, micronutrient deficiencies, and other variables. Seventy-three patients were enrolled, 24 (33%) with T1R, 21 (29%) with T2R, 8 (15%) with mixed T1R/T2R, and 20 (27%) without reactions. Evidence of helminth infections were found in 11 participants (15%) and included IgG4 reactivity against Schistosoma mansoni, Strongyloides, and Ascaris antigens. Thirty-eight (52%) had vitamin D deficiency, eight (11%) had vitamin A insufficiency, 21 (29%) had anemia, and one (1.4%) had iron deficiency. Multivariable logistic regression showed no statistically significant associations between helminth coinfections and total reactions (adjusted odds ratios [aOR]: 1.36, 95% CI: 0.22, 8.33), T1R (aOR: 0.85, 95% CI: 0.17, 4.17), or T2R (aOR: 2.41, 95% CI: 0.29, 20.0). Vitamin D deficiency and vitamin A insufficiency were also not statistically associated with reactions. However, vitamin deficiencies and helminth infections were prevalent in these patients, suggesting a potential role for additional treatment interventions. Studying reactions prospectively may further clarify the role of comorbidities in the clinical presentation of leprosy.
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Affiliation(s)
- Jessica K Fairley
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jose A Ferreira
- Faculdade Saúde e Ecologia Humana (FASEH), Vespasiano, Brazil
| | | | | | | | | | | | | | | | | | | | | | - Parminder S Suchdev
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | | | | | | | | | | | - Uriel Kitron
- Department of Environmental Sciences, Emory University, Atlanta, Georgia
| | - Sandra Lyon
- Faculdade Saúde e Ecologia Humana (FASEH), Vespasiano, Brazil
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5
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Wang C, Wang Z, Wang H, Pan Q, Fu X, Liu T, Yu G, Liu H, Zhang F. Association analysis of the genetic polymorphisms with leprosy subtypes in Chinese Han population from Northern China. J Eur Acad Dermatol Venereol 2018; 32:e377-e379. [DOI: 10.1111/jdv.14946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. Wang
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Science; No. 27397 Jingshi Road Jinan Shandong 250022 China
- Shandong Provincial Key Lab for Dermatovenereology; No. 27397 Jingshi Road Jinan Shandong 250022 China
| | - Z. Wang
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Science; No. 27397 Jingshi Road Jinan Shandong 250022 China
- Shandong Provincial Key Lab for Dermatovenereology; No. 27397 Jingshi Road Jinan Shandong 250022 China
| | - H. Wang
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Science; No. 27397 Jingshi Road Jinan Shandong 250022 China
- Shandong Provincial Key Lab for Dermatovenereology; No. 27397 Jingshi Road Jinan Shandong 250022 China
- Shandong Provincial Hospital for Skin Diseases; Shandong University; Jinan Shandong 250022 China
| | - Q. Pan
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Science; No. 27397 Jingshi Road Jinan Shandong 250022 China
- Shandong Provincial Key Lab for Dermatovenereology; No. 27397 Jingshi Road Jinan Shandong 250022 China
| | - X. Fu
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Science; No. 27397 Jingshi Road Jinan Shandong 250022 China
- Shandong Provincial Key Lab for Dermatovenereology; No. 27397 Jingshi Road Jinan Shandong 250022 China
| | - T. Liu
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Science; No. 27397 Jingshi Road Jinan Shandong 250022 China
- Shandong Provincial Key Lab for Dermatovenereology; No. 27397 Jingshi Road Jinan Shandong 250022 China
| | - G. Yu
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Science; No. 27397 Jingshi Road Jinan Shandong 250022 China
- Shandong Provincial Key Lab for Dermatovenereology; No. 27397 Jingshi Road Jinan Shandong 250022 China
| | - H. Liu
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Science; No. 27397 Jingshi Road Jinan Shandong 250022 China
- Shandong Provincial Key Lab for Dermatovenereology; No. 27397 Jingshi Road Jinan Shandong 250022 China
- Shandong Provincial Hospital for Skin Diseases; Shandong University; Jinan Shandong 250022 China
| | - F. Zhang
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Science; No. 27397 Jingshi Road Jinan Shandong 250022 China
