RESUMO
Genetically determined differences in immune responses to environmental agents may underlie susceptibility to many autoimmune and infectious diseases. Leprosy provides an example of a polarity in the type of immune response made to an infectious agent, and there is evidence that the major histocompatibility complex is genetically linked to leprosy type. It was found that HLA-DR2 is associated with both tuberculoid and lepromatous types of leprosy; however, a variant at position -308 of the promoter of the neighboring tumor necrosis factor (TNF) gene was increased in frequency in lepromatous (odds ratio = 3.0, P = .02) but not tuberculoid leprosy. Some studies have found higher serum levels of TNF in lepromatous than tuberculoid leprosy, and high TNF levels are found in malaria and leishmaniasis, which are also associated with this TNF allele. It is speculated that this association reflects genetic variability in cytokine production, which influences the immune response to and clinical outcome of leprosy.
Assuntos
Hanseníase Virchowiana/genética , Polimorfismo Genético , Regiões Promotoras Genéticas/genética , Fator de Necrose Tumoral alfa/genética , Adulto , Estudos de Casos e Controles , Suscetibilidade a Doenças , Feminino , Frequência do Gene , Genes MHC da Classe II/genética , Antígeno HLA-DR2/genética , Humanos , Hanseníase Virchowiana/etnologia , Hanseníase Tuberculoide/etnologia , Hanseníase Tuberculoide/genética , MasculinoAssuntos
Síndrome do Túnel Carpal/etiologia , Hanseníase Tuberculoide/complicações , Adulto , Camboja/etnologia , Síndrome do Túnel Carpal/etnologia , Síndrome do Túnel Carpal/patologia , Síndrome do Túnel Carpal/cirurgia , Feminino , Humanos , Hanseníase Tuberculoide/etnologia , Hanseníase Tuberculoide/patologia , Hanseníase Tuberculoide/cirurgia , Nervo Mediano/patologia , Nervo Mediano/cirurgia , Recidiva , ReoperaçãoAssuntos
Feminino , Adulto , Camboja/etnologia , Hanseníase Tuberculoide/cirurgia , Hanseníase Tuberculoide/complicações , Hanseníase Tuberculoide/etnologia , Hanseníase Tuberculoide/patologia , Nervo Mediano/cirurgia , Nervo Mediano/patologia , Recidiva , Reoperação , Síndrome do Túnel Carpal/cirurgia , Síndrome do Túnel Carpal/etiologia , Síndrome do Túnel Carpal/etnologia , Síndrome do Túnel Carpal/patologiaAssuntos
Humanos , Hanseníase Dimorfa/epidemiologia , Hanseníase Dimorfa/etnologia , Hanseníase Dimorfa/fisiopatologia , Hanseníase Tuberculoide/epidemiologia , Hanseníase Tuberculoide/etnologia , Hanseníase Tuberculoide/fisiopatologia , Hanseníase Virchowiana/epidemiologia , Hanseníase Virchowiana/etnologia , Hanseníase Virchowiana/fisiopatologiaRESUMO
1. A variety of tuberculoid leprosy seen in South Africa, which in certain respects differs from the usual, is discussed on the basis of thirteen of the sixteen cases from which biopsy specimens were obtained for histological examination, and more than twenty-five others examined less carefully. Cases of this variety are distinguished from others by South African leprologists, but not on the basis that is indicated by their histological characteristics. 2- The well-established terms "tuberculoid", as applied to a non-specific histological picture, and "tuberculoid leprosy", signifying a distinct and clinically recognizable variety of the disease, are held to be appropriate and useful. 3- A tentative clinical picture of the lesions under discussion is set up. The outstanding peculiarity of the condition is an unusual tendency to a rough, pebbled or "granular" surface, and striking linear lesions are also seen. The relatively slight sensory disturbance common in these cases is correlated with a slight degree of nerve involvement in the sections studied...
