Oktaria Salma, Anfasa Fatih, Menaldi Sri Linuwih, Bramono Kusmarinah, Nijsten Tamar E C, Thio Hok Bing
Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Dermatology and Venerology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Open Forum Infect Dis. 2022 Feb 2;9(3):ofac010. doi: 10.1093/ofid/ofac010. eCollection 2022 Mar.
Leprosy is a chronic infectious disease that can lead to severe lifelong disabilities. Close contacts of patients with leprosy have a higher risk of acquiring the disease. Nevertheless, there is a lack of reliable markers to predict infection. We aimed to identify new potential markers for developing clinical leprosy among contacts.
Serum levels of interleukin (IL) 6, IL-8, IL-10, hemoglobin, ferritin, and transferrin saturation were measured in 67 patients with multibacillary leprosy (MB), 65 household contacts (HHCs) of MB patients, and 127 endemic controls (ECs). By means of multivariate logistic regression and receiver operating characteristic (ROC) analyses, we analyzed baseline variables and laboratory parameters that showed significant differences between MB in the HHC and EC groups and obtained the respective areas under the curve (AUC). Optimal cutoff values of the associated cytokines were also determined.
Elevated IL-6 level was observed in MB patients compared to HHCs and ECs ( = .022 and .0041, respectively). Anemia and iron deficiency were also higher in the MB group compared to HHCs or ECs ( < .001). Likewise, we observed an increased risk of having MB leprosy in underweight HHCs (odds ratio [OR], 2.599 [95% confidence interval {CI}, .991-6.820]) and underweight ECs (OR, 2.176 [95% CI, 1.010-4.692]). Further ROC analysis showed that high serum IL-6 level, underweight, anemia, and iron deficiency can discriminate leprosy from their HHCs (AUC, 0.843 [95% CI, .771-.914]; .000; optimal cutoff value of IL-6 = 9.14 pg/mL).
Our results suggest that serum IL-6 and nutrition status could serve as potential prognostic markers for the development of clinical leprosy in infected individuals.
麻风病是一种慢性传染病，可导致严重的终身残疾。麻风病患者的密切接触者感染该病的风险更高。然而，缺乏可靠的标志物来预测感染情况。我们旨在识别接触者中发生临床麻风病的新的潜在标志物。
测定了67例多菌型麻风病（MB）患者、65例MB患者的家庭接触者（HHC）和127例流行区对照者（EC）的血清白细胞介素（IL）-6、IL-8、IL-10、血红蛋白、铁蛋白和转铁蛋白饱和度水平。通过多因素逻辑回归和受试者工作特征（ROC）分析，我们分析了在HHC组和EC组的MB之间显示出显著差异的基线变量和实验室参数，并获得了各自的曲线下面积（AUC）。还确定了相关细胞因子的最佳截断值。
与HHC和EC相比，MB患者的IL-6水平升高（分别为P = 0.022和0.0041）。与HHC或EC相比，MB组的贫血和缺铁情况也更严重（P < 0.001）。同样，我们观察到体重过轻的HHC发生MB麻风病的风险增加（比值比[OR]，2.599 [95%置信区间{CI}，0.991 - 6.820]）以及体重过轻的EC发生MB麻风病的风险增加（OR，2.176 [95% CI，1.010 - 4.692]）。进一步的ROC分析表明，高血清IL-6水平、体重过轻、贫血和缺铁可将麻风病与他们的HHC区分开来（AUC，0.843 [95% CI，0.771 - 0.914]；P < 0.000；IL-6的最佳截断值 = 9.14 pg/mL）。
我们的结果表明，血清IL-6和营养状况可作为感染个体发生临床麻风病的潜在预后标志物。
