@article{103778,
  keywords = {Macrophages, Diversity, Systematic review, leprosy},
  author = {Dahlan H and Rinonce HT and Wahyuningsih AT and Soebono H},
  title = {Macrophage diversity in different types of leprosy: a systematic review},
  abstract = {<p>Leprosy shows a clinicopathological spectrum that reflects divergent host responses to&nbsp;Mycobacterium leprae, with macrophages playing a central role in lesion immunopathology. This systematic review synthesised in situ evidence on marker-defined macrophage phenotypes in human leprosy skin lesions. A PRISMA-guided search identified 14 observational studies published between 1996 and 2023 that examined macrophage-associated markers in clinically classified skin biopsies using immunohistochemistry or lesion-based molecular approaches. Because the included studies were heterogeneous in marker panels, lesion classification, laboratory methods, and outcome reporting, findings were synthesised narratively rather than by meta-analysis. Tuberculoid-spectrum lesions were consistently associated with M1-related marker patterns, including NOS2 (iNOS), TNF-α, IL-6, and MMP-9, in keeping with preserved granuloma organisation and bacillary containment. Lepromatous lesions more often showed dominant M2-associated and M4-like marker-defined phenotypes, characterised by IL-10, CD163, ARG1, PPARG, STAT6, IDO, MRP8, and MMP7, consistent with immuno-regulatory, tissue-remodelling, and bacillus-permissive lesion environments. These findings improve lesion-level biological interpretation across the leprosy spectrum, but they do not yet support routine diagnostic, prognostic, or reaction-prediction use. Macrophage phenotypic reprogramming remains a hypothesis-generating translational direction requiring longitudinal validation.</p>
},
  year = {2026},
  journal = {Leprosy Review},
  volume = {97},
  pages = {1 - 13},
  month = {06/2026},
  publisher = {Lepra},
  issn = {2162-8807},
  url = {https://leprosyreview.org/article/97/2/20-25149},
  doi = {10.47276/lr.97.2.2025149},
  language = {ENG},
}