title: The effect of systemic corticosteroid therapy on the expression of toll-like receptor 2 and toll-like receptor 4 in the cutaneous lesions of leprosy Type 1 reactions.
abstract: BACKGROUND
  Leprosy is complicated by immunological reactions which can occur before, during and after successful completion of multidrug therapy. Genetic studies have suggested that polymorphisms in toll-like receptors (TLRs) may affect the susceptibility of an individual with leprosy to developing Type 1 reactions.
  
  
  OBJECTIVE
  To examine the gene and protein expression of TLRs in the cutaneous lesions of leprosy Type 1 reactions at the onset of reaction and during systemic corticosteroid therapy.
  
  
  METHODS
  Patients who were being treated for leprosy type 1 reactions with corticosteroids as part of a randomized controlled trial of corticosteroid treatment had skin biopsies performed before, during and at the end of treatment. The gene and protein expression of TLR2 and TLR4 were measured.
  
  
  RESULTS
  We have demonstrated that the gene hARP-P0 is a suitable control gene for TLR gene expression studies in this population. The gene and protein expression of TLR2 and TLR4 were both reduced significantly during corticosteroid treatment.
  
  
  CONCLUSIONS
  This is the first study to examine the expression of TLR2 and TLR4 in vivo in individuals experiencing leprosy Type 1 reactions. The data support the possibility of an important role for TLR2 and TLR4 in the pathogenesis of this important complication of leprosy.
authors.affiliation: Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. drstevewalker@hotmail.com
authors.forename: S L
authors.initials: SL
authors.lastname: Walker
authors.forename: C H
authors.initials: CH
authors.lastname: Roberts
authors.forename: S E
authors.initials: SE
authors.lastname: Atkinson
authors.forename: S
authors.initials: S
authors.lastname: Khadge
authors.forename: M
authors.initials: M
authors.lastname: Macdonald
authors.forename: K D
authors.initials: KD
authors.lastname: Neupane
authors.forename: C
authors.initials: C
authors.lastname: Ranjit
authors.forename: B R
authors.initials: BR
authors.lastname: Sapkota
authors.forename: S
authors.initials: S
authors.lastname: Dhakal
authors.forename: R A
authors.initials: RA
authors.lastname: Hawksworth
authors.forename: K
authors.initials: K
authors.lastname: Mahat
authors.forename: S
authors.initials: S
authors.lastname: Ruchal
authors.forename: S
authors.initials: S
authors.lastname: Hamal
authors.forename: D A
authors.initials: DA
authors.lastname: Hagge
authors.forename: D N J
authors.initials: DN
authors.lastname: Lockwood
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D018076:DNA, Complementary / Q000096:biosynthesis; D004359:Drug Therapy, Combination; D005260:Female; D015870:Gene Expression; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007150:Immunohistochemistry; D007918:Leprosy / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D051195:Toll-Like Receptor 2 / Q000187:drug effects / Q000235:genetics / Q000378:metabolism / Q000502:physiology*; D051197:Toll-Like Receptor 4 / Q000187:drug effects / Q000235:genetics / Q000378:metabolism / Q000502:physiology*; D055815:Young Adult
chemical_list: D000904:Antibiotics, Antitubercular; D018076:DNA, Complementary; D005938:Glucocorticoids; C495342:TLR2 protein, human; C495345:TLR4 protein, human; D051195:Toll-Like Receptor 2; D051197:Toll-Like Receptor 4; D011239:Prednisolone; D008775:Methylprednisolone