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Cell changes and soluble interleukin-2 receptors (Tac peptide) in leprosy reversal reactions using suction-induced
C Theetranont1, L Bhoopat, D M Scollard
1Department of Pathology, Faculty of Medicine, Chiang Mai University, Thailand.
Insights
Reversal reactions (RR) in leprosy involve increased T-helper cells (CD4+) and interleukin-2 receptor (IL-2R) levels, indicating enhanced cell-mediated immunity. Corticosteroids reduce these immune markers in lesions.
Area of Science:
- Immunology
- Dermatology
- Infectious Diseases
Background:
- Leprosy, a complex infectious disease, presents with various clinical manifestations.
- Reversal reactions (RR) are immune-mediated complications in leprosy patients.
- Understanding the immunological basis of RR is crucial for effective treatment and vaccine development.
Purpose of the Study:
- To investigate the cellular and soluble immune markers in skin lesions during reversal reactions in leprosy.
- To correlate these immune changes with the clinical status of borderline lepromatous (BL) leprosy.
- To explore the impact of corticosteroid treatment on these immune parameters.
Main Methods:
- Induction of skin blisters in 7 leprosy patients experiencing reversal reactions.
- Analysis of cellular contents (CD4+ cells) using immunoperoxidase staining.
- Quantification of soluble interleukin-2 receptor (IL-2R) [Tac peptide] levels via ELISA.
- Comparison of immune markers in active RR lesions versus quiescent BL lesions.
Main Results:
- Significantly higher helper T cell activity (CD4+ cells) and helper:suppressor ratios were observed in BL lesions with RR compared to quiescent BL lesions.
- Elevated intracutaneous levels of Tac peptide were found, directly correlating with increased CD4+ cell counts.
- Systemic corticosteroid administration led to a reduction in CD4+ cell numbers within the lesions.
Conclusions:
- Reversal reactions in leprosy are associated with a spontaneous increase in delayed type hypersensitivity (DTH) and cell-mediated immunity (CMI).
- The observed elevation in Tac peptide levels reflects increased T-cell activation during RR.
- These findings provide valuable insights into the immunological mechanisms underlying leprosy reactions, informing potential immunotherapy and vaccine strategies.
Abstract:
The cellular contents and soluble interleukin-2 receptor (IL-2R) [Tac peptide] of skin blisters induced by suction over 7 reversal reaction (RR) patients were examined using immunoperoxidase and ELISA techniques respectively. The helper T activity (CD4+ cells) and helper:suppressor ratio were significantly greater in borderline lepromatous (BL) lesions with RR than in quiescent BL lesions. Interestingly, the intracutaneous levels of Tac peptide were elevated and directly correlated with the increases in CD4+ cells. The systemic administration of corticosteroids revealed a reduction in the numbers of CD4+ cells in the lesions. These results indicate that RRs are manifestations of a spontaneous increase in delayed type hypersensitivity (DTH) and possibly cell mediated immunity (CMI) in leprosy patients. The mechanism of such changes in immunity is of considerable value in understanding reversal reactions and the underlying determinants of DTH and CMI in leprosy and this in turn will have a bearing on the potential for proposed vaccines or immunotherapy.