01420nas a2200217   4500000000100000008004100001260002500042653002300067653002100090653002200111653001600133653002000149653002600169653002800195100002000223700001200243245013100255490000700386520079500393022001401188       2026                            d  c08/2026bElsevier BV10aHansen’s disease10aType II reaction10aMultidrug therapy10aThalidomide10aOptimal control10aoptimal drug regimen 10a Forward-backward sweep1 aRamanjaneyulu C1 aVamsi D00aMathematical modeling of type II lepra reactions: Cytokine dynamics and the impact of multi drug therapy (MDT) and thalidomide0 v103 a<p>This study presents three mathematical models to analyze the progression and treatment of Type II lepra reactions in leprosy, driven by the dysregulation of eight key cytokine biomarkers. The first model uses 11 compartments to simulate direct drug effects, while the second and third models expand to 13 compartments to incorporate indirect drug actions, with the third including a delayed dual dose approach. Model validation through bacterial growth heat maps and optimal control simulations via the forward-backward sweep method reveal that a combination of MDT and thalidomide is more effective than MDT alone in regulating cytokine levels and reducing bacterial burden. The results emphasize the importance of cytokine modulation in the prevention of Type II lepra reactions.</p>
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