This case controlled study included one group of patients diagnosed to have leprosy and the other group was healthy controlled individuals with matched age, sex and area of residence. All the patients with type II lepra reaction responded to Capsule Thalidomide clinically and all the skin lesions resolved in 7-14 days. Blood samples and skin biopsy was subjected to histopathology, immunoflourescence assay, immunohistochemical staining, quantitative RT-PCR (Reverse Transcriptase-Polymerase Chain reaction) and flow cytometry.
Results: Interferon-γ and TNF-α are sensitive markers in diagnosing erythema nodosum leprosum and Cd-64 expression on activated circulating neutrophils is both a specific and sensitive marker in Type II Lepra reaction. Cd-64 expression also had a positive correlation with Thalidomide treatment and clinical response. High polymorphonuclear Cd-64 expression was correlated with severity of ENL.
Conclusion: Cd-64 expression on circulating neutrophils is a potential early biophysical marker for diagnosing erythema nodosum leprosum and can be used as a tool to assess thalidomide response. It is however not a good index to diagnose leprosy infection as it was specific for Type II lepra reaction. Interferon-γ and TNF-α are sensitive markers to screen for lepra reactions and this study showed no significant correlation with Thalidomide therapy.
B. Mitra, None