2011, Number 2
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Bol Med Hosp Infant Mex 2011; 68 (2)
Are leprosy reactions autoinflammatory diseases?
Quandelacy T, Holtz M, Franco-Paredes C
Language: English
References: 10
Page: 117-119
PDF size: 219.43 Kb.
ABSTRACT
There are two types of leprosy reactions: reversal reactions or type 1 and erythema nodosum leprosum or type 2. Deformity and disability associated with leprosy are frequently the result of uncontrolled or untreated reactions. Although there is current availability of glucocorticoids as the mainstay of therapy, much needs to be learned about the etiology, risk factors, and pathogenesis of leprosy reactions. There is some evidence that leprosy reactions may represent, particularly, erythema nodosum leprosum autoinflammatory disease due to the aberrant activation of the innate immune system. The role for herpesviruses influencing autophagy in macrophages needs to be evaluated in the pathogenesis of leprosy reactions.
REFERENCES
McGonagle D, McDermott MF. A proposed classification of the immunological diseases. PLoS Med 2006;3:e297.
Masters SL, Simon A, Aksentijevich I, Kastner DL. Horror autoinflammaticus: the molecular pathophysiology of autoinflammatory disease. Annu Rev Immunol 2009;27:261-268.
Franco-Paredes C, Jacob JT, Stryjewska B, Yoder L. Two patients with leprosy and the sudden appearance of inflammation in the skin and new sensory loss. PLoS Negl Trop Dis 2009;3:e425.
Scollard DM, Adams LB, Gillis TP, Krahenbuhl JL, Truman RW, Williams DL. The continuing challenges of leprosy. Clin Microbiol Rev 2006;19:338-381.
Jacob JT, Kozarsky P, Dismukes R, Bynoe V, Margoles L, Leonard M, et al. Five-year experience with type 1 and type 2 reactions in Hansen disease at a US travel clinic. Am J Trop Med Hyg 2008;79:452-454.
Pocaterra L, Jain S, Reddy R, Muzaffarullah S, Torres O, Suneetha S, et al. Clinical course of erythema nodosum leprosum: an 11-year cohort study in Hyderabad, India. Am J Trop Med Hyg 2006;74:868-879.
Lee DJ, Li H, Ochoa MT, Tanaka M, Carbone RJ, Damoiseaux AB, et al. Integrated pathways for neutrophil recruitment and inflammation in leprosy. J Infect Dis 2010;201:558-569.
Zhang FR, Huang W, Chen SM, Sun LD, Liu H, Li Y, et al. Genomewide association study of leprosy. N Engl J Med 2009;361:2609-2618.
Modlin RL. The innate immune response in leprosy. Curr Opin Immunol 2010;22:48-54.
Montoya D, Modlin RL. Learning from leprosy: insight into the human innate immune response. Adv Immunol 2010;105:1-24.