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de Mattos Barbosa MG, de Andrade Silva BJ, Assis TQ, da Silva Prata RB, Ferreira H, Andrade PR, da Paixão de Oliveira JA, Sperandio da Silva GM, da Costa Nery JA, Sarno EN, Pinheiro RO. Autophagy Impairment Is Associated With Increased Inflammasome Activation and Reversal Reaction Development in Multibacillary Leprosy. Front Immunol 2018; 9:1223. [PMID: 29915584 PMCID: PMC5994478 DOI: 10.3389/fimmu.2018.01223] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 05/15/2018] [Indexed: 12/15/2022] Open
Abstract
Leprosy reactions are responsible for incapacities in leprosy and represent the major cause of permanent neuropathy. The identification of biomarkers able to identify patients more prone to develop reaction could contribute to adequate clinical management and the prevention of disability. Reversal reaction may occur in unstable borderline patients and also in lepromatous patients. To identify biomarker signature profiles related with the reversal reaction onset, multibacillary patients were recruited and classified accordingly the occurrence or not of reversal reaction during or after multidrugtherapy. Analysis of skin lesion cells at diagnosis of multibacillary leprosy demonstrated that in the group that developed reaction (T1R) in the future there was a downregulation of autophagy associated with the overexpression of TLR2 and MLST8. The autophagy impairment in T1R group was associated with increased expression of NLRP3, caspase-1 (p10) and IL-1β production. In addition, analysis of IL-1β production in serum from multibacillary patients demonstrated that patients who developed reversal reaction have significantly increased concentrations of IL-1β at diagnosis, suggesting that the pattern of innate immune responses could predict the reactional episode outcome. In vitro analysis demonstrated that the blockade of autophagy with 3-methyladenine (3-MA) in Mycobacterium leprae-stimulated human primary monocytes increased the assembly of NLRP3 specks assembly, and it was associated with an increase of IL-1β and IL-6 production. Together, our data suggest an important role for autophagy in multibacillary leprosy patients to avoid exacerbated inflammasome activation and the onset of reversal reaction.
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Affiliation(s)
| | | | - Tayná Quintella Assis
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Helen Ferreira
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | | | | | - Euzenir Nunes Sarno
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Roberta Olmo Pinheiro
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Andrade P, Amadeu T, Nery J, Pinheiro R, Sarno E. CD123, the plasmacytoid dendritic cell phenotypic marker, is abundant in leprosy type 1 reaction. Br J Dermatol 2014; 172:268-71. [DOI: 10.1111/bjd.13430] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- P.R. Andrade
- Leprosy Laboratory; Oswaldo Cruz Institute; FIOCRUZ; Rio de Janeiro RJ Brazil
| | - T.P. Amadeu
- Laboratory of Immunopathology; Department of Pathology and Laboratories; FCM; State University of Rio de Janeiro; Rio de Janeiro RJ Brazil
| | - J.A. Nery
- Leprosy Laboratory; Oswaldo Cruz Institute; FIOCRUZ; Rio de Janeiro RJ Brazil
| | - R.O. Pinheiro
- Leprosy Laboratory; Oswaldo Cruz Institute; FIOCRUZ; Rio de Janeiro RJ Brazil
| | - E.N. Sarno
- Leprosy Laboratory; Oswaldo Cruz Institute; FIOCRUZ; Rio de Janeiro RJ Brazil
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Antunes DE, Araujo S, Ferreira GP, da Cunha ACSR, da Costa AV, Gonçalves MA, Goulart IMB. Identification of clinical, epidemiological and laboratory risk factors for leprosy reactions during and after multidrug therapy. Mem Inst Oswaldo Cruz 2013; 108:901-8. [PMID: 24271045 PMCID: PMC3970646 DOI: 10.1590/0074-0276130222] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 08/16/2013] [Indexed: 11/03/2022] Open
Abstract
This cross-sectional retrospective study evaluated 440 leprosy patients; 57% (251/440) had leprosy reactions during and/or after multidrug therapy, 80.5% (202/251) of whom presented with multibacillary leprosy. At diagnosis, positive bacterial index (BI) [odds ratio (OR) = 6.39; 95% confidence interval (CI): 4.1-10.1)] or polymerase chain reaction (PCR) (OR = 9.15; 95% CI: 5.4-15.5) in skin smears, anti-phenolic glycolipid-1 (anti-PGL-1) ELISA (OR = 4.77; 95% CI: 2.9-7.9), leucocytosis (OR = 9.97; 95% CI: 3.9-25.7), thrombocytopenia (OR = 5.72; 95% CI: 2.3-14.0) and elevated lactate dehydrogenase (OR = 2.38; 95% CI: 1.4-4.0) were potential markers for the development of reactions during treatment. After treatment, positive BI (OR = 8.47; 95% CI: 4.7-15.3) and PCR (OR = 6.46; 95% CI: 3.4-12.3) in skin smears, anti-PGL-1 ELISA (OR = 2.25; 95% CI: 1.3-3.9), anaemia (OR = 2.36; 95% CI: 1.2-4.5), leucocytosis (OR = 4.14; 95% CI: 1.5-11.6) and thrombocytopenia (OR = 3.70; 95% CI: 1.3-2.2) were risk factors for the occurrence of reactions during the study period. The identification of groups with an increased risk for developing reactions will allow for the timely development of a treatment plan to prevent nerve damage and, therefore, the appearance of the disabling sequelae associated with the stigma of leprosy.
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Affiliation(s)
- Douglas Eulálio Antunes
- Centro de Referência Nacional em Hanseníase/Dermatologia Sanitária, Hospital de Clínicas,Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil
| | - Sergio Araujo
- Centro de Referência Nacional em Hanseníase/Dermatologia Sanitária, Hospital de Clínicas,Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil
| | - Gabriela Porto Ferreira
- Centro de Referência Nacional em Hanseníase/Dermatologia Sanitária, Hospital de Clínicas,Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil
| | - Ana Carolina Sousa Rodrigues da Cunha
- Centro de Referência Nacional em Hanseníase/Dermatologia Sanitária, Hospital de Clínicas,Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil
| | - Adeilson Vieira da Costa
- Centro de Referência Nacional em Hanseníase/Dermatologia Sanitária, Hospital de Clínicas,Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil
| | - Maria Aparecida Gonçalves
- Centro de Referência Nacional em Hanseníase/Dermatologia Sanitária, Hospital de Clínicas,Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil
| | - Isabela Maria Bernardes Goulart
- Centro de Referência Nacional em Hanseníase/Dermatologia Sanitária, Hospital de Clínicas,Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil
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