TY - JOUR KW - Adolescent KW - Adult KW - CD4-Positive T-Lymphocytes KW - CD8-Positive T-Lymphocytes KW - Cytokines KW - Erythema Nodosum KW - Flow Cytometry KW - Gene Expression KW - Humans KW - Immunologic Factors KW - Interferon-gamma KW - Leprostatic Agents KW - Leprosy, lepromatous KW - Male KW - Middle Aged KW - Prospective Studies KW - Reverse Transcriptase Polymerase Chain Reaction KW - RNA, Messenger KW - Skin KW - Thalidomide AU - Haslett P AU - Roche P AU - Butlin CR AU - Macdonald M AU - Shrestha N AU - Manandhar R AU - Lemaster J AU - Hawksworth RA AU - Shah M AU - Lubinsky SA AU - Albert M AU - Worley J AU - Kaplan G AB -

The immunomodulatory drug thalidomide is the treatment of choice for erythema nodosum leprosum (ENL), an inflammatory cutaneous and systemic complication of multibacillary leprosy. To elucidate the mechanism of action of thalidomide in this syndrome, we prospectively investigated 20 patients with ENL who were treated with thalidomide for 21 days. All patients responded to treatment, with the majority of them having complete resolution of cutaneous lesions within 7 days. This response was associated with a marked but transient increase in ex vivo mitogen-induced expression of interleukin (IL)-2 and interferon- gamma by CD4(+) and CD8(+) T cells that was observed on treatment day 7, but these returned to pretreatment levels by day 21. Plasma tumor necrosis factor- alpha levels were not high at baseline, and they increased modestly during treatment. Plasma levels of IL-12 increased steadily during thalidomide treatment. Hence, the therapeutic effect of thalidomide in ENL appears to be associated with transient immune stimulation, which suggests that the drug may promote an active immunoregulatory response.

BT - The Journal of infectious diseases C1 - http://www.ncbi.nlm.nih.gov/pubmed/16288366?dopt=Abstract CN - HASLETT 2005 DA - 2005 Dec 15 DO - 10.1086/498216 IS - 12 J2 - J. Infect. Dis. LA - eng N2 -

The immunomodulatory drug thalidomide is the treatment of choice for erythema nodosum leprosum (ENL), an inflammatory cutaneous and systemic complication of multibacillary leprosy. To elucidate the mechanism of action of thalidomide in this syndrome, we prospectively investigated 20 patients with ENL who were treated with thalidomide for 21 days. All patients responded to treatment, with the majority of them having complete resolution of cutaneous lesions within 7 days. This response was associated with a marked but transient increase in ex vivo mitogen-induced expression of interleukin (IL)-2 and interferon- gamma by CD4(+) and CD8(+) T cells that was observed on treatment day 7, but these returned to pretreatment levels by day 21. Plasma tumor necrosis factor- alpha levels were not high at baseline, and they increased modestly during treatment. Plasma levels of IL-12 increased steadily during thalidomide treatment. Hence, the therapeutic effect of thalidomide in ENL appears to be associated with transient immune stimulation, which suggests that the drug may promote an active immunoregulatory response.

PY - 2005 SP - 2045 EP - 53 T2 - The Journal of infectious diseases TI - Effective treatment of erythema nodosum leprosum with thalidomide is associated with immune stimulation. UR - https://academic.oup.com/jid/article/192/12/2045/839139 VL - 192 SN - 0022-1899 ER -