Altered cytokine profiles in relapsed paucibacillary leprosy: a case report

Abstract Background Individuals with relapses of leprosy should be monitored carefully, however, with respect to paucibacillary (PB) leprosy, it is sometimes difficult to make a definitive diagnosis of relapse, because the bacillary index is often negative. To evaluate the usefulness of cytokine pro...

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Autores principales:	Tomoyuki Sameshima, Yumi Maeda, Tetsu Mukai, Masamichi Goto
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Case report Paucibacillary leprosy Relapse Cytokine profiles Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/3ce90ae52650426ba9c7e5b368962fc4
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spelling	oai:doaj.org-article:3ce90ae52650426ba9c7e5b368962fc42021-11-14T12:44:31ZAltered cytokine profiles in relapsed paucibacillary leprosy: a case report10.1186/s12879-021-06836-81471-2334https://doaj.org/article/3ce90ae52650426ba9c7e5b368962fc42021-11-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06836-8https://doaj.org/toc/1471-2334Abstract Background Individuals with relapses of leprosy should be monitored carefully, however, with respect to paucibacillary (PB) leprosy, it is sometimes difficult to make a definitive diagnosis of relapse, because the bacillary index is often negative. To evaluate the usefulness of cytokine profiling in a patient with relapsed PB leprosy who tested negative for anti-phenolic glycolipid-I antibodies, we analyzed the Mycobacterium leprae protein-induced cytokine expression in peripheral blood mononuclear cells of the patient. Case presentation An 89-year-old-male relapsed PB patient, first treated for leprosy over 50 years prior, was examined. In April 2012, he noticed three skin lesions consisting of annular erythema in the thighs. Slit skin smear tests were negative, and skin biopsies revealed a pathology of indeterminate-to-borderline tuberculoid leprosy. He received 600 mg of rifampicin once per month and 75 mg of dapsone daily for 12 months. The annular erythemas disappeared after starting treatment. Before treatment, and 6 and 12 months after starting treatment, the Th1/Th2 cytokine profiles in the supernatant of mononuclear cells from the patient before and after stimulation with Mycobacterium leprae soluble protein (MLS) were examined using a Cytometric Bead Array (CBA) Human Th1/Th2 Cytokine Kit II. The CBA Enhanced Sensitivity Flex Set system was applied to detect small amounts of cytokines in the serum just before treatment and one year before relapse. In the culture supernatant, just before treatment, increases in IFN-γ level and the IFN-γ/IL-10 ratio and a decreased IL-6 level were observed without stimulation. Upon stimulation with MLS, just before treatment, both the IFN-γ and TNF levels increased markedly, and twelve months after starting treatment, the IFN-γ and TNF levels decreased greatly. In the serum, just before treatment, increases in IFN-γ and TNF levels and the IFN-γ/IL-10 ratio were evident compared with those measured one year before relapse. Conclusions Cytokine profiling using culture supernatants and serum samples may be useful for the diagnosis of relapsed PB leprosy.Tomoyuki SameshimaYumi MaedaTetsu MukaiMasamichi GotoBMCarticleCase reportPaucibacillary leprosyRelapseCytokine profilesInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Case report Paucibacillary leprosy Relapse Cytokine profiles Infectious and parasitic diseases RC109-216
spellingShingle	Case report Paucibacillary leprosy Relapse Cytokine profiles Infectious and parasitic diseases RC109-216 Tomoyuki Sameshima Yumi Maeda Tetsu Mukai Masamichi Goto Altered cytokine profiles in relapsed paucibacillary leprosy: a case report
description	Abstract Background Individuals with relapses of leprosy should be monitored carefully, however, with respect to paucibacillary (PB) leprosy, it is sometimes difficult to make a definitive diagnosis of relapse, because the bacillary index is often negative. To evaluate the usefulness of cytokine profiling in a patient with relapsed PB leprosy who tested negative for anti-phenolic glycolipid-I antibodies, we analyzed the Mycobacterium leprae protein-induced cytokine expression in peripheral blood mononuclear cells of the patient. Case presentation An 89-year-old-male relapsed PB patient, first treated for leprosy over 50 years prior, was examined. In April 2012, he noticed three skin lesions consisting of annular erythema in the thighs. Slit skin smear tests were negative, and skin biopsies revealed a pathology of indeterminate-to-borderline tuberculoid leprosy. He received 600 mg of rifampicin once per month and 75 mg of dapsone daily for 12 months. The annular erythemas disappeared after starting treatment. Before treatment, and 6 and 12 months after starting treatment, the Th1/Th2 cytokine profiles in the supernatant of mononuclear cells from the patient before and after stimulation with Mycobacterium leprae soluble protein (MLS) were examined using a Cytometric Bead Array (CBA) Human Th1/Th2 Cytokine Kit II. The CBA Enhanced Sensitivity Flex Set system was applied to detect small amounts of cytokines in the serum just before treatment and one year before relapse. In the culture supernatant, just before treatment, increases in IFN-γ level and the IFN-γ/IL-10 ratio and a decreased IL-6 level were observed without stimulation. Upon stimulation with MLS, just before treatment, both the IFN-γ and TNF levels increased markedly, and twelve months after starting treatment, the IFN-γ and TNF levels decreased greatly. In the serum, just before treatment, increases in IFN-γ and TNF levels and the IFN-γ/IL-10 ratio were evident compared with those measured one year before relapse. Conclusions Cytokine profiling using culture supernatants and serum samples may be useful for the diagnosis of relapsed PB leprosy.
format	article
author	Tomoyuki Sameshima Yumi Maeda Tetsu Mukai Masamichi Goto
author_facet	Tomoyuki Sameshima Yumi Maeda Tetsu Mukai Masamichi Goto
author_sort	Tomoyuki Sameshima
title	Altered cytokine profiles in relapsed paucibacillary leprosy: a case report
title_short	Altered cytokine profiles in relapsed paucibacillary leprosy: a case report
title_full	Altered cytokine profiles in relapsed paucibacillary leprosy: a case report
title_fullStr	Altered cytokine profiles in relapsed paucibacillary leprosy: a case report
title_full_unstemmed	Altered cytokine profiles in relapsed paucibacillary leprosy: a case report
title_sort	altered cytokine profiles in relapsed paucibacillary leprosy: a case report
publisher	BMC
publishDate	2021
url	https://doaj.org/article/3ce90ae52650426ba9c7e5b368962fc4
work_keys_str_mv	AT tomoyukisameshima alteredcytokineprofilesinrelapsedpaucibacillaryleprosyacasereport AT yumimaeda alteredcytokineprofilesinrelapsedpaucibacillaryleprosyacasereport AT tetsumukai alteredcytokineprofilesinrelapsedpaucibacillaryleprosyacasereport AT masamichigoto alteredcytokineprofilesinrelapsedpaucibacillaryleprosyacasereport
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Altered cytokine profiles in relapsed paucibacillary leprosy: a case report

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