Antigenic trigger for type 1 reaction in leprosy☆

Wilkinson, Robert J.; Lockwood, Diana N J

doi:10.1016/j.jinf.2004.02.012

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…Second, the T cell repertoire is progressively constituted throughout childhood. Moreover, it has been suggested that T1Rs can result from antigenic cross-reaction secondary to non-M. leprae mycobacterial infection, such as tuberculosis [30]. It is, therefore, plausible that adults, because of their broader memory T cell repertoire, show more frequent T1Rs that are triggered by crossreaction to M. leprae antigens following sensitization by non-M. leprae mycobacterial infection.…”

Section: Discussionmentioning

confidence: 99%

Age Is an Important Risk Factor for Onset and Sequelae of Reversal Reactions in Vietnamese Patients with Leprosy

Ranque

Thuc

et al. 2007

CLIN INFECT DIS

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Section: Discussionmentioning

confidence: 99%

Age Is an Important Risk Factor for Onset and Sequelae of Reversal Reactions in Vietnamese Patients with Leprosy

Ranque

Thuc

et al. 2007

CLIN INFECT DIS

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“…Type 1 reactions have been observed to follow immunization with other mycobacteria in some circumstances (433,452), and various environmental factors have been considered but not confirmed to be associated with the onset of these reactions. The possibility that genetic factors might predispose some patients to develop type 1 reactions has not yet been examined (see Genetic Influences, above).…”

Section: Immunological Features Of Reactionsmentioning

confidence: 99%

The Continuing Challenges of Leprosy

et al. 2006

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SUMMARY Leprosy is best understood as two conjoined diseases. The first is a chronic mycobacterial infection that elicits an extraordinary range of cellular immune responses in humans. The second is a peripheral neuropathy that is initiated by the infection and the accompanying immunological events. The infection is curable but not preventable, and leprosy remains a major global health problem, especially in the developing world, publicity to the contrary notwithstanding. Mycobacterium leprae remains noncultivable, and for over a century leprosy has presented major challenges in the fields of microbiology, pathology, immunology, and genetics; it continues to do so today. This review focuses on recent advances in our understanding of M. leprae and the host response to it, especially concerning molecular identification of M. leprae, knowledge of its genome, transcriptome, and proteome, its mechanisms of microbial resistance, and recognition of strains by variable-number tandem repeat analysis. Advances in experimental models include studies in gene knockout mice and the development of molecular techniques to explore the armadillo model. In clinical studies, notable progress has been made concerning the immunology and immunopathology of leprosy, the genetics of human resistance, mechanisms of nerve injury, and chemotherapy. In nearly all of these areas, however, leprosy remains poorly understood compared to other major bacterial diseases.

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“…14,15 Varied mechanisms have been proposed to explain the possible role of these triggers in leprosy reactions (Table 6). 14,16–43…”

Section: Discussionmentioning

confidence: 99%

“…Literature summary on the purported link between infectious triggers and leprosy reaction.Spill over of inflammatory products in peripheral circulation→inflammatory response Mycobacterium tuberculosis ↑T cell reactivity to peptides to M. tuberculosis & cross reactivity to M. leprae antigens→ T1R17 TetanusWhile leprosy patients usually have resistance to C. tetani infection (due to repeated wound infection by the anaerobes) case reports suggest that Late T1R can be triggered by tetanus due to ↑CMI…”

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confidence: 99%

Time to revisit the purported link of leprosy reactions with infective triggers: An unnecessary economic burden for patients

Muddebihal,

Sardana,

Khurana

et al. 2023

Trop Doct

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Existing literature on factors triggering leprosy reactions is based only on case reports and case series, and thus probably gives a biased view. We undertook a case–control study to investigate such purported trigger factors in 42 leprosy reaction patients and 40 non-reactional controls, and the cost of investigations required for the same. Detailed history, clinical evaluation and investigations for triggers were carried out. Infections (typhoid, dental caries) were the most common triggers found, followed by pregnancy. Trigger factors were commoner in the type 2 reaction (T2R) group compared to type 1 (T1R) reaction group. There was however no statistical difference between the two groups. The average estimated cost of investigations was higher in the reactional group and this difference was statistically significant. Hence, except for essential investigations required for initiating steroids, an extensive battery of investigations is unjustified unless the medical history suggests a definitive infective trigger.

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Antigenic trigger for type 1 reaction in leprosy☆

Cited by 7 publications

References 8 publications

Age Is an Important Risk Factor for Onset and Sequelae of Reversal Reactions in Vietnamese Patients with Leprosy

Age Is an Important Risk Factor for Onset and Sequelae of Reversal Reactions in Vietnamese Patients with Leprosy

The Continuing Challenges of Leprosy

Time to revisit the purported link of leprosy reactions with infective triggers: An unnecessary economic burden for patients

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