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Sacramento IDS, Gomes-Filho IS, Cruz SSD, Trindade SC, Figueiredo ACMG, Machado PRL, Vianna MIP, Falcão MML, Hintz AM, de Lacerda JA, Matos BC, Seymour GJ, Scannapieco FA, Loomer PM, Passos-Soares JDS. The effect of antireaction medications on the association between periodontitis and leprosy reactions: An important methodological issue in periodontal medicine. J Periodontol 2024. [PMID: 39031771 DOI: 10.1002/jper.23-0725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/26/2024] [Accepted: 05/11/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND The treatment of leprosy reactions (LRs) involves thalidomide, corticosteroids, and other immunomodulatory medications. This study evaluated the effect of these treatments on the association between periodontitis and LRs, as well as factors associated with LRs. METHODS This case-control study was conducted on 283 individuals followed at a leprosy outpatient clinic in Brazil. The case group was comprised of 158 individuals presenting type 1 or type 2 LRs, and the control group of 125 leprosy individuals without reactions. A complete oral examination was performed to diagnose periodontitis, the independent variable. Antireaction medication used was collected from medical records, and participants were classified according to the use of prednisone and/or thalidomide, time of use, or non-use of medication. Socioeconomic-demographic, clinical, and lifestyle covariables were collected by interview. Unconditional logistic regression analysis by subgroups evaluated the effect of antireaction medication on the association between periodontitis and LRs, estimating the odds ratio with a 95% confidence interval (OR; 95% CI). RESULTS A relationship between periodontitis and LRs was observed only in the subgroup using the association prednisone and thalidomide: ORadjusted = 0.32; 95% CI = 0.11-0.95. Conversely, more severe periodontal clinical parameters were observed in cases versus controls. Several socioeconomic, health conditions, and lifestyle factors were associated with the presence of LRs. CONCLUSIONS Although periodontal disease indicators were worse among the cases, the findings showed a negative relationship between periodontitis and LRs in individuals receiving associated prednisone and thalidomide. These medications appear to influence the inflammatory cascade between diseases, modifying and masking the manifestations of periodontitis.
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Affiliation(s)
| | | | - Simone Seixas da Cruz
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
- Health Sciences Center, Federal University of Recôncavo of Bahia, Bahia, Brazil
| | - Soraya Castro Trindade
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
| | | | | | | | | | | | | | - Bruno Costa Matos
- Department of Preventive Dentistry, Faculty of Dentistry, Federal University of Bahia, Salvador, Brazil
| | | | | | - Peter Michael Loomer
- School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Johelle de Santana Passos-Soares
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
- Department of Preventive Dentistry, Faculty of Dentistry, Federal University of Bahia, Salvador, Brazil
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Biswas SK, Mohanty KK, Singh V, Natrajan M, Arora M, Chakma JK, Tripathy SP. Association of CC-chemokine ligand-2 gene polymorphisms with leprosy reactions. Microbes Infect 2024; 26:105298. [PMID: 38244764 DOI: 10.1016/j.micinf.2024.105298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/23/2023] [Accepted: 01/08/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND C-C motif chemokine ligand 2, a gene that codes for a protein involved in inflammation. Certain SNPs in the CCL2 gene have been studied for their potential associations with susceptibility to various diseases. These SNPs may affect the production and function of the CCL2 protein, which is involved in the recruitment of immune cells to the site of inflammation. Variations in CCL2 may influence the immune response to Mycobacterium leprae infection. OBJECTIVE To investigate the association of the C-C motif chemokine ligand-2 single nucleotide polymorphisms with leprosy. METHODS CCL2 single nucleotide polymorphisms were analyzed in a total of 975 leprosy patients and 357 healthy controls. Of those, 577 leprosy and 288 healthy controls were analyzed by PCR-RFLP for CCL2 -2518 A>G, 535 leprosy and 290 controls for CCL2 -362 G>C, 295 leprosy and 240 controls for CCL2 -2134 T>G, 325 leprosy and 288 controls for CCL2 -1549 A>T SNPs by melting curve analysis using hybridization probe chemistry and detection by fluorescence resonance energy transfer (FRET) technique in Realtime PCR. The levels of CCL2, IL-12p70, IFN-γ, TNF-α, and TGF-β were estimated in sera samples and correlated with CCL2 genotypes. RESULTS The frequency of the GCT (-2518 A>G, -362 G>C, -2134 T>G) haplotype is observed to be higher in leprosy patients compared to healthy controls (P = 0.04). There was no significant difference observed in genotypic frequencies between leprosy patients and healthy controls {(-2518A>G, p = 0.53), (-362 G>C, p = 0.01), (-2134 T>G, p = 0.10)}. G allele at the -2134 site is predominant in leprosy (borderline) without any reaction (8 %) compared to borderline patients with RR reactions (2.1 %) (P = 0.03). GG genotype (p = 0.008) and G allele at -2518 (p = 0.030) of the CCL 2 gene were found to be associated with patients with ENL reaction. An elevated level of serum CCL2 was observed in leprosy patients with the -2518 AA and AG genotypes (p = 0.0001). CONCLUSIONS G allele and GG genotype at the CCL2 -2518 site are associated with a risk of ENL reactions.
