Caracterização clínica e imunológica das recidivas da hanseníase no Estado do Espírito Santo

• Autor(a) principal: Abreu, Karina Demoner de
• Data de Publicação: 2009
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
• Texto Completo: http://repositorio.ufes.br/handle/10/5936
• topic: Leprosy; Relapse; Cytokines; Immune response; Hanseníase; Recidiva; Citocinas; Imunologia; Doenças Infecciosas e Parasitárias; 61

Introduction: Leprosy relapse occurs in patients, who underwent regular anti-leprosy therapy, were considered cured, and in whom after a certain period post-treatment disease reappears. Objectives: 1) Determine the frequency of leprosy relapse in the state of Espirito Santo, and 2) Evaluate the serum levels of Th-1 and Th-2 cytokines (TNF-a, IFN-g , IL-2, IL-4, IL-5 & IL-10) and of chemokines (CCL2/MCP-1, CCL10/IP-10, CXCL9/MIG, CCL5/RANTES & CXCL8/IL-8) in patients with relapsing leprosy. Methods: Fourty-five patients with relapsing leprosy, and 19 controls (without disease but who had leprosy treated and cured) were enrolled in this case-control study. Clinical characteristics and demographical data for all cases and controls were recorded, such as: age, gender, initial clinical form, baciloscopy results, leprosy household contactants, leprosy reaction, therapeutic regimen, and ML Flow test results. Association between these parameters were also evaluated. Results: Observed median age for patients and controls was 44 years, 64.4% were males and 35 patients were diagnosed as relapsing leprosy cases after Five years post-cure of first leprosy episode, and dimorphous leprosy were diagnosed in 40 out of 45 patients. Serum levels of TNF-a and IFN-g were higher among paucibacillary patients whem compared with multibacillary patients with a positive baciloscopic índex. Similar levels of IL-2, IL-4, IL-5 e IL-10 were observed for these two groups. On the other hand, multibacillary patients presented higher levels of chemokines when compared to paucibacillary patients. Conclusions: The observed relapsing frequency was 2.41%; TNF-a and IFN-g data are in agreement with previous published data for non-treated patients. However, data for IL-2, IL-4, IL-5 & IL-10 do not agree with previous reports.