The Influence of Thalidomide on the Clinical and Immunologic Manifestation of Erythema Nodosum Leprosum
Immunologic and clinical manifestations of erythema nodosum leprosum (ENL) and their response to thalidomide therapy were evaluated. Circulating tumor necrosis factor-α (TNFα) levels were assayed in serum obtained from lepromatous leprosy patients at diagnosis, during multidrug therapy, at the onset...
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Published in | The Journal of infectious diseases Vol. 168; no. 2; pp. 408 - 414 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Chicago, IL
The University of Chicago Press
01.08.1993
University of Chicago Press |
Subjects | |
Online Access | Get full text |
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Summary: | Immunologic and clinical manifestations of erythema nodosum leprosum (ENL) and their response to thalidomide therapy were evaluated. Circulating tumor necrosis factor-α (TNFα) levels were assayed in serum obtained from lepromatous leprosy patients at diagnosis, during multidrug therapy, at the onset of ENL episodes, and during treatment with thalidomide. Patients with systemic ENL demonstrated the highest serum TNFα levels, which decreased significantly during thalidomide treatment. Serum TNFα in nonreactional patients was associated with mild flu-like symptoms and local inflammatory lesions. Serum interferon-γ (IFN-γ was also elevated in patients with high TNFα levels. Thalidomide therapy reduced not only serum TNFα levels and the clinical symptoms but also the dermal infiltration of polymorphonuclear leukocytes and T cells. The expression of intercellular adhesion molecule 1 and major histocompatibility complex class II antigens on the epidermal keratinocytes was also down-regulated. These results indicate that the thalidomide-induced alleviation of clinical symptoms of ENL was associated with a reduction of TNFα levels. |
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Bibliography: | istex:0B30FF76AEF810F1CD343DD6EB87067AE302D141 ark:/67375/HXZ-CJPRJT1H-M Reprints or correspondence: Dr. Euzenir N. Sarno, Leprosy Unit, Oswaldo Cruz Foundation, Avenida Brasil 4365, Manguinhos, Rio de Janeiro, RJ, Brazil, 21040. ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
ISSN: | 0022-1899 1537-6613 |
DOI: | 10.1093/infdis/168.2.408 |