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Study of serum Interleukin-17 and Interleukin-4 levels in South Indian leprosy patients across clinico-histopathological spectrum.

Abstract

Leprosy is a chronic granulomatous disorder of the skin and peripheral nervous system caused by Mycobacterium leprae. Tuberculoid leprosy (TT) has predominance of CD4+T cells and lepromatous leprosy (LL) of CD8+ and type 2 cytokines. In this study, clinico-histopathological profile of leprosy has been analyzed and correlated with serum Interleukin-17 and interleukin-4 levels. Thirty newly diagnosed leprosy cases fulfilling the inclusion criteria and thirty healthy controls constituted the study carried out over a period of one and half years. Clinical assessment, slit skin smear (SSS) and skin biopsy were done and classified according to Ridley Jopling. Serum IL-17 and IL-4 were estimated by ELISA. Among 30 cases, most were of 41-50 years (43.3%). Twelve (40%) were borderline leprosy who constituted majority. Four cases were in Type 1 reaction (T1R) and three in Type 2 reaction (T2R). Clinico-histopathological correlation was 100% TT/LL poles of spectrum, it varied in borderline leprosy. Serum IL-17 was significantly lower in leprosy cases (Mean = 3.8969 pg/mL), compared to controls (P = 0.001). Serum IL-4 was elevated in cases (Mean = 37.8346 = pg/mL) than controls (Mean = 6.1693 pg/mL) (P = 0.001), highest level being LL patients (Mean = 48.3403 pg/mL). Serum IL-4 had the highest level in type 2 reactions (T2R) (Mean = 48.5563 pg/ml) (P = 0.269). Defective secretion of IL-17 appears to correlate with disease acquisition and progression towards lepromatous pole. Overproduction of IL-4 in patients with lepromatous leprosy may predisposeto development of ENL. Further studies are required on a larger representative numbers to for better and definitive role of these cytokines in leprosy.

More information

Type
Journal Article
Author
Poovamma A S
Ashwini P K
Veeranna S
Jayadev B