- Shandong Provincial Key Lab for Dermatovenereology; No. 27397 Jingshi Road Jinan Shandong 250022 China
- Shandong Provincial Hospital for Skin Diseases; Shandong University; Jinan Shandong 250022 China
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6
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Cambri G, Mira MT. Genetic Susceptibility to Leprosy-From Classic Immune-Related Candidate Genes to Hypothesis-Free, Whole Genome Approaches. Front Immunol 2018; 9:1674. [PMID: 30079069 PMCID: PMC6062607 DOI: 10.3389/fimmu.2018.01674] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 07/06/2018] [Indexed: 01/15/2023] Open
Abstract
Genetics plays a crucial role in controlling susceptibility to infectious diseases by modulating the interplay between humans and pathogens. This is particularly evident in leprosy, since the etiological agent, Mycobacterium leprae, displays semiclonal characteristics not compatible with the wide spectrum of disease phenotypes. Over the past decades, genetic studies have unraveled several gene variants as risk factors for leprosy per se, disease clinical forms and the occurrence of leprosy reactions. As expected, several of these genes are immune-related; yet, hypothesis-free approaches have led to genes not classically linked to immune response. The PARK2, originally described as a Parkinson's disease gene, illustrates the case: Parkin-the protein coded by PARK2-was defined as an important player regulating innate and adaptive immune responses only years after its description as a leprosy susceptibility gene. Interestingly, even with the use of powerful hypothesis-free study designs such as genome-wide association studies, most of the major gene effect controlling leprosy susceptibility remains elusive. One hypothesis to explain this "hidden heritability" is that rare variants not captured by classic association studies are of critical importance. To address this question, massively parallel sequencing of large segments of the human genome-even whole exomes/genomes-is an alternative to properly identify rare, disease-causing mutations. These mutations may then be investigated through sophisticated approaches such as cell reprogramming and genome editing applied to create in vitro models for functional leprosy studies.
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Affiliation(s)
- Geison Cambri
- Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Marcelo Távora Mira
- Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
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7
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Wang Z, Mi Z, Wang H, Sun L, Yu G, Fu X, Wang C, Bao F, Yue Z, Zhao Q, Wang N, Cheng X, Liu H, Zhang F. Discovery of 4 exonic and 1 intergenic novel susceptibility loci for leprosy. Clin Genet 2018; 94:259-263. [PMID: 29722023 DOI: 10.1111/cge.13376] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 04/26/2018] [Accepted: 05/01/2018] [Indexed: 12/13/2022]
Abstract
Seven new risk coding variants have been identified through an exome-wide association study (EWAS), which studied the contributions of protein-coding variants to leprosy susceptibility. But some potential susceptibility loci were not studied in the previous EWAS study because of the project consideration. Seventeen unstudied potential susceptibility loci of the previous EWAS were validated in 3169 cases and 9814 controls in this study. Four disease-associated exonic loci were identified: rs671 in ALDH2 (P = 2.0 × 10-20 , odds ratio [OR] = 1.35), rs13259978 in SLC7A2 (P = 1.74 × 10-8 , OR = 1.28), rs925368 in GIT2 (P = 9.18 × 10-17 , OR = 1.44), and rs75680863 in TCN2 (P = 8.37 × 10-21 , OR = 0.74). Potentially implicating ZFP36L1 as a new susceptibility gene, 1 intergenic single nucleotide polymorphism (SNP), rs1465788 (P = 7.81 × 10-6 , OR = 0.88), was also suggested to be associated with leprosy. A luciferase reporter assay showed that the rs1465788 risk allele notably decreased the transcription activity of the flanking sequence. These findings suggest the possible involvement of lipid metabolism, NF-κB homeostasis and macrophage antimicrobial pathways in leprosy pathogenesis.
