Inflammatory Mediators of Leprosy Reactional Episodes and Dental Infections: A Systematic Review.
Reactional episodes in leprosy are a result of complex interactions between the immune system, Mycobacterium leprae, and predisposing factors, including dental infections. To determine the main inflammatory mediators in the immunopathological process of dental infections and leprosy reactions, we conducted a systematic review of primary literature published between 1996 and 2013. A three-stage literature search was performed (Stage I, "leprosy reactions" and "inflammatory mediators"; Stage II, "dental infections" and "inflammatory mediators"; and Stage III, "leprosy reactions," "dental infections," and "inflammatory mediators"). Of the 911 eligible publications, 10 were selected in Stage I, 68 in Stage II, and 1 in Stage III. Of the 27 studied inflammatory mediators, the main proinflammatory mediators were IL-6, IFN-γ, TNF-α, IL-1β, and IL-17; the main anti-inflammatory mediators were IL-10 and IL-4. Serum IL-6 and TNF-α concentrations were significant during periodontal and reactional lesion evolution; IFN-γ and IL-1β were associated with types 1 and 2 reactions and chronic periodontal disease. The proinflammatory mediators in dental infections and leprosy reactions, especially IL-6 and TNF-α, were similar across studies, regardless of the laboratory technique and sample type. IFN-γ and IL-1β were significant for leprosy reactions and periodontal diseases. This pattern was maintained in serum.
School of Health Sciences, State University of Mato Grosso, São João Street, S/N, 78000-000 Cáceres, MT, Brazil.
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Cortela
School of Health Sciences, State University of Mato Grosso, São João Street, S/N, 78000-000 Cáceres, MT, Brazil.
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de Souza Junior
Research Department, Instituto Lauro de Souza Lima, Comandante J. R. Barros Rodovia Km 225/226, 17034-971 Bauru, SP, Brazil.
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Virmond
School of Health Sciences, State University of Mato Grosso, São João Street, S/N, 78000-000 Cáceres, MT, Brazil.
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Ignotti
D000818:Animals; D016207:Cytokines / Q000378:metabolism*; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D007918:Leprosy / Q000276:immunology*; D009057:Stomatognathic Diseases / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma