Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
Laboratório de Imunopatologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
J Infect Dis. 2017 Dec 19;216(12):1635-1643. doi: 10.1093/infdis/jix267.
Leprosy, the leading infectious cause of disability worldwide, remains a major public health challenge in the most severely affected countries despite the sharp decline in new cases in recent years. The search for biomarkers is essential to achieve a better understanding of the molecular and cellular mechanisms underlying the disease.
Pentraxin-3 (PTX3) analyses of sera from 87 leprosy patients with or without reactions were conducted via enzyme-linked immunosorbent assay. In situ identification of PTX3 in skin lesion was confirmed by quantitative reverse-transcription polymerase chain reaction, immunohistochemistry, and immunofluorescence assays.
We found that PTX3 serum levels were higher in multibacillary patients when evaluated before the onset of acute erythema nodosum leprosum (ENL) and persistently elevated during reaction. Thalidomide treatment reduced PTX3 in the serum 7 days after starting treatment. In situ analyses have also demonstrated enhancement of PTX3 in ENL lesions and showed that treatment with thalidomide reduced its expression and the prominent neutrophilic infiltrate, a hallmark of the disease.
In summary, our study provides in vivo evidence that PTX3 is enhanced during ENL but not in reversal reaction and provides a new molecular target in ENL pathogenesis.
麻风病是全球致残的首要感染性病因，尽管近年来新发病例急剧减少，但在受影响最严重的国家，它仍然是一个主要的公共卫生挑战。寻找生物标志物对于更好地理解疾病的分子和细胞机制至关重要。
通过酶联免疫吸附试验对 87 例伴有或不伴有反应的麻风病患者的血清进行五聚素-3（PTX3）分析。通过定量逆转录聚合酶链反应、免疫组织化学和免疫荧光分析，在皮肤病变中对 PTX3 进行了原位鉴定。
我们发现，在急性结节性红斑性麻风病（ENL）发作前评估时，多菌型患者的血清 PTX3 水平较高，并且在反应期间持续升高。反应发生时，沙利度胺治疗可使血清中的 PTX3 水平在治疗开始后 7 天内降低。原位分析还表明，PTX3 在 ENL 病变中增强，并且表明沙利度胺治疗可降低其表达和突出的中性粒细胞浸润，这是该疾病的一个标志。
总之，我们的研究提供了体内证据，表明 PTX3 在 ENL 期间增强，但在逆转反应中不增强，并为 ENL 发病机制提供了一个新的分子靶点。
