title: Serum levels of interferon-gamma, tumour necrosis factor-alpha, soluble interleukin-6R and soluble cell activation markers for monitoring response to treatment of leprosy reactions.
abstract: Identifying pathogen and host-related laboratory parameters are essential for the early diagnosis of leprosy reactions. The present study aimed to clarify the validity of measuring the profiles of serum cytokines [interleukin (IL)-4, IL-6, IL-10, interferon (IFN)-gamma and tumour necrosis factor (TNF)-alpha], the soluble IL-6 receptor (sIL-6R), soluble T cell (sCD27) and macrophage (neopterin) activation markers and Mycobacterium leprae-specific anti-PGL-I IgM antibodies in relation to the leprosy spectrum and reactions. Serum samples from 131 Indonesian leprosy patients (82 non-reactional leprosy patients and 49 reactional) and 112 healthy controls (HC) from the same endemic region were investigated. Forty-four (89.8%) of the reactional patients had erythema nodosum leprosum (ENL) while only five (10.2%) had reversal reaction (RR). Follow-up serum samples after corticosteroid treatment were also obtained from 17 of the patients with ENL and one with RR. A wide variability in cytokine levels was observed in the patient groups. However, IFN-gamma and sIL-6R were elevated significantly in ENL compared to non-ENL patients. Levels of IFN-gamma, TNF-alpha and sIL-6R declined significantly upon corticosteroid treatment of ENL. Thus, although the present study suggests limited applicability of serial measurement of IFN-gamma, TNF-alpha and sIL-6R in monitoring treatment efficacy of ENL, reactions it recommends a search for a wider panel of more disease-specific markers in future studies.
authors.affiliation: Department of Pathology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Iyer
authors.forename: M
authors.initials: M
authors.lastname: Hatta
authors.forename: R
authors.initials: R
authors.lastname: Usman
authors.forename: S
authors.initials: S
authors.lastname: Luiten
authors.forename: L
authors.initials: L
authors.lastname: Oskam
authors.forename: W
authors.initials: W
authors.lastname: Faber
authors.forename: A
authors.initials: A
authors.lastname: Geluk
authors.forename: P
authors.initials: P
authors.lastname: Das
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D002648:Child; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood*; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006017:Glycolipids / Q000276:immunology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D018836:Inflammation Mediators / Q000097:blood; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D007918:Leprosy / Q000188:drug therapy* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000276:immunology; D019798:Neopterin / Q000097:blood; D011239:Prednisolone / Q000627:therapeutic use; D019947:Receptors, Interleukin-6 / Q000097:blood; D012995:Solubility; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D015415:Biomarkers; D016207:Cytokines; D005938:Glucocorticoids; D006017:Glycolipids; D007075:Immunoglobulin M; D018836:Inflammation Mediators; D019947:Receptors, Interleukin-6; D014409:Tumor Necrosis Factor-alpha; C045169:phenolic glycolipid I, Mycobacterium leprae; D016753:Interleukin-10; D015847:Interleukin-4; D019798:Neopterin; D007371:Interferon-gamma; D011239:Prednisolone