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Related Experiment Videos

Nerve in reversal reaction

C K Job1

  • 1St Thomas Hospital, Chettupattu.

Indian Journal of Leprosy
|January 1, 1996
PubMed
Summary
This summary is machine-generated.

Nerve damage in leprosy often occurs during reactions like Reversal Reaction (RR). High-risk patients need prompt treatment to prevent irreversible paralysis from inflammation and immune responses.

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Area of Science:

  • Immunology
  • Neurology
  • Infectious Diseases

Background:

  • Leprosy nerve destruction predominantly occurs during reactive phases, specifically Erythema Nodosum Leprosum (ENL) and Reversal Reactions (RR).
  • High-risk individuals for RR include borderline leprosy patients with over 10 skin lesions or three or more thickened nerve trunks.

Purpose of the Study:

  • To elucidate the mechanisms of nerve damage during leprosy reactions.
  • To identify high-risk patients for Reversal Reactions (RR).
  • To propose preventive and therapeutic strategies for nerve damage in leprosy.

Main Methods:

  • Observational analysis of nerve pathology during leprosy reactions.
  • Immunological assessment of inflammatory markers (TNF-alpha, INF-gamma, IL-2) in RR.

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  • Histopathological examination of nerve granulomas.

    • Main Results:

    • RR involves a heightened delayed-type hypersensitivity (DTH) response to Mycobacterium leprae, leading to excessive cytokine release.
    • Granulomas enlarge rapidly due to edema and inflammatory cell infiltration, causing nerve ischemia and potential caseous necrosis.
    • Ischemic paralysis is reversible with anti-inflammatory drugs, but nerve destruction by immune granulomas leads to irreversible paralysis.

    Conclusions:

    • Prompt anti-inflammatory treatment is crucial for reversible nerve damage in RR.
    • A six-month course of corticosteroids alongside anti-leprosy therapy is recommended for high-risk patients.
    • Addressing persistent nerve damage post-clinical cure in leprosy is an urgent clinical challenge.