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Affiliation(s)
- Z Wang
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China
| | - Z Mi
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China
| | - H Wang
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China.,School of Medicine, Shandong University, Jinan, China
| | - L Sun
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China
| | - G Yu
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China
| | - X Fu
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China.,School of Medicine, Shandong University, Jinan, China
| | - C Wang
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China
| | - F Bao
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China
| | - Z Yue
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China.,School of Medicine, Shandong University, Jinan, China
| | - Q Zhao
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China.,School of Medicine, Shandong University, Jinan, China
| | - N Wang
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China.,School of Medicine, Shandong University, Jinan, China
| | - X Cheng
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China.,School of Medicine, Shandong University, Jinan, China
| | - H Liu
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China.,Shandong Provincial Medical Center for Dermatovenereology, Jinan, China
| | - F Zhang
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, China.,Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, China.,Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, China.,School of Medicine, Shandong University, Jinan, China.,Shandong Provincial Medical Center for Dermatovenereology, Jinan, China.,School of Medicine and Life Science, University of Jinan-Shandong Academy of Medical Sciences, Jinan, China.,National Clinical Key Project of Dermatology and Venereology, Jinan, China
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8
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Ferreira SMB, Yonekura T, Ignotti E, Oliveira LBD, Takahashi J, Soares CB. Effectiveness of rifampicin chemoprophylaxis in preventing leprosy in patient contacts: a systematic review of quantitative and qualitative evidence. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2017; 15:2555-2584. [PMID: 29035966 DOI: 10.11124/jbisrir-2016-003301] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Individuals in contact with patients who have leprosy have an increased risk of disease exposure, which reinforces the need for chemoprophylactic measures, such as the use of rifampicin. OBJECTIVES The objective of the review was to synthesize the best available evidence regarding the effectiveness of rifampicin chemoprophylaxis for contacts with patients with leprosy, and to synthesize the best available evidence on the experience and acceptability of rifampicin chemoprophylaxis as reported by the contacts and health professionals involved in the treatment of leprosy or Hansen's disease. INCLUSION CRITERIA TYPES OF PARTICIPANTS In the quantitative component, individuals in contact with leprosy patients were included. In the qualitative component, in addition to contacts, health professionals who were in the practice of treating leprosy were included. TYPES OF INTERVENTION(S)/PHENOMENA OF INTEREST The quantitative component considered as an intervention rifampicin at any dose, frequency and mode of administration, and rifampicin combination regimens.The qualitative component considered as phenomena of interest the experience and acceptability of rifampicin chemoprophylaxis. TYPES OF STUDIES The quantitative component considered experimental and observational studies whereas the qualitative component considered studies that focused on qualitative data, including but not limited to, designs such as phenomenology, grounded theory, ethnography and action-research. OUTCOMES The quantitative component considered studies that reported on outcomes such as the development of clinical leprosy in the contacts of patients who had leprosy, incidence rates, adverse effects and safety/harmful effects of the intervention. SEARCH STRATEGY A three-step strategy for published and unpublished literature was used. The search for published studies included: PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Scopus, Web of Science, National Institute for Health and Clinical Excellence, Latin American and Caribbean Health Sciences Literature; and Google Scholar and EVIPnet for unpublished studies. Studies published from the time of the respective database inception to January 2016 in English, Spanish, Portuguese, Japanese and Chinese were considered. METHODOLOGICAL QUALITY Two reviewers independently assessed the studies for methodological quality using standardized critical appraisal instruments from the Joanna Briggs Institute. DATA EXTRACTION Standardized data extraction tools developed by the Joanna Briggs Institute were used to extract quantitative and qualitative data from papers included in the review. DATA SYNTHESIS Due to clinical and methodological heterogeneity in the interventions of the included studies, no statistical meta-analysis was possible. Quantitative and qualitative research findings are presented in narrative form. RESULTS Following critical appraisal, eight studies were included in this review, seven quantitative and one qualitative. The reduction in incidence of leprosy, using one dose of rifampicin in the first two years, was 56.5%; in the follow up period of one to four years, the reduction was 34.9%. The combination of rifampicin and the Bacillus Calmette-Guérin vaccine showed a preventative effect of 80% against the disease. The only controlled clinical trial using two doses of rifampicin was community-based and did not indicate effectiveness of the intervention. The qualitative findings showed social acceptability of rifampicin. CONCLUSIONS Chemoprophylaxis with one dose of rifampicin is found to be effective in preventing contacts of leprosy patients from contracting the disease. Also, there is indication that this strategy is socially accepted.
