Abstract

Leprosy is a disease caused by Mycobacterium leprae (ML) with diverse clinical manifestations, which are strongly correlated with the host’s immune response. Skin lesions may be accompanied by peripheral neural damage, leading to sensory and motor losses, as well as deformities of the hands and feet. Both innate and acquired immune responses are involved, but the disease has been classically described along a Th1/Th2 spectrum, where the Th1 pole corresponds to the most limited presentations and the Th2 to the most disseminated ones. We discuss this dichotomy in the light of current knowledge of cytokines, Th subpopulations and regulatory T cells taking part in each leprosy presentation. Leprosy reactions are associated with an increase in inflammatory activity both in limited and disseminated presentations, leading to a worsening of previous symptoms or the development of new symptoms. Despite the efforts of many research groups around the world, there is still no adequate serological test for diagnosis in endemic areas, hindering the eradication of leprosy in these regions.

摘要

麻风病是由麻风分枝杆菌引起的疾病(ML) 临床表现多样，与宿主的免疫反应密切相关。皮肤损伤可能伴有周围神经损伤，导致感觉和运动丧失，以及手足畸形。涉及先天性和获得性免疫反应，但该疾病已被经典地描述为沿着 Th1/Th2 谱，其中 Th1 极对应于最有限的表现，而 Th2 对应于最广泛传播的表现。我们根据当前对参与每个麻风病表现的细胞因子、Th 亚群和调节性 T 细胞的了解来讨论这种二分法。麻风反应与炎症活动的增加有关，无论是在有限的和散布的表现中，导致先前症状的恶化或新症状的发展。