02712nas a2200361 4500000000100000008004100001260001600042653001200058653001500070653001400085653002700099100001100126700001500137700001300152700001700165700001500182700001100197700001400208700001000222700001600232700001300248700001200261700001600273700001600289700001800305700001600323245017000339856006300509300000800572490000700580520174900587022001402336 2014 d c2014 Jul 2810aleprosy10aPrednisone10aTreatment10aSerological biomarkers1 aRaju R1 aSuneetha S1 aJadhav R1 aChaduvula MV1 aAtkinson S1 aJain S1 aVisser LH1 aDas L1 aPanhalkar R1 aShinde V1 aReddy P1 aBarkataki P1 aLockwood DN1 avan Brakel WH1 aSuneetha LM00aSerological responses to prednisolone treatment in leprosy reactions: study of TNF-alpha, antibodies to phenolic glycolipid-1, lipoarabinomanan, ceramide and S100-B. uhttp://www.lipidworld.com/content/pdf/1476-511X-13-119.pdf a1190 v133 a

BACKGROUND: Corticosteroids have been extensively used in the treatment of immunological reactions and neuritis in leprosy. The present study evaluates the serological response to steroid treatment in leprosy reactions and neuritis.

METHODS: Seven serological markers [TNF-alpha, antibodies to Phenolic glycolipid-1 (PGL-1 IgM and IgG), Lipoarabinomannan (LAM IgG1 and IgG3), C2-Ceramide and S100 B] were analyzed longitudinally in 72 leprosy patients before, during and after the reaction. At the onset of reaction these patients received a standard course of prednisolone. The levels of the above markers were measured by Enzyme linked immunosorbent assay (ELISA) and compared with the individuals own value in the month prior to the reaction and presented as percentage increase.

RESULTS: One month before the reaction individuals showed a varying increase in the level of different markers such as TNF-alpha (53%) and antibodies to Ceramide (53%), followed by to GL-1 (51%), S100B (50%) and LAM (26%). The increase was significantly associated with clinical finding of nerve pain, tenderness and new nerve function impairment. After one month prednisolone therapy, there was a fall in the levels [TNF-alpha (60%), C2 -Ceramide (54%), S100B (67%), PGL-1(47%) and LAM (52%)] with each marker responding differently to steroid.

CONCLUSION: Reactions in leprosy are inflammatory processes wherein a rise in set of serological markers can be detected a month before the clinical onset of reaction, some of which remain elevated during their action and steroid treatment induces a variable fall in the levels, and this forms the basis for a variable individual response to steroid therapy.

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