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Affiliation(s)
- Silvana Margarida Benevides Ferreira
- 1The University of Cuiabá, and Graduate Program, Federal University of Mato Grosso/School of Nursing, Mato Grosso, Brazil 2School of Nursing, University of São Paulo, São Paulo, Brazil 3Mato Grosso State University, Mato Grosso, Brazil 4The Brazilian Centre for Evidence-based Healthcare: a Joanna Briggs Institute Centre of Excellence
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9
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Crux NB, Elahi S. Human Leukocyte Antigen (HLA) and Immune Regulation: How Do Classical and Non-Classical HLA Alleles Modulate Immune Response to Human Immunodeficiency Virus and Hepatitis C Virus Infections? Front Immunol 2017; 8:832. [PMID: 28769934 PMCID: PMC5513977 DOI: 10.3389/fimmu.2017.00832] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 06/30/2017] [Indexed: 12/13/2022] Open
Abstract
The genetic factors associated with susceptibility or resistance to viral infections are likely to involve a sophisticated array of immune response. These genetic elements may modulate other biological factors that account for significant influence on the gene expression and/or protein function in the host. Among them, the role of the major histocompatibility complex in viral pathogenesis in particular human immunodeficiency virus (HIV) and hepatitis C virus (HCV), is very well documented. We, recently, added a novel insight into the field by identifying the molecular mechanism associated with the protective role of human leukocyte antigen (HLA)-B27/B57 CD8+ T cells in the context of HIV-1 infection and why these alleles act as a double-edged sword protecting against viral infections but predisposing the host to autoimmune diseases. The focus of this review will be reexamining the role of classical and non-classical HLA alleles, including class Ia (HLA-A, -B, -C), class Ib (HLA-E, -F, -G, -H), and class II (HLA-DR, -DQ, -DM, and -DP) in immune regulation and viral pathogenesis (e.g., HIV and HCV). To our knowledge, this is the very first review of its kind to comprehensively analyze the role of these molecules in immune regulation associated with chronic viral infections.
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Affiliation(s)
- Nicole B Crux
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, AB, Canada.,Faculty of Medicine and Dentistry, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
| | - Shokrollah Elahi
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, AB, Canada.,Faculty of Medicine and Dentistry, Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, Canada
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10
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Aguilar-Medina M, Escamilla-Tilch M, Frías-Castro LO, Romero-Quintana G, Estrada-García I, Estrada-Parra S, Granados J, Arambula Meraz E, Sánchez-Schmitz G, Khader SA, Rangel-Moreno J, Ramos-Payán R. HLA Alleles are Genetic Markers for Susceptibility and Resistance towards Leprosy in a Mexican Mestizo Population. Ann Hum Genet 2016; 81:35-40. [PMID: 28025823 DOI: 10.1111/ahg.12183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 12/04/2016] [Indexed: 01/27/2023]
Abstract
Despite the use of multidrug therapy, leprosy remains endemic in some countries. The association of several human leucocyte antigen (HLA) alleles and gene polymorphisms with leprosy has been demonstrated in many populations, but the major immune contributors associated to the spectrum of leprosy have not been defined yet. In this study, genotyping of HLA-A, -B, -DR, and -DQ alleles was performed in leprosy patients (n = 113) and control subjects (n = 117) from the region with the highest incidence for the disease in México. The odds of developing leprosy and lepromatous subtype were 2.12- and 2.74-fold higher in carriers of HLA-A*28, and 2.48- and 4.14-fold higher for leprosy and dimorphic subtype in carriers of DQB1*06. Interestingly, DQB1*07 was overrepresented in healthy individuals, compared to patients with leprosy (OR = 0.08) and the lepromatous subtype (OR = 0.06). These results suggest that HLA-A*28 is a marker for predisposition to leprosy and the lepromatous subtype and DQB1*06 to leprosy and the dimorphic subtype, while DQB1*07 might be a resistance marker in this Mestizo population.
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Affiliation(s)
- Maribel Aguilar-Medina
- Faculty of Biological and Chemical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, Mexico
| | - Monica Escamilla-Tilch
- Division of Immunogenetics, National Institute of Medical Sciences and Nutrition, CDMX, Mexico
| | | | - Geovanni Romero-Quintana
- Faculty of Biological and Chemical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, Mexico
| | - Iris Estrada-García
- Department of Immunology, National School of Biological Science, National Polytechnic Institute, CDMX, Mexico
| | - Sergio Estrada-Parra
- Department of Immunology, National School of Biological Science, National Polytechnic Institute, CDMX, Mexico
| | - Julio Granados
- Division of Immunogenetics, National Institute of Medical Sciences and Nutrition, CDMX, Mexico
| | - Eliakym Arambula Meraz
- Faculty of Biological and Chemical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, Mexico
| | - Guzman Sánchez-Schmitz
- Division of Infectious Diseases, Boston Children's Hospital and Harvard Medical School, Harvard University, Boston, MA, USA
| | | | - Javier Rangel-Moreno
- Division of Allergy, Immunology and Rheumatology, University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, NY, USA
| | - Rosalío Ramos-Payán
- Faculty of Biological and Chemical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, Mexico
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11
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Grzybowski A, Virmond M. Leprosy: Between biblical descriptions to advances in immunology and diagnostic techniques. Clin Dermatol 2016; 34:1-2. [DOI: 10.1016/j.clindermatol.2015.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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