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Infection and Immunity, June 2005, p. 3725-3733, Vol. 73, No. 6
0019-9567/05/$08.00+0     doi:10.1128/IAI.73.6.3725-3733.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Effects of Prednisolone Treatment on Cytokine Expression in Patients with Leprosy Type 1 Reactions

Anna K. Andersson,1 MeherVani Chaduvula,2 Sara E. Atkinson,1 Saroj Khanolkar-Young,1 Suman Jain,2 Lavanya Suneetha,2 Sujai Suneetha,2 and Diana N. J. Lockwood1*

Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom,1 Blue Peter Research Centre-Lepra, Hyderabad, India2

Received 22 December 2004/ Returned for modification 31 January 2005/ Accepted 9 February 2005

Leprosy type 1 reactions (T1R) are due to increased cell-mediated immunity and result in localized tissue damage. The anti-inflammatory drug prednisolone is used for treatment, but there is little good in vivo data on the molecular actions of prednisolone. We investigated the effect of prednisolone treatment on tumor necrosis factor alpha (TNF-{alpha}), interleukin-1ß (IL-1ß), IL-10, and transforming growth factor ß1 (TGF-ß1) mRNA and protein expression in blood and skin biopsies from 30 patients with T1R in India. After 1 month of prednisolone treatment the sizes of the skin granulomas were reduced, as were the grades of cells positive for TNF-{alpha} and IL-10 in skin lesions. Increased production of TGF-ß1 was seen in skin lesions after 6 months of prednisolone treatment. Expression of mRNA for TNF-{alpha}, IL-1ß, and TGF-ß1 was reduced, whereas no change in IL-10 mRNA expression was detected during treatment. The circulating cytokine profiles were similar in patients with and without T1R, and prednisolone treatment had no detectable effects on cytokine expression in the blood. The data emphasize the compartmentalization of pathology in T1R and the importance of the immune response in the skin. Clinical improvement and cytokine expression were compared. Surprisingly, patients with improved skin and nerve function and patients with nonimproved skin and nerve function had similar cytokine profiles, suggesting that clinical improvement is not directly mediated by the cytokines studied here. This in vivo well-controlled study of the immunosuppressive effects of prednisolone showed that the drug does not switch off cytokine responses effectively.

* Corresponding author. Mailing address: Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E &HTM, United Kingdom. Phone: 020 7637 4314. Fax: 020 76374314. E-mail: Diana.Lockwood{at}lshtm.ac.uk.

Editor: W. A. Petri, Jr.

Infection and Immunity, June 2005, p. 3725-3733, Vol. 73, No. 6
0019-9567/05/$08.00+0     doi:10.1128/IAI.73.6.3725-3733.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Lockwood, D N J, Lucas, S B, Desikan, K V, Ebenezer, G, Suneetha, S, Nicholls, P (2008). The histological diagnosis of leprosy type 1 reactions: identification of key variables and an analysis of the process of histological diagnosis. J. Clin. Pathol. 61: 595-600 [Abstract] [Full Text]  
  • Walker, S. L., Lockwood, D. N. J. (2006). The clinical and immunological features of leprosy. Br Med Bull 0: ldl010v1-19 [Abstract] [Full Text]  
  • Scollard, D. M., Adams, L. B., Gillis, T. P., Krahenbuhl, J. L., Truman, R. W., Williams, D. L. (2006). The Continuing Challenges of Leprosy. Clin. Microbiol. Rev. 19: 338-381 [Abstract] [Full Text]  


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