02879nas a2200505   4500000000100000008004100001260001600042653001500058653001000073653002500083653001000108653002100118653001300139653001100152653003800163653001500201653001100216653001100227653002000238653001200258653002700270653000900297653002700306653001600333653002600349653003600375653002500411100001300436700001200449700001600461700001700477700001400494700001400508700001300522700001200535700001200547700001300559700001300572245009600585856010700681300001100788490000800799520155200807022001402359       2008                            d  c2008 Jan 1510aAdolescent10aAdult10aCase-Control Studies10aChild10aChild, Preschool10aEthiopia10aFemale10aGenetic Predisposition to Disease10aHaplotypes10aHumans10aInfant10aInfant, Newborn10aleprosy10aLinkage Disequilibrium10aMale10aMicrosatellite Repeats10aMiddle Aged10aPolymorphism, Genetic10aPolymorphism, Single Nucleotide10aToll-Like Receptor 21 aBochud P1 aHawn TR1 aSiddiqui RM1 aSaunderson P1 aBritton S1 aAbraham I1 aArgaw AT1 aJaner M1 aZhao LP1 aKaplan G1 aAderem A00aToll-like receptor 2 (TLR2) polymorphisms are associated with reversal reaction in leprosy.  uhttp://jid.oxfordjournals.org/content/197/2/253.full.pdf+html?sid=64d8458a-d31d-4e85-a05a-5e5d1a69b0d4  a253-610 v1973 a<p><b>BACKGROUND: </b>Leprosy is characterized by a spectrum of clinical manifestations that depend on the type of immune response against the pathogen. Patients may undergo immunological changes known as "reactional states" (reversal reaction and erythema nodosum leprosum) that result in major clinical deterioration. The goal of the present study was to assess the effect of Toll-like receptor 2 (TLR2) polymorphisms on susceptibility to and clinical presentation of leprosy.</p><p><b>METHODS: </b>Three polymorphisms in TLR2 (597C-->T, 1350T-->C, and a microsatellite marker) were analyzed in 431 Ethiopian patients with leprosy and 187 control subjects. The polymorphism-associated risk of developing leprosy, lepromatous (vs. tuberculoid) leprosy, and leprosy reactions was assessed by multivariate logistic regression models.</p><p><b>RESULTS: </b>The microsatellite and the 597C-->T polymorphisms both influenced susceptibility to reversal reaction. Although the 597T allele had a protective effect (odds ratio [OR], 0.34 [95% confidence interval {CI}, 0.17-0.68]; P= .002 under the dominant model), homozygosity for the 280-bp allelic length of the microsatellite strongly increased the risk of reversal reaction (OR, 5.83 [95% CI, 1.98-17.15]; P= .001 under the recessive model). These associations were consistent among 3 different ethnic groups.</p><p><b>CONCLUSIONS: </b>These data suggest a significant role for TLR-2 in the occurrence of leprosy reversal reaction and provide new insights into the immunogenetics of the disease.</p>  a0022-1899