The Effects of Prednisolone Treatment on Cytokine Expression in Patients with Erythema Nodosum Leprosum Reactions

Negera, Edessa; Walker, Stephen L.; Bobosha, Kidist; Bekele, Yonas; Endale, Birtukan; Tarekegn, Azeb; Abebe, Markos; Aseffa, Abraham; Dockrell, Hazel M.

doi:10.3389/fimmu.2018.00189

Cited by 20 publications

(17 citation statements)

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“…Similar to other results, no associations between IL10, IL17, OPN levels and the duration of disease have been demonstrated [22,23,25]. Despite reducing IL-17 after the use of steroids therapy, IL-10 was increased [26]. The present study revealed no associations between IL-10, IL-17, OPN levels and the types of treatment.…”

Section: Discussionsupporting

confidence: 87%

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Association between Inflammatory Cytokines and Liver Functions in Rheumatoid Arthritis Patients

Eltahir

Mohammedsalih

Mohamed

et al. 2021

SJMS

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Background: Rheumatoid arthritis (RA) is associated with abnormal liver tests, and the medications used for RA are often hepatotoxic. Therefore, this study aimed to investigate an association between pro-inflammatory and anti-inflammatory cytokines and liver function tests in RA patients. Methods: In this descriptive cross-sectional study, 88 RA patients were included, 84 of them were women and 4 men, aged 21–81 years. Serum interleukin-10 (IL-10), interleukin-17 (IL-17), Osteopontin (OPN) were measured and liver function tests were conducted. Results: The frequency of RA was higher among adults aged >41 years (72 [81.8%]) than young adults aged ≤41 years (16 [18.2%]). RA was more common in women (84 [95.5%]) than in men (4 [4.5%]) – approximately 21:1-fold. Young adults had higher abnormal IL-10 than adult RA patients (OR = 3.72, p-value 0.044). Abnormal IL-17 (OR = 5.67, p-value 0.034) was found to be increased in young-adult RA patients. No association was observed between age and OPN and between the duration of disease and IL-10, IL-17, and OPN. Similarly, no association was noted between the types of treatment and IL-10, IL-17, and OPN, nor between IL-10, IL-17, OPN and liver parameters (AST, ALT, ALP, ALB, TP, and GGT). Conclusion: Pro-inflammatory and anti-inflammatory cytokines are not associated with abnormal liver functions, as has been demonstrated in RA patients.

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Section: Discussionsupporting

confidence: 87%

“…The present study revealed no associations between IL-10, IL-17, OPN levels and the types of treatment. It has become clear that steroids directly modulate the pro-inflammatory cytokine or suppress cytokines-producing cells [26,27].…”

Section: Discussionmentioning

confidence: 99%

Association between Inflammatory Cytokines and Liver Functions in Rheumatoid Arthritis Patients

Eltahir

Mohammedsalih

Mohamed

et al. 2021

SJMS

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“…New insights show that prednisolone also reduces Th1, IL-6, IL-8, Th17, interferon gamma levels, and increases the anti-inflammatory cytokine (IL-10) levels. 28 This broader anti-inflammatory activity, with different transcriptional effects on various immune cells may explain its benefit in CRSsNP. 29 Hence, the clinical division to define CRS microenvironment as primarily inflammatory (CRSwNP) or infectious (CRSsNP) etiology is oversimplified and maybe insufficient to strongly recommend prednisolone for the former and antibiotics for the latter.…”

Section: Discussionmentioning

confidence: 99%

Short‐term Oral Steroids Significantly Improves Chronic Rhinosinusitis Without Nasal Polyps