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Affiliation(s)
- Sanjay Kumar Biswas
- Immunology Division, ICMR-National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Dr. M. Miyazaki Marg, Agra, 282001, India.
| | - Keshar Kunja Mohanty
- Immunology Division, ICMR-National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Dr. M. Miyazaki Marg, Agra, 282001, India.
| | - Vandana Singh
- Immunology Division, ICMR-National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Dr. M. Miyazaki Marg, Agra, 282001, India.
| | - Mohan Natrajan
- Histopathology Division, ICMR-National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Dr. M. Miyazaki Marg, Agra, 282001, India.
| | - Mamta Arora
- Clinical Division, ICMR-National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Dr. M. Miyazaki Marg, Agra, 282001, India.
| | - Joy Kumar Chakma
- Clinical Division, ICMR-National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Dr. M. Miyazaki Marg, Agra, 282001, India.
| | - Srikanth Prasad Tripathy
- ICMR-National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Dr. M. Miyazaki Marg, Agra, 282001, India.
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Prakoeswa FRS, Haningtyas N, Dewi LM, Handoko EJ, Azenta MT, Ilyas MF. The role of CXCL10 as a biomarker for immunological response among patients with leprosy: a systematic literature review. PeerJ 2024; 12:e17170. [PMID: 38590701 PMCID: PMC11000641 DOI: 10.7717/peerj.17170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/07/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Involvement of a chemokine known as C-X-C motif chemokine ligand 10 or CXCL10 in the immunopathology of leprosy has emerged as a possible immunological marker for leprosy diagnosis and needed to be investigate further. The purpose of this systematic review is to assess CXCL10's potential utility as a leprosy diagnostic tool and evaluation of therapy. Methods This systematic review is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. A thorough search was carried out to find relevant studies only in English and limited in humans published up until September 2023 using PubMed, Scopus, Science Direct, and Wiley Online Library database with keywords based on medical subject headings (MeSH) and no exclusion criteria. The Newcastle-Ottawa Scale (NOS) was utilized for quality assessment, while the Risk of Bias Assessment tool for Non-randomized Studies (RoBANS) was utilized for assessing the risk of bias. Additionally, a narrative synthesis was conducted to provide a comprehensive review of the results. Results We collected a total of 115 studies using defined keywords and 82 studies were eliminated after titles and abstracts were screened. We assessed the eligibility of the remaining 26 reports in full text and excluded four studies due to inappropriate study design and two studies with incomplete outcome data. There were twenty included studies in total with total of 2.525 samples. The included studies received NOS quality evaluation scores ranging from 6 to 8. The majority of items in the risk bias assessment, using RoBANS, across all included studies yielded low scores. However, certain items related to the selection of participants and confounding variables showed variations. Most of studies indicate that CXCL10 may be a helpful immunological marker for leprosy diagnosis, particularly in leprosy reactions as stated in seven studies. The results are better when paired with other immunological markers. Its effectiveness in field-friendly diagnostic tools makes it one of the potential biomarkers used in diagnosing leprosy patients. Additionally, CXCL10 may be utilized to assess the efficacy of multidrug therapy (MDT) in leprosy patients as stated in three studies. Conclusion The results presented in this systematic review supports the importance of CXCL10 in leprosy diagnosis, particularly in leprosy responses and in tracking the efficacy of MDT therapy. Using CXCL10 in clinical settings might help with leprosy early diagnosis. Yet the findings are heterogenous, thus more investigation is required to determine the roles of CXCL10 in leprosy while taking into account for additional confounding variables.
