03150nas a2200505   4500000000100000008004100001260001700042653004800059653004800107653004200155653001500197653001000212653002100222653001400243653003800257653001100295653002000306653001100326653001900337653003200356653002700388653001900415653001800434653001200452653000900464653001600473653005200489653000900541653003200550653001600582100001800598700001400616700001200630700001700642700001200659700001100671700001500682700001500697245009400712300001100806490000800817050001900825520178600844022001402630       2013                            d  c2013 Nov-Dec10a11-beta-Hydroxysteroid Dehydrogenase Type 110a11-beta-Hydroxysteroid Dehydrogenase Type 210a11-beta-Hydroxysteroid Dehydrogenases10aAdolescent10aAdult10aChemokine CXCL1010aCytokines10aEnzyme-Linked Immunosorbent Assay10aFemale10aGene Expression10aHumans10aHydrocortisone10aHypersensitivity, Immediate10aInflammation Mediators10aInterleukin-1710aInterleukin-610aleprosy10aMale10aMiddle Aged10aReverse Transcriptase Polymerase Chain Reaction10aSkin10aTumor Necrosis Factor-alpha10aYoung Adult1 aChaitanya V S1 aLavania M1 aNigam A1 aTurankar R P1 aSingh I1 aHoro I1 aSengupta U1 aJadhav R S00aCortisol and proinflammatory cytokine profiles in type 1 (reversal) reactions of leprosy.  a159-670 v156  aCHAITANYA 20133 a<p><b>PURPOSE: </b>Cortisol levels in the circulation and at the sites of peripheral inflammation regulate type 1 (Reversal) reactions in leprosy akin to delayed type hypersensitivity reactions (DTH). In this study we determine the extent to which the differential mRNA expression of genes encoding cortisone-cortisol shuttle enzymes (11 β hydroxysteriod dehydrogenase I & II (11 β HSD I & II)), circulatory levels of proinflammatory cytokines (IL-6, IL-7, IP-10, IL-17F, IL-23, TNF-α, IL-1β, PDGF BB and CRP) and cortisol are associated with development of type 1 reactions in leprosy.</p><p><b>METHODS: </b>Urine, blood and incisional skin biopsy samples from site of lesions were collected from 49 newly diagnosed untreated leprosy cases in T1R and 51 cases not in reaction (NR). mRNA expression levels of genes encoding 11 β HSD I & II in skin biopsy samples were determined by realtime PCR. Cortisol levels from the lesional skin biopsies, serum and urine samples and serum proinflammatory cytokine levels were measured using ELISA.</p><p><b>RESULTS: </b>The mean expression ratios of 11 β HSD I & II are significantly lower in leprosy cases with T1R when compared to the NR leprosy cases. Cortisol levels in lesional skin biopsies and in urine are significantly lower (p=0.001) in leprosy cases with T1R. Serum cytokine levels of IP-10, IL-17F, IL-IL-6 and TNF-α are significantly higher (p<0.05) in leprosy cases with T1R when compared the NR leprosy cases.</p><p><b>CONCLUSION: </b>Our study indicated an association of urinary and lesional skin cortisol levels with the manifestation of T1R in leprosy. IP-10, IL-17F, IL-6 and TNF-α can be potential prognostic serological markers and gene expression markers for early detection of type 1 reactions in leprosy.</p>  a1879-0542