Leprosy is an infectious and contagious spectral disease accompanied by a series of immunological events triggered by the host response to the aetiologic agent, Mycobacterium leprae . The induction and maintenance of the immune/inflammatory response in leprosy are linked to multiple cell interactions and soluble factors, primarily through the action of cytokines. The purpose of the present study was to evaluate the serum levels of tumour necrosis factor (TNF)-α and its soluble receptors (sTNF-R1 and sTNF-R2) in leprosy patients at different stages of multidrug treatment (MDT) in comparison with non-infected individuals and to determine their role as putative biomarkers of the severity of leprosy or the treatment response. ELISA was used to measure the levels of these molecules in 30 healthy controls and 37 leprosy patients at the time of diagnosis and during and after MDT. Our results showed increases in the serum levels of TNF-α and sTNF-R2 in infected individuals in comparison with controls. The levels of TNF-α, but not sTNF-R2, decreased with treatment. The current results corroborate previous reports of elevated serum levels of TNF-α in leprosy and suggest a role for sTNF-R2 in the control of this cytokine during MDT.

FUNDAMENTOS: As incapacidades e deformidades decorrentes dos surtos reacionais de hanseníase podem acarretar inúmeros problemas aos pacientes, interferindo na qualidade de vida. OBJETIVOS: Avaliar a qualidade de vida de pacientes portadores de hanseníase em estado reacional identificados em centro de referência de Belo Horizonte, MG. MÉTODOS: Trata-se de um estudo epidemiológico transversal, descritivo e analítico, envolvendo 120 pacientes em tratamento de surto reacional de hanseníase, no período de dezembro de 2007 a março de 2008, realizado no ambulatório de dermatologia do Hospital Eduardo de Menezes da Fhemig. Foram utilizados dois instrumentos referentes às variáveis sociodemográficas, econômicas e clínicas e o instrumento genérico WHOQOL-bref da OMS. Os dados foram tabulados no SPSS e analisados por meio do escore médio com aplicação de testes estatísticos (p < 0,05). RESULTADOS: Constatou-se que a mediana da idade dos pacientes estudados foi de 48 anos, sendo a maioria deles do sexo masculino, casada, de cidades circunvizinhas a BH, com primeiro grau incompleto, aposentada ou gozando de licença saúde e com renda familiar de um a dois salários mínimos vigentes. A maioria deles relatou que a doença interferiu muito nas atividades profissionais e de lazer. Na avaliação da QV, o índice mais baixo foi observado no domínio físico e os mais altos foram observados nos domínios psicológico e das relações sociais. A consistência interna do WHOQOL-bref foi aceitável para as facetas e domínios. CONCLUSÕES: A hanseníase causa sofrimento que ultrapassa a dor e o mal-estar estritamente vinculados ao prejuízo físico, com grande impacto social e psicológico.

BACKGROUND: Disabilities and deformities resulting from reactive outbreaks of leprosy can cause many problems for the patients, interfering with their quality of life. OBJECTIVES: To assess the quality of life of patients with leprosy reactional states identified at the Reference Center in Belo Horizonte - MG. METHODS: This was an epidemiological cross-sectional descriptive and analytical study, involving 120 patients in treatment for leprosy reactional states, from December 2007 to March 2008, held at the Dermatology outpatients clinic of the Hospital Eduardo de Menezes from FHEMIG, BH. We used two instruments for the socio-demographic, economic and clinical variables and a generic instrument WHOQOL WHO. The data were tabulated in SPSS and analyzed using the mean score with the application of statistical tests (p <0.05). RESULTS: We found that the median age of the patients was 48 years, most were males, married, from cities around BH, with incomplete elementary school, retired or pensioner, and with a family income of two minimum wages. Most of them reported that the disease interfered a great deal with their professional activities and leisure. In the assessment of QoL, the lowest rating was observed in the physical domain and the highest was observed in the psychological and social relations. The internal consistency of WHO-QOL-bref was acceptable to the facets and domains. CONCLUSIONS: Leprosy causes suffering that goes beyond the pain and discomfort strictly related to the physical damage, with great social and psychological impact.