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Affiliation(s)
- Flora Ramona Sigit Prakoeswa
- Department of Dermatology and Venereology, Faculty of Medicine, Muhammadiyah University of Surakarta, Surakarta, Central Java, Indonesia
- Department of Dermatology and Venereology, PKU Muhammadiyah Surakarta Hospital, Surakarta, Central Java, Indonesia
| | - Nabila Haningtyas
- Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
| | - Listiana Masyita Dewi
- Department of Microbiology, Faculty of Medicine, Muhammadiyah University of Surakarta, Surakarta, Central Java, Indonesia
| | | | - Moch. Tabriz Azenta
- Faculty of Medicine, Muhammadiyah University of Surakarta, Surakarta, Central Java, Indonesia
| | - Muhana Fawwazy Ilyas
- Department of Neurology, Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
- Department of Anatomy and Embryology, Faculty of Medicine, Sebelas Maret University, Surakarta, Central Java, Indonesia
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Serrano-Coll H, Wan EL, Restrepo-Rivera L, Cardona-Castro N. Leprosy reactions: Unraveling immunological mechanisms underlying tissue damage in leprosy patients. Pathog Dis 2024; 82:ftae013. [PMID: 38806255 PMCID: PMC11180982 DOI: 10.1093/femspd/ftae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/21/2024] [Accepted: 05/27/2024] [Indexed: 05/30/2024] Open
Abstract
Leprosy is a chronic granulomatous infectious and disabling disease caused by two mycobacteria, Mycobacterium leprae and Mycobacterium lepromatosis. Acute inflammatory responses, known as leprosy reactions, are significant contributors to disabilities. Three types of leprosy reactions have been identified based on excessive cytokine release (e.g. type 1) or the accumulation of immune complexes in tissues inducing multiorgan damage (e.g. types 2 and 3). The type of leprosy reaction has implications on treatment and management strategies, yet are not well understood by health workers caring for leprosy patients. We attempt to describe the immunologic mechanisms behind the different leprosy reactions and the rationale for tailoring clinical treatment and management to the particular type of leprosy reaction based on the underlying immunologic situation.
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Affiliation(s)
- Héctor Serrano-Coll
- Instituto Colombiano de Medicina Tropical-Universidad CES, Medellín 055450, Colombia
| | - Eric L Wan
- Georgetown University School of Medicine, 3900 Reservoir Rd NW, Washington DC 200072, United States
| | - Lina Restrepo-Rivera
- Instituto Colombiano de Medicina Tropical-Universidad CES, Medellín 055450, Colombia
| | - Nora Cardona-Castro
- Instituto Colombiano de Medicina Tropical-Universidad CES, Medellín 055450, Colombia
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Ding Z, Jiang M, Qian J, Gu D, Bai H, Cai M, Yao D. Role of transforming growth factor-β in peripheral nerve regeneration. Neural Regen Res 2024; 19:380-386. [PMID: 37488894 PMCID: PMC10503632 DOI: 10.4103/1673-5374.377588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/29/2023] [Accepted: 04/27/2023] [Indexed: 07/26/2023] Open
Abstract
Injuries caused by trauma and neurodegenerative diseases can damage the peripheral nervous system and cause functional deficits. Unlike in the central nervous system, damaged axons in peripheral nerves can be induced to regenerate in response to intrinsic cues after reprogramming or in a growth-promoting microenvironment created by Schwann cells. However, axon regeneration and repair do not automatically result in the restoration of function, which is the ultimate therapeutic goal but also a major clinical challenge. Transforming growth factor (TGF) is a multifunctional cytokine that regulates various biological processes including tissue repair, embryo development, and cell growth and differentiation. There is accumulating evidence that TGF-β family proteins participate in peripheral nerve repair through various factors and signaling pathways by regulating the growth and transformation of Schwann cells; recruiting specific immune cells; controlling the permeability of the blood-nerve barrier, thereby stimulating axon growth; and inhibiting remyelination of regenerated axons. TGF-β has been applied to the treatment of peripheral nerve injury in animal models. In this context, we review the functions of TGF-β in peripheral nerve regeneration and potential clinical applications.
