Abstract
Leprosy is an ancient disease that remains endemic and continues to be a major public health problem in some tropical countries, where it has been internationally recognized as being linked to the underdevelopment conditions. The natural course of the disease covers a wide variety of clinical conditions with systemic involvement. In this paper, we review the findings obtained in studies of the pathological mechanisms of leprosy, including a survey of the literature and of our own work. The understanding and control of the wide variety of clinical conditions should help improve patient care and thus prevent the onset of physical impairment and the stigma of the disease.
Highlights
Leprosy is an ancient disease that remains endemic and continues to be a major public health problem in some tropical countries, where it has been internationally recognized as being linked to the underdevelopment conditions
Leprosy is a chronic infectious disease caused by the intracellular pathogen Mycobacterium leprae, which presents a long period of incubation, providing an extraordinary opportunity to investigate the human immune regulation of infection, because it presents a spectrum of clinical manifestations that correlate with the immune response of the host against the pathogen (Ridley & Jopling 1966)
transforming growth factor-β1 (TGF-β1) produced in vitro by cultures of adherent cells from peripheral blood mononuclear cells (PBMC) was spontaneously released in all clinical forms of leprosy and in healthy individuals, but patients with erythema nodosum leprosum (ENL) showed markedly higher TGF-β1 concentrations than all other patients and controls. This led to the conclusion that TGF-β1 appears to play different roles in leprosy: it presents a pro-inflammatory effect on the inflammatory reaction, especially in ENL, stimulating the Th2 response and an immunosuppressive effect in the presence of phenolic glycolipid-I (PGL-I) or other M. leprae antigens (Goulart et al 2000)
Summary
Leprosy is an ancient disease that remains endemic and continues to be a major public health problem in some tropical countries, where it has been internationally recognized as being linked to the underdevelopment conditions. This led to the conclusion that TGF-β1 appears to play different roles in leprosy: it presents a pro-inflammatory effect on the inflammatory reaction, especially in ENL, stimulating the Th2 response and an immunosuppressive effect in the presence of PGL-I or other M. leprae antigens (Goulart et al 2000).
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