et al. 2021

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Objectives/Hypothesis: The efficacy of short-term oral corticosteroids in chronic rhinosinusitis without nasal polyps (CRSsNP) is unknown. The aim of this controlled study was to assess the immediate and long-term outcomes from a short course of a commonly used oral corticosteroid, prednisolone, in well-defined CRSsNP patients.Study Design: Prospective, observational controlled study. Methods: A prospective-controlled study of CRSsNP patients treated with prednisolone at 0.5 mg/kg tapered over 10 days and non-prednisolone treated CRSsNP patients (controls) and follow-up at 2, 6, and 12 months. Baseline and follow-up SinoNasal Outcome Test (SNOT)-22, nasal endoscopy (Lund-Kennedy), and sinus CT scan scores (Lund-Mackay) were compared.Results: At 2 months, there was a significant improvement in the SNOT-22, nasal endoscopy, and sinus CT scan scores in the prednisolone group (P < .0001) compared with controls (p = ns, Mann-Whitney U test). 52.5% of prednisolone-treated CRSsNP patients had improved symptoms and did not require sinus surgery at 12 months compared with 14.3% of controls (P < .001). Side-effects were reported in 8.9% of prednisolone-treated patients. Patients who benefited from prednisolone had a median symptom duration of 7.25 (99% confidence, upper limit of 11) months compared with 18 months in those requiring surgery.Conclusions: Short-term oral prednisolone significantly improved all three clinical measures of disease in CRSsNP patients and avoided surgical intervention in 52.5% patients in the first 12 months. Patients with symptoms for less than 11 months were most likely to benefit. The side-effects of oral steroids require careful consideration and further studies are needed to ascertain appropriate dosage and treatment duration.

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“…From each patient 10 mL venous blood sample was obtained before treatment and after prednisolone treatment of patients with ENL reactions. A fifteen day prednisolone treatment free period was used to obtain blood samples for the after treatment sample [22, 23].…”

Section: Methodsmentioning

confidence: 99%

The effects of prednisolone treatment on serological responses and lipid profiles in Ethiopian leprosy patients with Erythema Nodosum Leprosum reactions

et al. 2018

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BackgroundErythema nodosum leprosum (ENL) is a systemic inflammatory complication occurring mainly in patients with lepromatous leprosy (LL) and borderline lepromatous leprosy (BL). Prednisolone is widely used for treatment of ENL reactions. However, it has been reported that prolonged treatment with prednisolone increases the risk for prednisolone-induced complications such as osteoporosis, diabetes, cataract and arteriosclerosis. It has been speculated that perhaps these complications result from lipid profile alterations by prednisolone. The effects of extended prednisolone treatment on lipid profiles in ENL patients have not been studied in leprosy patients with ENL reactions. Therefore, in this study we conducted a case-control study to investigate the changes in lipid profiles and serological responses in Ethiopian patients with ENL reaction after prednisolone treatment.MethodsA prospective matched case–control study was employed to recruit 30 patients with ENL and 30 non-reactional LL patient controls at ALERT Hospital, Ethiopia. Blood samples were obtained from each patient with ENL reaction before and after prednisolone treatment as well as from LL controls. The serological host responses to PGL-1, LAM and Ag85 M. leprae antigens were measured by ELISA. Total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were measured by spectrophotometric method.ResultsThe host antibody response to M. leprae PGL-1, LAM and Ag85 antigens were significantly reduced in patients with ENL reactions compared to LL controls after treatment. Comparison between patients with acute and chronic ENL showed that host-response to PGL-1 was significantly reduced in chronic ENL after prednisolone treatment. Untreated patients with ENL reactions had low lipid concentration compared to LL controls. However, after treatment, both groups had comparable lipid profiles except for LDL, which was significantly higher in patients with ENL reaction. Comparison within the ENL group before and after treatment showed that prednisolone significantly increased LDL and HDL levels in ENL patients and this was more prominent in chronic ENL than in acute patients with ENL.ConclusionThe significantly increased prednisolone-induced LDL and TG levels, particularly in patients with chronic ENL reactions, is a concern in the use of prednisolone for extended periods in ENL patients. The findings highlight the importance of monitoring lipid profiles during treatment of patients to minimize the long-term risk of prednisolone-induced complications.

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The Effects of Prednisolone Treatment on Cytokine Expression in Patients with Erythema Nodosum Leprosum Reactions

Cited by 20 publications

References 46 publications

Association between Inflammatory Cytokines and Liver Functions in Rheumatoid Arthritis Patients

Association between Inflammatory Cytokines and Liver Functions in Rheumatoid Arthritis Patients

Short‐term Oral Steroids Significantly Improves Chronic Rhinosinusitis Without Nasal Polyps

The effects of prednisolone treatment on serological responses and lipid profiles in Ethiopian leprosy patients with Erythema Nodosum Leprosum reactions

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