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Affiliation(s)
- Zihan Ding
- School of Life Sciences, Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
| | - Maorong Jiang
- School of Life Sciences, Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
| | - Jiaxi Qian
- School of Life Sciences, Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
| | - Dandan Gu
- School of Life Sciences, Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
| | - Huiyuan Bai
- School of Life Sciences, Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
| | - Min Cai
- Medical School of Nantong University, Nantong, Jiangsu Province, China
| | - Dengbing Yao
- School of Life Sciences, Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
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Cerqueira DDN, Pereira ALS, da Costa AEC, de Souza TJ, de Sousa Fernandes MS, Souto FO, Santos PDA. Xenophagy as a Strategy for Mycobacterium leprae Elimination during Type 1 or Type 2 Leprosy Reactions: A Systematic Review. Pathogens 2023; 12:1455. [PMID: 38133338 PMCID: PMC10747110 DOI: 10.3390/pathogens12121455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Mycobacterium leprae is an intracellular bacillus that causes leprosy, a neglected disease that affects macrophages and Schwann cells. Leprosy reactions are acute inflammatory responses to mycobacterial antigens, classified as type1 (T1R), a predominant cellular immune response, or type2 (T2R), a humoral phenomenon, leading to a high number of bacilli in infected cells and nerve structures. Xenophagy is a type of selective autophagy that targets intracellular bacteria for lysosomal degradation; however, its immune mechanisms during leprosy reactions are still unclear. This review summarizes the relationship between the autophagic process and M. leprae elimination during leprosy reactions. METHODS Three databases, PubMed/Medline (n = 91), Scopus (n = 73), and ScienceDirect (n = 124), were searched. After applying the eligibility criteria, articles were selected for independent peer reviewers in August 2023. RESULTS From a total of 288 studies retrieved, eight were included. In multibacillary (MB) patients who progressed to T1R, xenophagy blockade and increased inflammasome activation were observed, with IL-1β secretion before the reactional episode occurrence. On the other hand, recent data actually observed increased IL-15 levels before the reaction began, as well as IFN-γ production and xenophagy induction. CONCLUSION Our search results showed a dichotomy in the T1R development and their relationship with xenophagy. No T2R studies were found.
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Affiliation(s)
- Débora Dantas Nucci Cerqueira
- Department of Immunology, Keizo Asami Institute-iLIKA, Federal University of Pernambuco-UFPE, Recife 50670-901, Pernambuco, Brazil; (D.D.N.C.); (A.L.S.P.); (A.E.C.d.C.); (M.S.d.S.F.); (F.O.S.)
- Postgraduate Program in Biology Applied to Health-PPGBAS, Federal University of Pernambuco-UFPE, Recife 50670-901, Pernambuco, Brazil
| | - Ana Letícia Silva Pereira
- Department of Immunology, Keizo Asami Institute-iLIKA, Federal University of Pernambuco-UFPE, Recife 50670-901, Pernambuco, Brazil; (D.D.N.C.); (A.L.S.P.); (A.E.C.d.C.); (M.S.d.S.F.); (F.O.S.)
| | - Ana Elisa Coelho da Costa
- Department of Immunology, Keizo Asami Institute-iLIKA, Federal University of Pernambuco-UFPE, Recife 50670-901, Pernambuco, Brazil; (D.D.N.C.); (A.L.S.P.); (A.E.C.d.C.); (M.S.d.S.F.); (F.O.S.)
| | - Tarcísio Joaquim de Souza
- Life Sciences Center-NCV, Agreste Academic Center-CAA, Federal University of Pernambuco-UFPE, Caruaru 55014-900, Pernambuco, Brazil;
| | - Matheus Santos de Sousa Fernandes
- Department of Immunology, Keizo Asami Institute-iLIKA, Federal University of Pernambuco-UFPE, Recife 50670-901, Pernambuco, Brazil; (D.D.N.C.); (A.L.S.P.); (A.E.C.d.C.); (M.S.d.S.F.); (F.O.S.)
- Postgraduate Program in Biology Applied to Health-PPGBAS, Federal University of Pernambuco-UFPE, Recife 50670-901, Pernambuco, Brazil
| | - Fabrício Oliveira Souto
- Department of Immunology, Keizo Asami Institute-iLIKA, Federal University of Pernambuco-UFPE, Recife 50670-901, Pernambuco, Brazil; (D.D.N.C.); (A.L.S.P.); (A.E.C.d.C.); (M.S.d.S.F.); (F.O.S.)
- Postgraduate Program in Biology Applied to Health-PPGBAS, Federal University of Pernambuco-UFPE, Recife 50670-901, Pernambuco, Brazil
- Life Sciences Center-NCV, Agreste Academic Center-CAA, Federal University of Pernambuco-UFPE, Caruaru 55014-900, Pernambuco, Brazil;
| | - Patrícia d’Emery Alves Santos
- Department of Immunology, Keizo Asami Institute-iLIKA, Federal University of Pernambuco-UFPE, Recife 50670-901, Pernambuco, Brazil; (D.D.N.C.); (A.L.S.P.); (A.E.C.d.C.); (M.S.d.S.F.); (F.O.S.)
