01977nas a2200313   4500000000100000008004100001260004900042653001400091653001700105653002700122653001200149653001700161653002300178653001000201653001400211653001400225100001600239700001600255700001400271700001700285700001500302700001800317700000800335245012500343856006900468300001000537490000600547520111000553       2011                            d  c12bPublic Library of ScienceaSan Francisco10aPathology10aNerve damage10aMultibacillary leprosy10aleprosy10aInflammation10aINFIR Cohort study10aIndia10aDiagnoses10aCytokines1 aLockwood DN1 aSuneetha LM1 aSagili KD1 aChaduvula MV1 aMohammed I1 avan Brakel WH1 aal 00aCytokine and Protein Markers of Leprosy Reactions in Skin and Nerves: Baseline Results for the North Indian INFIR Cohort  uhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236729/?tool=pubmed  ae13270 v53 a<p>Leprosy affects skin and peripheral nerves. Although we have effective antibiotics to treat the mycobacterial infection, a key part of the disease process is the accompanying inflammation. This can worsen after starting antibacterial treatment with episodes of immune mediated inflammation, so called ‘reactions’. These reactions are associated with worsening of the nerve damage. We recruited a cohort of 303 newly diagnosed leprosy patients in North India with the aim of understanding and defining the pathological processes better. We took skin and nerve biopsies from patients and examined them to define which molecules and mediators of inflammation were present. We found high levels of the cytokines Tumour Necrosis Factor alpha, Transforming Growth Factor beta and inducible Nitric Oxide Synthase in biopsies from patients with reactions. We also found high levels of bacteria and inflammation in the nerves. These experiments tell us that we need to determine which other molecules are present and to explore ways of switching off the production of these pro-inflammatory molecules.</p>