title: Elevated free tear lactoferrin levels in leprosy are associated with Type 2 reactions.
abstract: OBJECTIVE
  To determine the association of demographics, leprosy and ocular characteristics with altered levels of lactoferrin in the tears of normal subjects and leprosy patients, and to detect the presence of antibodies to lactoferrin in these tear samples.
  
  
  METHODS
  We collected light-stimulated tears from 298 leprosy patients and an equal number of normal subjects using the glass capillary method. Free lactoferrin levels were estimated using ELISA and the presence of antibodies to lactoferrin was detected using the immuno-blotting method. Significant associations were looked for between tear lactoferrin levels and demographic characteristics, leprosy characteristics such as type of disease, duration of disease, reactions, deformity and bacterial load, and ocular complications, using chi-square and regression analysis.
  
  
  RESULTS
  Tear lactoferrin levels with a mean (SD) of 2.55 (2.83)mg/ml in the control group were significantly different (P<0.000) from leprosy patients with a smean (SD) of 5.66 (7.21)mg/ml. Age showed an inverse correlation with tear lactoferrin levels in controls. Increased bacterial load, grade 2 leg deformity and Type 2 reactions were significantly associated (P<0.05) with increased tear lactoferrin levels. Type 2 reactions remained significantly associated (P=0.01) on multiple regression analysis. Tear lactoferrin levels were not associated with gender, serum lactoferrin levels, Type 1 reactions, face patches, treatment status, orbicularis oculi weakness, lagophthalmos, ectropion, entropion, corneal opacity, cataract and iridocyclitis.
  
  
  CONCLUSIONS
  Age is inversely related to tear lactoferrin levels in normal subjects. Free lactoferrin levels in tears are significantly higher in leprosy patients compared with normal controls. Type 2 reactions in leprosy are significantly associated with elevated tear lactoferrin levels.
authors.affiliation: Department of Ophthalmology, Schieffelin Leprosy Research and Training Center, Tamil Nadu, India. oculep@vsnl.com
authors.forename: Ebenezer
authors.initials: E
authors.lastname: Daniel
authors.forename: Muruganand
authors.initials: M
authors.lastname: Duriasamy
authors.forename: Gigi J
authors.initials: GJ
authors.lastname: Ebenezer
authors.lastname: Shobhana
authors.forename: Charles K
authors.initials: CK
authors.lastname: Job
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007781:Lactoferrin / Q000032:analysis / Q000378:metabolism*; D015440:Leprosy, Lepromatous / Q000378:metabolism*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D013666:Tears / Q000378:metabolism*
chemical_list: D007781:Lactoferrin