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  1. Article ; Online: The red flags of ulnar neuropathy in leprosy.

    Jardim, Márcia / Vital, Robson T / Illarramendi, Ximena / Hacker, Mariana / Junqueira, Beatriz / Pitta, Izabela J R / Pinheiro, Roberta O / Sarno, Euzenir N

    PloS one

    2021  Volume 16, Issue 11, Page(s) e0259804

    Abstract: The diagnosis of pure neural leprosy is more challenging because patients share characteristics with other common pathologies, such as ulnar compression, which should be taken into consideration for differential diagnosis. In this study, we identify ... ...

    Abstract The diagnosis of pure neural leprosy is more challenging because patients share characteristics with other common pathologies, such as ulnar compression, which should be taken into consideration for differential diagnosis. In this study, we identify ulnar nerve conduction characteristics to aid in the differential diagnosis of ulnar neuropathy (UN) in leprosy and that of non-leprosy etiology. In addition, we include putative markers to better understand the inflammatory process that may occur in the nerve. Data were extracted from a database of people affected by leprosy (leprosy group) diagnosed with UN at leprosy diagnosis. A non-leprosy group of patients diagnosed with mechanical neuropathy (compressive, traumatic) was also included. Both groups were submitted to clinical, neurological, neurophysiological and immunological studies. Nerve enlargement and sensory impairment were significantly higher in leprosy patients than in patients with compressive UN. Bilateral impairment was significantly higher in the leprosy group than in the non-leprosy group. Leprosy reactions were associated to focal demyelinating lesions at the elbow and to temporal dispersion (TD). Clinical signs such as sensory impairment, nerve enlargement and bilateral ulnar nerve injury associated with eletrodiagnostic criteria such as demyelinating finds, specifically temporal dispersion, could be tools to help us decided on the best conduct in patients with elbow ulnar neuropathy and specifically decide if we should perform a nerve biopsy for diagnosis of pure neural leprosy.
    MeSH term(s) Adolescent ; Adult ; Aged ; Biomarkers ; Brazil/epidemiology ; Cross-Sectional Studies ; Data Management ; Databases, Factual ; Diagnosis, Differential ; Elbow Joint ; Female ; Humans ; Leprosy/diagnosis ; Leprosy/metabolism ; Leprosy, Tuberculoid ; Male ; Middle Aged ; Neural Conduction ; Ulnar Nerve/metabolism ; Ulnar Neuropathies/diagnosis ; Ulnar Neuropathies/physiopathology
    Chemical Substances Biomarkers
    Language English
    Publishing date 2021-11-19
    Publishing country United States
    Document type Journal Article ; Observational Study
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0259804
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Progression of leprosy neuropathy: a case series study.

    Vital, Robson T / Illarramendi, Ximena / Nascimento, Osvaldo / Hacker, Mariana A / Sarno, Euzenir N / Jardim, Marcia R

    Brain and behavior

    2012  Volume 2, Issue 3, Page(s) 249–255

    Abstract: A need still exists to determine the clinical and neurophysiological characteristics of leprosy neuropathy at distinct times of the disease by different methods that measure the various nerve fiber functions. A prospective clinical study was performed ... ...

    Abstract A need still exists to determine the clinical and neurophysiological characteristics of leprosy neuropathy at distinct times of the disease by different methods that measure the various nerve fiber functions. A prospective clinical study was performed with 10 paucibacillary (PB) and 12 multibacillary (MB) patients evaluated at diagnosis and one year after cessation of multidrug therapy (MDT). Peripheral nerve function was assessed clinically and by means of the sympathetic skin response, skin vasomotor reflex, and nerve conduction study (NCS). At diagnosis, 73% of the total 22 patients had nerve function impairment (NFI). Autonomic function (χ(2)= 5.5, P= 0.019) and NCS (χ(2)= 7.765, P= 0.01) were significantly more altered in MB than PB patients. At final evaluation, NFI of the MB patients had worsened, especially among the six who had leprosy reaction. As the NFI of PB patients showed improvement, a significant difference between the two groups (χ(2)= 12.320, P= 0.001) was observed. A high prevalence of neuropathy was observed in newly diagnosed patients. Associating different tests with a thorough clinical neurological evaluation increases detection rates.
    Language English
    Publishing date 2012-05-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2623587-0
    ISSN 2162-3279 ; 2162-3279
    ISSN (online) 2162-3279
    ISSN 2162-3279
    DOI 10.1002/brb3.40
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Transforming growth factor-β1 may be a key mediator of the fibrogenic properties of neural cells in leprosy.

    Petito, Rafael B / Amadeu, Thaís P / Pascarelli, Bernardo M O / Jardim, Márcia R / Vital, Robson T / Antunes, Sérgio L / Sarno, Euzenir N

    Journal of neuropathology and experimental neurology

    2013  Volume 72, Issue 4, Page(s) 351–366

    Abstract: Fibrosis is the main cause of irreversible nerve damage in leprosy. Phenotypic changes in Mycobacterium leprae (ML)-infected Schwann cells (SCs) have been suggested to mediate this process. We found that SC line cultures stimulated with ML upregulated ... ...

