Department of Chemistry, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan.
Key Laboratory of Economic Plants and Biotechnology, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming 560201, Yunnan, China.
Curr Top Med Chem. 2018;18(18):1550-1558. doi: 10.2174/1568026618666181025100434.
Many of the tropical diseases are neglected by the researchers and medicinal companies due to lack of profit and other interests. The Drugs for Neglected Diseases initiative (DNDi) is established to overcome the problems associated with these neglected diseases. According to a report published by the WHO, leprosy (Hansen's disease) is also a neglected infectious disease.
A negligible amount of advancements has been made in last few decades which includes the tools of diagnosis, causes, treatment, and genetic studies of the bacterium (Mycobacterium leprae) that causes leprosy. The diagnosis of leprosy at earlier stages is important for its effective treatment. Recent studies on vitamin D and its receptors make leprosy diagnosis easier at earlier stages. Skin biopsies and qPCR are the other tools to identify the disease at its initial stages.
Until now a specific drug for the treatment of leprosy is not available, therefore, Multi-Drug Therapy (MDT) is used, which is hazardous to health. Besides Mycobacterium leprae, recently a new bacterium Mycobacterium lepromatosis was also identified as a cause of leprosy. During the last few years the genetic studies of Mycobacterium leprae, the role of vitamin D and vitamin D receptors (VDR), and the skin biopsies made the treatment and diagnosis of leprosy easier at early stages. The studies of micro RNAs (miRNAs) made it easy to differentiate leprosy from other diseases especially from tuberculosis.
Leprosy can be distinguished from sarcoidosis by quantitative study of reticulin fibers present in skin. The treatment used until now for leprosy is multi-drug treatment. The complete genome identification of Mycobacterium leprae makes the research easy to develop target specified drugs for leprosy. Rifampicin, identified as a potent drug, along with other drugs in uniform multi-drug treatment, has a significant effect when given to leprosy patients at initial stages. These are effective treatments but a specific drug for leprosy is still needed to be identified. The current review highlights the use of modern methods for the identification of leprosy at its earlier stages and the effective use of drugs alone as well as in combination.
由于缺乏利润和其他利益，许多热带疾病被研究人员和制药公司忽视。药品研发促进基金会（DNDi）的成立就是为了克服这些被忽视疾病所带来的问题。根据世界卫生组织（WHO）发布的一份报告，麻风病（汉森病）也是一种被忽视的传染病。
在过去的几十年中，尽管取得了一些微不足道的进展，包括诊断工具、病因、治疗方法以及引起麻风病的细菌（麻风分枝杆菌）的遗传研究，但仍无法根治麻风病。早期诊断麻风病对于有效治疗至关重要。最近关于维生素 D 及其受体的研究使得麻风病在早期阶段更容易诊断。皮肤活检和 qPCR 是在疾病早期识别它的其他工具。
到目前为止，还没有专门用于治疗麻风病的药物，因此使用的是多药联合化疗（MDT），这对健康有危害。除了麻风分枝杆菌外，最近还发现一种新的细菌——麻风分枝杆菌，也可引起麻风病。在过去的几年中，麻风分枝杆菌的遗传研究、维生素 D 和维生素 D 受体（VDR）的作用以及皮肤活检使麻风病的治疗和诊断在早期阶段变得更加容易。微小 RNA（miRNA）的研究使得将麻风病与其他疾病（尤其是结核病）区分开来变得更加容易。
麻风病可以通过定量研究皮肤中存在的网状纤维与肉瘤样病相区别。目前用于治疗麻风病的方法是多药联合化疗。麻风分枝杆菌的全基因组鉴定使得研究人员更容易开发针对麻风病的靶向特定药物。利福平被鉴定为一种有效的药物，与其他药物联合使用于多药联合化疗中，在麻风病早期阶段对患者有显著效果。这些都是有效的治疗方法，但仍需要确定一种专门用于治疗麻风病的药物。本综述重点介绍了在早期阶段识别麻风病的现代方法的使用，以及单独和联合使用药物的有效方法。
