title: Angiogenesis and lymphangiogenesis in the spectrum of leprosy and its reactional forms.
abstract: BACKGROUND
  Angiogenesis and lymphangiogenesis are the processes of neovascularization that evolve from preexisting blood and lymphatic vessels. There are few studies on angiogenesis and none on lymphangiogenesis in leprosy. Thus, the role of neovascularization in the pathophysiological mechanisms of the disease was studied across the spectrum of leprosy, its reactional states and its residual lesions.
  
  
  RESULTS
  Seventy-six biopsies of leprosy skin lesions and seven healthy controls were selected. Fifty-five serum samples were used for the detection of CD105 by ELISA. Histological sections were stained with antibodies against CD31 (blood and lymphatic vessels), D2-40/podoplanin (lymphatic vessels), and CD105/endoglin (neovessels). Microvessels were counted in 100 high-power fields (400x) and the number of vessels was evaluated in relation to the extension of the inflammatory infiltrate (0-3), to the bacillary index (0-6) and to the clinical forms. Angiogenesis, as marked by CD31 and CD105, was observed across the leprosy spectrum, compared with the controls. Additionally, there was a positive correlation between these markers with extension of the infiltrate (p <0.0001). For D2/40, lymphangiogenesis was observed in the tuberculoid form (p <0.0001). There was no statistical significance for values of CD105 detected in plasma by ELISA.
  
  
  CONCLUSIONS
  Angiogenesis is present across the spectrum of leprosy and in its reactional forms. The increase in the number of vessels, as detected by CD31 and CD105 staining, is related to the extension of the inflammatory infiltrate. Samples from reactional lesions have a higher number of CD31+ and CD105+ stained vessels, which indicates their involvement in the pathophysiological mechanisms of the reactional states. The regression of lesions is accompanied by the regression of neovascularization. Drugs inhibiting angiogenesis may be relevant in the treatment of leprosy, in addition to multidrugtherapy, and in the prevention of the development of reactions.
authors.affiliation: Laboratory of Anatomic Pathology, Lauro de Souza Lima Institute, Bauru, São Paulo, Brazil.
authors.forename: Cleverson Teixeira
authors.initials: CT
authors.lastname: Soares
authors.forename: Patrícia Sammarco
authors.initials: PS
authors.lastname: Rosa
authors.forename: Ana Paula Fávaro
authors.initials: AP
authors.lastname: Trombone
authors.forename: Luciana Raquel Vicenzi
authors.initials: LR
authors.lastname: Fachin
authors.forename: Cássio César
authors.initials: CC
authors.lastname: Ghidella
authors.forename: Somei
authors.initials: S
authors.lastname: Ura
authors.forename: Jaison Antonio
authors.initials: JA
authors.lastname: Barreto
authors.forename: Andréa de Faria Fernandes
authors.initials: Ade F
authors.lastname: Belone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D001706:Biopsy; D016022:Case-Control Studies; D002648:Child; D000071063:Endoglin; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism / Q000503:physiopathology; D007918:Leprosy / Q000188:drug therapy* / Q000503:physiopathology*; D042583:Lymphangiogenesis / Q000187:drug effects; D008297:Male; D008562:Membrane Glycoproteins / Q000378:metabolism; D008833:Microcirculation; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000188:drug therapy / Q000378:metabolism*; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D011956:Receptors, Cell Surface / Q000378:metabolism; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology; D055815:Young Adult; D000098853:Podoplanin
chemical_list: D015703:Antigens, CD; D000071063:Endoglin; D008562:Membrane Glycoproteins; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D011956:Receptors, Cell Surface; C064206:ENG protein, human; C117468:PDPN protein, human; D000098853:Podoplanin
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