Análise do perfil de citocinas séricas em pacientes com as formas polares da Hanseníase, antes e seis meses após inicio da poliquimioterapia

Abstract

Leprosy is a chronic infectious disease of the skin and nerves caused by the intracellular pathogen Mycobacterium leprae. It is characterized by a spectrum of clinical forms depending on the hosts immune response to M. leprae. Patients with tuberculoid leprosy (TT) have strong cell-mediated immunity (CMI) with elimination of the bacilli, whereas patients with lepromatous leprosy (LL) exhibit defective CMI to M. leprae. Despite advances in the understanding of the pathogenesis of leprosy and the development of new therapeutic strategies, there is a need for the identification and/or validation of biomarkers that can be used for early diagnosis, for discrimination between different forms of the disease and, additionally, as prognostic markers. Therefore in this study the profile of IFN-, IL-1, IL-6, IL8, IL-10, IL-12p70, IL-13, IL-17A and TNF was analyzed in order to address the contribution of these cytokines in late phase of M. leprae infection before and after treatment. The results demonstrated that patients of LL group presented higher expression of serum levels of inflammatory cytokines before MDT therapy, while TT patients presented a balance between inflammatory and regulatory cytokines. The impact of MDT therapy changes the profile of serum cytokines in M. leprae infected patients, as evidenced by the cytokine network, which pointed out that LL patients displayed a multifaceted cytokine system characterized by strong connecting axes involving pro-inflammatory/regulatory molecules. On the other hand, TT patients presented and overall modest cytokine network with low involvement of regulatory cytokines. In conclusion, the effect of treatment showed that the MDT therapy switches off cytokine responses with important changes in the balance of IL-6, IL-10 and IFN-Y.