Pain is a frequent symptom in leprosy patients. It may be predominantly nociceptive, as in neuritis, or neuropathic, due to injury or nerve dysfunction. The differential diagnosis of these two forms of pain is a challenge in clinical practice, especially because it is quite common for a patient to suffer from both types of pain. A better understanding of cytokine profile may serve as a tool in assessing patients and also help to comprehend pathophysiology of leprosy pain. Patients with leprosy and neural pain (n = 22), neuropathic pain (n = 18), neuritis (nociceptive pain) (n = 4), or no pain (n = 17), further to those with diabetic neuropathy and neuropathic pain (n = 17) were recruited at Souza Araujo Out-Patient Unit (Fiocruz, Rio de Janeiro, RJ, Brazil). Serum levels of IL1β, IL-6, IL-10, IL-17, TNF, CCL-2/MCP-1, IFN-γ, CXCL-10/IP-10, and TGF-β were evaluated in the different Groups. Impairment in thermal or pain sensitivity was the most frequent clinical finding (95.5%) in leprosy neuropathy patients with and without pain, but less frequent in Diabetic Group (88.2%). Previous reactional episodes have occurred in patients in the leprosy and Pain Group (p = 0.027) more often. Analysis of cytokine levels have demonstrated that the concentrations of IL-1β, TNF, TGF-β, and IL-17 in serum samples of patients having leprosy neuropathy in combination with neuropathic or nociceptive pain were higher when compared to the samples of leprosy neuropathy patients without pain. In addition, these cytokine levels were significantly augmented in leprosy patients with neuropathic pain in relation to those with neuropathic pain due to diabetes. IL-1β levels are an independent variable associated with both types of pain in patients with leprosy neuropathy. IL-6 concentration was increased in both groups with pain. Moreover, CCL-2/MCP-1 and CXCL-10/IP-10 levels were higher in patients with diabetic neuropathy over those with leprosy neuropathy. In brief, IL-1β is an independent variable related to neuropathic and nociceptive pain in patients with leprosy, and could be an important biomarker for patient follow-up. IL-6 was higher in both groups with pain (leprosy and diabetic patients), and could be a therapeutic target in pain control.

中文翻译：

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麻风神经痛中的细胞因子水平。

疼痛是麻风病人的常见症状。由于受伤或神经功能障碍，在神经炎或神经性疾病中，它可能主要是伤害性的。这两种形式的疼痛的鉴别诊断在临床实践中是一个挑战，特别是因为患者遭受两种类型的疼痛相当普遍。对细胞因子谱的更好理解可以作为评估患者的工具，也有助于理解麻风痛的病理生理学。患有糖尿病性神经病和神经性疼痛的患者（麻风和神经痛（n = 22），神经性疼痛（n = 18），神经炎（伤害性疼痛）（n = 4）或无疼痛（n = 17）的患者） n = 17）在Souza Araujo门诊部招募（巴西里约热内卢里约热内卢Fiocruz）。血清IL1β，IL-6，IL-10，IL-17，TNF，CCL-2 / MCP-1，IFN-γ，CXCL-10 / IP-10，TGF-β和TGF-β在不同的组中进行了评估。在有或没有疼痛的麻风神经病患者中，热或疼痛敏感性的损害是最常见的临床发现（95.5％），而在糖尿病组中则较不常见（88.2％）。麻风和疼痛组的患者先前发生过反应性发作（p = 0.027）。细胞因子水平分析表明，与麻风神经病患者相比，麻风神经病合并神经病或伤害性疼痛患者的血清样品中IL-1β，TNF，TGF-β和IL-17的浓度更高没有痛苦。另外，与患有糖尿病引起的神经性疼痛的麻风病患者相比，在患有神经性疼痛的麻风病患者中这些细胞因子水平显着增加。IL-1β水平是与麻风神经病患者的两种疼痛相关的独立变量。两组伴有疼痛的IL-6浓度均升高。此外，糖尿病性神经病患者的CCL-2 / MCP-1和CXCL-10 / IP-10水平高于麻风神经病患者。简而言之，IL-1β是与麻风病患者神经性和伤害性疼痛相关的独立变量，并且可能是患者随访的重要生物标志物。两组疼痛（麻风病和糖尿病患者）中的IL-6均较高，并且可能是控制疼痛的治疗靶点。简而言之，IL-1β是与麻风病患者神经性和伤害性疼痛相关的独立变量，并且可能是患者随访的重要生物标志物。两组疼痛（麻风病和糖尿病患者）中的IL-6均较高，并且可能是控制疼痛的治疗靶点。简而言之，IL-1β是与麻风病患者神经性和伤害性疼痛相关的独立变量，并且可能是患者随访的重要生物标志物。两组疼痛（麻风病和糖尿病患者）中的IL-6均较高，并且可能是控制疼痛的治疗靶点。