ABSTRACT
BACKGROUND: Studies investigating the nutritional status of patients with leprosy and plantar ulcers are sparse. Therefore, the objective of this study was to describe the protein profile of leprosy patients with plantar ulcers from the Eastern Amazon region. METHODS: A case record form was created for 75 patients with leprosy (31 with plantar ulcers and 44 without plantar ulcers) with the following data: sociodemographic characteristics, clinical form of leprosy, presence or absence of plantar ulcers, and nutritional assessment using anthropometry consisting of the measurement of body mass index, arm circumference, arm muscle circumference, and triceps skinfold. Levels of blood albumin, transferrin, and C-reactive protein (CRP) were also measured. Data regarding protein intake were obtained using a Food Frequency Questionnaire. RESULTS: Plantar ulcers occurred more frequently in male patients (67.7%), patients aged 40-49 years (mean ± SD: 47.3 ± 8.0 years), and patients receiving 300 or 600 USD (71.0%). The mean weight and height of patients were 71.6 ± 11.4 kg and 1.62 ± 0.1 m, respectively. High levels of CRP were detected in 51.6% of leprosy patients with plantar ulcers and only 9.1% of patients without plantar ulcers (P < 0.001). Nutritional depletion of transferrin was observed in 14.3% of patients with paucibacillary leprosy and 44.3% of patients with multibacillary leprosy (P = 0.0447). Most patients had normal levels of serum albumin (74.2% with plantar ulcers and 77.3% without plantar ulcers). CONCLUSIONS: Most leprosy patients with plantar ulcers have normal levels of serum albumin and transferrin and high CRP levels, which indicates the presence of an inflammatory process. Our findings suggest the need to monitor patients with leprosy to prevent the occurrence of plantar ulcers and to provide adequate treatment for patients with existing plantar ulcers.
Subject(s)
Dietary Proteins/analysis , Foot Ulcer/metabolism , Leprosy, Multibacillary/metabolism , Leprosy, Paucibacillary/metabolism , Nutritional Status , Adult , Brazil , Female , Foot Ulcer/etiology , Humans , Leprosy, Multibacillary/microbiology , Leprosy, Paucibacillary/microbiology , Male , Middle Aged , Young AdultSubject(s)
Interleukins/physiology , Leprosy, Lepromatous/immunology , Leprosy, Tuberculoid/immunology , T-Lymphocytes, Helper-Inducer/immunology , Adult , Female , Fibroblast Growth Factor 2/analysis , Fibroblast Growth Factor 2/physiology , Host-Pathogen Interactions/immunology , Humans , Immune Evasion , Interleukin-13/analysis , Interleukin-13/physiology , Interleukins/analysis , Leprosy, Lepromatous/etiology , Leprosy, Lepromatous/pathology , Leprosy, Tuberculoid/etiology , Leprosy, Tuberculoid/pathology , Macrophages/microbiology , Male , Mycobacterium leprae/immunology , T-Lymphocytes, Helper-Inducer/chemistry , T-Lymphocytes, Helper-Inducer/classification , Tumor Necrosis Factor-alpha/analysis , Tumor Necrosis Factor-alpha/physiology , Interleukin-22ABSTRACT
In order to understand the apoptotic response and the participation of Treg cells in the spectral clinical evolution of leprosy, this study evaluated the immunohistochemical expression of caspase-3 and FoxP3 in skin lesions of leprosy patients with the polar forms of the disease. Forty-nine patients with a confirmed diagnosis of the disease were selected, including 27 with the TT form and 22 with the LL form. Quantitative analysis of caspase-3 immunostaining showed a higher expression of this mediator in the LL form (3.409 ± 0.6517 cells/mm(2); p = 0.0001). Immunostaining for the transcription factor FoxP3 was higher in the LL form (3.891 ± 0.9294 cells/mm(2); p = 0.0001). A moderate correlation between the two markers was observed in the TT form (r = 0.5214; p = 0.005). It can be concluded that Treg cells and apoptosis play an effective role for the host defense response, inducing mechanisms involved in the activation of cascades that interfere with the control of the immune response and cell homeostasis.