    Abstract Fibrosis is the main cause of irreversible nerve damage in leprosy. Phenotypic changes in Mycobacterium leprae (ML)-infected Schwann cells (SCs) have been suggested to mediate this process. We found that SC line cultures stimulated with ML upregulated transforming growth factor-β1 (TGF-β1), and that TGF-β1 or ML induced increased numbers of α-smooth muscle actin (α-SMA)-positive cells with characteristic stress fibers. Mycobacterium leprae and TGF-β1 also induced increased type I collagen and fibronectin mRNA and secretion and augmented mRNA levels of SOX9 and ZEB1, which are involved in the epithelial-mesenchymal transition. These effects could be inhibited by the TGF-β1 type I receptor (ALK5) inhibitor, SB-431542. In nerve biopsies from leprosy-infected patients with varying grades of fibrosis (n = 11), type I and III collagen and fibronectin were found in the endoneurium and perineurium, α-SMA-positive cells filled the fibrotic perineurium but not the endoneurium, and CD34-positive fibroblasts predominated in the endoneurium. Results of transcriptional studies of 3 leprosy nerves and 5 controls were consistent with these data, but α-SMA and other mRNA levels were not different from those in the control samples. Our findings suggest that TGF-β1 may orchestrate events, including reprogramming of the SC phenotype, leading to transdifferentiation, connective tissue cell expansion, and fibrogenesis in the evolution of leprosy nerve lesions during some evolutionary stages.
    MeSH term(s) Adult ; Cell Differentiation/drug effects ; Cell Differentiation/physiology ; Cells, Cultured ; Female ; Fibrosis ; Humans ; Inflammation Mediators/metabolism ; Leprosy/metabolism ; Leprosy/pathology ; Male ; Middle Aged ; Mycobacterium leprae ; Neurons/drug effects ; Neurons/metabolism ; Neurons/pathology ; Schwann Cells/drug effects ; Schwann Cells/metabolism ; Schwann Cells/pathology ; Transforming Growth Factor beta1/physiology ; Transforming Growth Factor beta1/toxicity ; Young Adult
    Chemical Substances Inflammation Mediators ; Transforming Growth Factor beta1
    Language English
    Publishing date 2013-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 3088-0
    ISSN 1554-6578 ; 0022-3069
    ISSN (online) 1554-6578
    ISSN 0022-3069
    DOI 10.1097/NEN.0b013e31828bfc60
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Ui II Zs.134: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
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  4. Article ; Online: CXCL10, MCP-1, and other immunologic markers involved in neural leprosy.

    Medeiros, Mildred F / Rodrigues, Márcia M J / Vital, Robson T / da Costa Nery, José A / Sales, Anna M / de Andrea Hacker, Mariana / Ferreira, Helen / Chimelli, Leila / Sarno, Euzenir N / Antunes, Sérgio L G

    Applied immunohistochemistry & molecular morphology : AIMM

    2015  Volume 23, Issue 3, Page(s) 220–229

    Abstract: Nerve damage in leprosy can be directly induced by Mycobacterium leprae in the early stages of infection, however, immunomediated mechanisms add gravity to the impairment of neural function in symptomatic periods of the disease. This study investigated ... ...

    Abstract Nerve damage in leprosy can be directly induced by Mycobacterium leprae in the early stages of infection, however, immunomediated mechanisms add gravity to the impairment of neural function in symptomatic periods of the disease. This study investigated the immunohistochemical expression of immunomarkers involved in the pathogenic mechanisms of leprosy nerve damage. These markers selected were CXCL10, CCL2 chemokines and immunomarkers as CD3, CD4, CD8, CD45RA, CD45RO, CD68, HLA-DR, and metalloproteinases 2 and 9 (MMP2 and MMP9) occurring in nerve biopsy specimens collected from leprosy (23) and nonleprosy patients (5) suffering peripheral neuropathy. CXCL10, CCL2, MMP2, and MMP9 immunoreactivities were found in the leprosy nerves but not in nonleprosy samples. Immunolabeling was predominantly found in recruited macrophages and Schwann cells composing the inflammatory cellular population in the leprosy-affected nerves. The immunohistochemical expression of all the markers, but CXCL10, was associated with fibrosis, however, only CCL2 was, independently from the others, associated with this excessive deposit of extracellular matrix. No difference in the frequency of the immunolabeling was detected between the AFB⁺ and AFB⁻ leprosy subgroups of nerve, exception made to some statistical trend to difference in regard to CD68⁻ and HLA-DR⁺ cells in the AFB⁻ nerves exhibiting epithelioid granuloma. MMP9 expression associated with fibrosis is consistent with previous results of research group. The findings conveys the idea that CCL2 and CXCL10 chemokines at least in advanced stages of leprosy nerve lesions are not determinant for the establishment of AFB⁺ or AFB⁻ leprosy lesions, however, CCL2 is associated with macrophage recruitment and fibrosis.
    MeSH term(s) Adolescent ; Adult ; Aged ; Biomarkers/metabolism ; Chemokine CCL2/metabolism ; Chemokine CXCL10/metabolism ; Female ; Humans ; Leprosy, Tuberculoid/mortality ; Leprosy, Tuberculoid/pathology ; Male ; Middle Aged ; Peripheral Nerves/metabolism ; Peripheral Nerves/pathology
    Chemical Substances Biomarkers ; CCL2 protein, human ; CXCL10 protein, human ; Chemokine CCL2 ; Chemokine CXCL10
    Language English
    Publishing date 2015-03
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1473273-7
    ISSN 1533-4058 ; 1062-3345 ; 1541-2016
    ISSN (online) 1533-4058
    ISSN 1062-3345 ; 1541-2016
    DOI 10.1097/PAI.0000000000000074
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3783: Show issues Location:
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