O fator neurotrófico derivado do cérebro (BDNF) é uma neurotrofina envolvida na sobrevivência neuronal e no crescimento e diferenciação dos dendritos e axônios. O objetivo do presente estudo foi avaliar os níveis plasmáticos do BDNF de pacientes com hanseníase em diferentes fases da poliquimioterapia (PQT), em comparação com indivíduos não-infectados. Os níveis plasmáticos do BDNF foram mensurados pelo teste ELISA em 30 controles sadios e 37 pacientes com hanseníase no momento do diagnóstico, durante e após PQT. Os níveis plasmáticos do BDNF mostraram-se maiores nos indivíduos controles em comparação com os pacientes com hanseníase, mas não houve diferença estatisticamente significante. Curiosamente, os níveis de BDNF modificaram-se com o tratamento, mostrando diferença estatística apenas na segunda dose de PQT. Esses resultados indicam que o BDNF pode não ser um marcador de infecção na hanseníase e/ou neuropatias relacionadas. Novas pesquisas são necessárias para investigar o significado das alterações nos níveis de BDNF ao longo do tratamento da hanseníase.

Brain-derived neurotrophic factor (BDNF) is a neurotrophin involved in the survival of neurons and growth and differentiation of dendrites and axons. The purpose of the present study was to evaluate plasma levels of BDNF of leprosy patients at different stages of multidrug therapy (MDT) in comparison with non-infected individuals. Plasma levels of BDNF were measured by ELISA in 30 healthy controls and 37 leprosy patients at diagnosis, during and after MDT. Plasma levels of BDNF tended to be higher in control subjects in comparison with leprosy patients, but this difference does not reach statistical significance. Interestingly, BDNF levels changed following MDT, achieving statistical difference only at the 2nd dose of MDT. These results indicate that BDNF may not be a surrogate marker of leprosy infection and/or related neuropathy. Further research is needed to investigate the meaning of BDNF level changes following leprosy treatment.

A hanseníase é uma doença infectocontagiosa espectral que acompanha-se por uma série de eventos imunológicos desencadeados pela resposta do hospedeiro frente ao agente etiológico, o Mycobacterium leprae. Evidências sugerem que a indução e manutenção da resposta imune/inflamatória na hanseníase estão vinculadas a interações de múltiplas células e fatores solúveis, particularmente através da ação de citocinas. Nesse estudo, foram mensurados níveis de IL-1β e IL-1Ra de 37 casos novos de hanseníase acompanhados ao longo do tratamento e 30 controles sadios pelo teste ELISA. A coleta de sangue periférico foi realizada em quatro tempos para os casos de hanseníase (pré-tratamento com PQT, 2ª dose, 6ª dose e pós-PQT) e em único momento para os controles. Na comparação dos níveis das moléculas de casos no pré-PQT e controles, houve diferença estatisticamente significativa somente para IL-1β. Nossos resultados sugerem a participação dessa citocina no processo imune/inflamatório.

Leprosy is an infectious and contagious spectral disease accompanied by a series of immunological events triggered by the host's response to the etiologic agent, Mycobacterium leprae. Evidence suggests that the induction and maintenance of the immune/inflammatory response in leprosy are linked to multiple cell interactions and soluble factors, mainly through the action of cytokines. The ELISA test was used to measure the levels of IL-1β and IL-1Ra in 37 new leprosy patients followed-up during treatment and 30 healthy controls. Peripheral blood was collected four times during the treatment of leprosy patients (MDT pretreatment, 2nd dose, 6th dose and post-MDT), and only once from the controls. The comparison of molecular levels in pre-MDT patients and controls showed a statistically significant difference for IL-1β. The results suggest the participation of this cytokine in the genesis of the immune/inflammatory process.