02919nas a2200445   4500000000100000008004100001260001300042653001500055653002800070653001000098653000900108653002200117653001500139653002000154653001400174653002000188653002100208653001100229653002000240653001100260653002500271653000900296653001600305653001400321653001400335653000900349653001600358100001100374700001100385700001200396700001200408700001300420700001700433700001100450245010500461300001000566490000800576520187500584022001402459       2009                            d  c2009 Jun10aAdolescent10aAdrenal Cortex Hormones10aAdult10aAged10aAged, 80 and over10aBiomarkers10aCells, Cultured10aCytokines10aDrug Monitoring10aErythema Nodosum10aFemale10aHexosaminidases10aHumans10aLeprosy, lepromatous10aMale10aMiddle Aged10aMonocytes10aNeopterin10aSkin10aYoung Adult1 aIyer A1 aEijk M1 aSilva E1 aHatta M1 aFaber WR1 aAerts JM F G1 aDas PK00aIncreased chitotriosidase activity in serum of leprosy patients: association with bacillary leprosy.  a501-90 v1313 a<p>Human phagocyte-specific chitotriosidase is associated with several diseases involving macrophage activation. Since macrophage activation plays an important role in the control of Mycobacterium leprae infection, we studied the association of chitotriosidase with leprosy both in serum and in situ in lesional skin biopsies from patients. Serum samples from 78 Indonesian leprosy patients (39 non-reactional and 39 reactional leprosy patients) and 36 healthy controls (HC) from the same endemic region were investigated. The patients were classified as multibacillary (MB, n=69) or paucibacillary (PB, n=9) based on the bacterial index in slit-skin smears. Thirty-six of the reactional patients had erythema nodosum leprosum (ENL), while only 3 had reversal reaction (RR). Follow-up serum samples after corticosteroid treatment were also obtained from 17 patients with ENL and one with RR. Multibacillary (MB) patients showed increased chitotriosidase activity in serum as compared to paucibacillary (PB) patients and healthy controls. Although no significant difference was observed between reactional and the corresponding non-reactional groups, ENL showed significantly higher chitotriosidase activity as compared to HC. Furthermore, corticosteroid treatment resulted in significant decline of enzyme activity in ENL sera. Chitotriosidase activity correlated with levels of neopterin, another macrophage activation marker, but not with IL-6, IFN-gamma, TNF-alpha and IL-10. Immunohistochemical staining of 6 MB (LL=5, BL=1) lesional skin sections from stored material showed positive staining for chitotriosidase within lipid-laden macrophages suggesting that macrophages are the source of the enzyme detected in serum. Thus, serum chitotriosidase activity is potentially useful in distinguishing MB from PB leprosy and in monitoring response to therapy in ENL.</p>  a1521-7035