The histological diagnosis of leprosy type 1 reactions: identification of key variables and an analysis of the process of histological diagnosis

Lockwood, Diana N J; Lucas, Sebastian; Kv, Desikan; Ebenezer, Gigi J.; Suneetha, Sujai; Nicholls, Peter

doi:10.1136/jcp.2007.053389

Cited by 68 publications

(59 citation statements)

References 11 publications

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“…This, in itself, is an important advance, since currently there are no laboratory markers for T1R. Even in biopsy specimens of lesions there are no pathognomonic morphological features of T1R, and the information obtained from biopsy specimens does not provide conclusive evidence of this reaction in a large percentage of cases (7). However, these data do not demonstrate that elevation of circulating CXCL10 can be used as a predictor of T1R; additional studies are necessary to evaluate the possibility.…”

Section: Discussionmentioning

confidence: 56%

Increased CXC Ligand 10 Levels and Gene Expression in Type 1 Leprosy Reactions

Scollard¹,

Chaduvula²,

Martínez³

et al. 2011

Clin. Vaccine Immunol.

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Type 1 reaction (T1R) is a systemic inflammatory syndrome causing substantial morbidity in leprosy. T1R results from spontaneously enhanced cellular immunity in borderline types of leprosy, but there are no established laboratory markers for the reaction. Preliminary studies have identified elevated circulating CXC ligand 10 (CXCL10) during T1R. Correlation of CXCL10 with clinical T1R was studied in repeated serum specimens obtained before, during, and after T1R. CXCL10 gene expression was assessed in biopsy specimens taken before and during T1R, and sections were stained for the cytokine using monoclonal antibodies. Sequential serum specimens revealed elevation of circulating CXCL10 associated with episodes of T1R (P ‫؍‬

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Section: Discussionmentioning

confidence: 56%

Increased CXC Ligand 10 Levels and Gene Expression in Type 1 Leprosy Reactions

Scollard¹,

Chaduvula²,

Martínez³

et al. 2011

Clin. Vaccine Immunol.

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“…The heterogeneity of the RR samples may relate to differences in the severity and/or duration of the reactional state or intrinsic host ability to respond, as was also observed for RR blood samples (17). It is noteworthy that the histologic differentiation of T-lep and RR forms is often difficult (18,19). In contrast, the ENL samples formed a separate group that was equally dissimilar to both the L-lep and T-lep/RR clusters.…”

Section: Resultsmentioning

confidence: 85%

Cell-type deconvolution with immune pathways identifies gene networks of host defense and immunopathology in leprosy

Inkeles¹,

Teles²,

Pouldar³

et al. 2016

JCI Insight

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“…Type 1 reactions occur in borderline leprosy, and they are understood to be an intensification in the cell-mediated immune response to HD bacilli (1,12,32,(35)(36)(37). Patients with type 1 reactions generally have fewer HD bacilli and lower levels of antibodies to HD than patients with the lepromatous form of HD (38,39).…”

Section: Type 1 Reaction (Reversal Reaction)mentioning

confidence: 99%

Leprosy in the 21st Century

2015

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SUMMARY Despite significant improvements in leprosy (Hansen's disease) treatment and outlook for patients since the introduction of multidrug therapy (MDT) 3 decades ago, the global incidence remains high, and patients often have long-term complications associated with the disease. In this article, we discuss recent findings related to genetics, susceptibility, and disease reservoirs and the implications of these findings for Hansen's disease control and health outcomes for patients. We describe the continued difficulties associated with treatment of inflammatory episodes known as “leprosy reactions,” which cause much of the disability associated with the disease and can affect people for many years after MDT is complete. We also discuss some of the contemporary challenges for physicians and patients, including international and internal migration of people affected by the disease. We suggest some important areas of focus for future Hansen's disease research.

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The histological diagnosis of leprosy type 1 reactions: identification of key variables and an analysis of the process of histological diagnosis

Abstract: This study has identified T1R as being under-diagnosed in comparison with clinical assessments. Key variables for diagnosing T1R were established. This comparative masked study highlights the need for such studies in other inflammatory conditions.

Cited by 68 publications

References 11 publications

Increased CXC Ligand 10 Levels and Gene Expression in Type 1 Leprosy Reactions

Increased CXC Ligand 10 Levels and Gene Expression in Type 1 Leprosy Reactions

Cell-type deconvolution with immune pathways identifies gene networks of host defense and immunopathology in leprosy

Leprosy in the 21st Century

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