title: Effect of thalidomide on the expression of TNF-alpha m-RNA and synthesis of TNF-alpha in cells from leprosy patients with reversal reaction.
abstract: Hypersensitivity reactions called reversal reaction (RR) and erythema nodosum leprosum (ENL) occur in leprosy. They are characterized by an increase in tumor necrosis factor-alpha (TNF-alpha). Thalidomide is an effective treatment for ENL but not RR. Its effectiveness in ENL is attributed to inhibition of TNF-alpha, and this does not explain its failure to treat RR. We assessed thalidomide's effect on TNF-alpha in RR. Mononuclear cells from RR and non-RR patients and healthy individuals were treated with thalidomide and M.leprae (AFB), a cytosol fraction of M. leprae or Dharmendra lepromin. Thalidomide suppressed TNF-alpha, but when some RR patients' cells were stimulated with AFB, it enhanced TNF-alpha.
authors.affiliation: Armauer Hansen Research Institute, Addis Ababa, Ethiopia. Azeb.tadesse@mssm.edu
authors.forename: Azeb
authors.initials: A
authors.lastname: Tadesse
authors.forename: Markos
authors.initials: M
authors.lastname: Abebe
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bizuneh
authors.forename: Wondwossen
authors.initials: W
authors.lastname: Mulugeta
authors.forename: Abraham
authors.initials: A
authors.lastname: Aseffa
authors.forename: E J
authors.initials: EJ
authors.lastname: Shannon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000276:immunology / Q000494:pharmacology; D049109:Cell Proliferation / Q000187:drug effects; D002470:Cell Survival / Q000187:drug effects; D002478:Cells, Cultured; D004893:Erythema Nodosum / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D005260:Female; D006801:Humans; D007916:Lepromin / Q000276:immunology / Q000494:pharmacology; D007918:Leprosy / Q000097:blood / Q000150:complications / Q000473:pathology; D007963:Leukocytes, Mononuclear / Q000166:cytology / Q000187:drug effects* / Q000378:metabolism; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000276:immunology; D010835:Phytohemagglutinins / Q000494:pharmacology; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D013792:Thalidomide / Q000494:pharmacology*; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D000942:Antigens, Bacterial; D010835:Phytohemagglutinins; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D007916:Lepromin; D013792:Thalidomide