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Subject Area

Dermatology

Article Type

Original Study

Abstract

Objective The aim was to estimate the serum levels of anticeramide antibodies (ACAs), interleukin-4 (IL-4), and tumor necrosis factor (TNF) in patients with leprosy and their possible role in the anticipation of leprosy complications. Background Leprosy is a disease that primarily involves the peripheral nerves and skin. Nerve damage is concomitant with multibacillary (MB) leprosy, and as ceramide is an element of the myelin sheath, ACAs can be a marker in the nerve destruction evaluation. Cytokine estimation can anticipate inflammation instigated by infections or trauma. The authors aimed to detect the role of serum levels of ACA, IL-4, and TNF-α for the anticipation of leprosy complications. Patients and methods A total of 100 patients with leprosy and 100 controls were included. Lesions were examined microbiologically and then classified according to WHO as paucibacillary if no detected bacilli and MB if positive skin smear. ACA, IL-4, and TNF-α were quantified by enzyme-linked immunosorbent assay. Results The study included 63 patients who had MB, and 37 patients with paucibacillary leprosy, as well as 100 age-matched and sex-matched healthy controls. Serum ACA, IL-4, and TNF-α levels were the highest in MB cases. They represented 97 ± 24 ng/ml, 359 ± 238 pg/ml, and 314 ± 259 ng/l, respectively, in patients with MB; 46 ± 32 ng/ml, 79 ± 71 pg/ml, and 38 ± 26 ng/l, respectively, in controls; and 48 ± 17 ng/ml, 122 ± 74 pg/ml, and 78 ± 51 ng/l, respectively, in patients with paucibacillary. The cutoff values were 50 ng/ml, 126 pg/ml, and 39 ng/l, respectively, for distinguishing neural complications, with sensitivity and specificity of 80 and 49%, respectively, for ACA, 67 and 64%, respectively, for IL-4, and 93 and 49%, respectively, for TNF-α. Conclusion Serum levels of ACA, IL-4, and TNF-α may be markers of leprosy nerve damage.

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