@article{6729, keywords = {Erythema Nodosum, Humans, Interferon-gamma, Leprosy, Borderline, Leprosy, lepromatous, Monocytes, Recombinant Proteins, Skin, Thalidomide, Time Factors, Tumor Necrosis Factor-alpha}, author = {Sampaio E P and Moreira A L and Sarno E N and Malta A M and Kaplan G}, title = {Prolonged treatment with recombinant interferon gamma induces erythema nodosum leprosum in lepromatous leprosy patients.}, abstract = {

10 patients with borderline and lepromatous leprosy were selected for a prolonged trial with recombinant interferon gamma (rIFN-gamma). Patients received 30 micrograms intradermally for six injections over a 9-d period, and then either 100 micrograms intradermally every 1 mo for 10 mo or every 2 wk for 5 mo (total, 1.2 mg). Erythema nodosum leprosum (ENL) was induced in 60% of the patients within 6-7 mo, as compared with an incidence of 15% per year with multiple drug therapy alone. The mean whole-body reduction in bacterial index over the first 6 mo was 0.9 log units. Cutaneous induration at the intradermal injection sites of greater than or equal to 15 mm predicted the development of a subsequent reactional state. Monocytes obtained from patients receiving the lymphokine demonstrated an increased respiratory burst and a 2.5-5.1-fold increase in tumor necrosis factor alpha (TNF-alpha) secretion in response to agonists. Patients in ENL had an even higher release of TNF-alpha from monocytes as well as high levels of TNF-alpha in the plasma (mean, 2,000 pg/ml). Thalidomide therapy was required to treat the systemic manifestations of ENL. Control of toxic symptoms with thalidomide was associated with a 50-80% reduction in agonist-stimulated monocyte TNF-alpha secretion. IFN-gamma enhanced the monocyte release of TNF-alpha by 3-7.5-fold (agonist dependent) when added to patient's cells in vitro, and this could be suppressed by the in vitro addition of 10 micrograms/ml of thalidomide.

}, year = {1992}, journal = {The Journal of experimental medicine}, volume = {175}, pages = {1729-37}, month = {1992 Jun 01}, issn = {0022-1007}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2119233/pdf/je17561729.pdf}, doi = {10.1084/jem.175.6.1729}, language = {eng}, }