- Postgraduate Program in Biology Applied to Health-PPGBAS, Federal University of Pernambuco-UFPE, Recife 50670-901, Pernambuco, Brazil
- Life Sciences Center-NCV, Agreste Academic Center-CAA, Federal University of Pernambuco-UFPE, Caruaru 55014-900, Pernambuco, Brazil;
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Argentina F, Suwarsa O, Gunawan H, Berbudi A. A Comparison of Cathelicidin Levels in the Skin of Leprosy Patients and Their Household Contacts. Acta Med Acad 2023; 52:195-200. [PMID: 38407086 PMCID: PMC10945319 DOI: 10.5644/ama2006-124.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/29/2023] [Indexed: 02/27/2024] Open
Abstract
OBJECTIVE This study aimed to compare cathelicidin levels in the skin of leprae patients and leprae contacts. PATIENTS AND METHODS This research is an analytic observational study with a cross-sectional approach. Fifty-four research subjects participated in this study. They consisted of leprae patients, household contacts, and healthy individuals. Cathelicidin levels were measured using the ELISA method. Data analysis was carried out with the help of SPSS software, and univariate and bivariate analysis was conducted. RESULTS Cathelicidin levels in the leprae group (256.8±22.9 pg/ml) were higher than in the contact group (25.9±2.7 pg/ml). Likewise, the contact group had higher cathelicidin levels than healthy controls (1.4±0.1 pg/ml). Statistically, there were differences in cathelicidin levels between groups, P<0.050. CONCLUSION Cathelicidin levels in leprae patients were higher than those in household contacts.
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Affiliation(s)
- Fifa Argentina
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia.
| | - Oki Suwarsa
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Hendra Gunawan
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Afiat Berbudi
- Department of Biomedical Sciences, Parasitology Division, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; Infectious Disease Research Center, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
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Pinheiro RO, Rosa PS, Spencer JS, Soares CT. Editorial: Leprosy reactions: New knowledge on pathophysiology, diagnosis, treatment and prevention. Front Med (Lausanne) 2022; 9:1072274. [DOI: 10.3389/fmed.2022.1072274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022] Open
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Sharma M, Singh P. Advances in the Diagnosis of Leprosy. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.893653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Leprosy is a public health issue, and early detection is critical to avert disability. Despite the global attempt to eradicate this disease as a public health problem, it remains an important cause of global neurological disability. India, Brazil and Indonesia share more than 70% of the cases. The reduction of new cases is a priority in the WHO global strategy 2021-2030 which aims to reduce disease transmission in the community by diagnosing cases and identifying subclinical infection. The clinical manifestations of leprosy range from a few to several lesions. The identification remains difficult due to the limited sensitivity of traditional approaches based on bacillary counts of skin smears and histology. To aid in the diagnosis of this disease, molecular biology, and biotechnological technologies have been applied, each with its own set of benefits and downsides despite providing an essential tool to validate the clinical diagnosis of leprosy. Because of this, it is strongly recognized that specific, inexpensive point of care technologies should be developed, particularly to identify asymptomatic M. leprae infections or leprosy nearer to the suspected cases seeking medical attention. Thus, this review will provide an overview of the advancements in leprosy diagnosis over the world. The purpose of this review is to improve our understanding of the outcomes of current tests and technologies used in leprosy diagnosis and to emphasize critical aspects concerning the detection of leprosy bacilli.
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Ye Z, Wei J, Zhan C, Hou J. Role of Transforming Growth Factor Beta in Peripheral Nerve Regeneration: Cellular and Molecular Mechanisms. Front Neurosci 2022; 16:917587. [PMID: 35769702 PMCID: PMC9234557 DOI: 10.3389/fnins.2022.917587] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/11/2022] [Indexed: 11/24/2022] Open
Abstract
Peripheral nerve injury (PNI) is one of the most common concerns in trauma patients. Despite significant advances in repair surgeries, the outcome can still be unsatisfactory, resulting in morbidities such as loss of sensory or motor function and reduced quality of life. This highlights the need for more supportive strategies for nerve regrowth and adequate recovery. Multifunctional cytokine transforming growth factor-β (TGF-β) is essential for the development of the nervous system and is known for its neuroprotective functions. Accumulating evidence indicates its involvement in multiple cellular and molecular responses that are critical to peripheral nerve repair. Following PNI, TGF-β is released at the site of injury where it can initiate a series of phenotypic changes in Schwann cells (SCs), modulate immune cells, activate neuronal intrinsic growth capacity, and regulate blood nerve barrier (BNB) permeability, thus enhancing the regeneration of the nerves. Notably, TGF-β has already been applied experimentally in the treatment of PNI. These treatments with encouraging outcomes further demonstrate its regeneration-promoting capacity. Herein, we review the possible roles of TGF-β in peripheral nerve regeneration and discuss the underlying mechanisms, thus providing new cues for better treatment of PNI.
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Affiliation(s)
- Zhiqian Ye
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Junbin Wei
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chaoning Zhan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jin Hou
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Jin Hou,
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