The effect of systemic corticosteroid therapy on the expression of toll-like receptor 2 and toll-like receptor 4 in the cutaneous lesions of leprosy Type 1 reactions

Br J Dermatol. 2012 Jul;167(1):29-35. doi: 10.1111/j.1365-2133.2012.10891.x. Epub 2012 Jun 1.

Abstract

Background: Leprosy is complicated by immunological reactions which can occur before, during and after successful completion of multidrug therapy. Genetic studies have suggested that polymorphisms in toll-like receptors (TLRs) may affect the susceptibility of an individual with leprosy to developing Type 1 reactions.

Objectives: To examine the gene and protein expression of TLRs in the cutaneous lesions of leprosy Type 1 reactions at the onset of reaction and during systemic corticosteroid therapy.

Methods: Patients who were being treated for leprosy type 1 reactions with corticosteroids as part of a randomized controlled trial of corticosteroid treatment had skin biopsies performed before, during and at the end of treatment. The gene and protein expression of TLR2 and TLR4 were measured.

Results: We have demonstrated that the gene hARP-P0 is a suitable control gene for TLR gene expression studies in this population. The gene and protein expression of TLR2 and TLR4 were both reduced significantly during corticosteroid treatment.

Conclusions: This is the first study to examine the expression of TLR2 and TLR4 in vivo in individuals experiencing leprosy Type 1 reactions. The data support the possibility of an important role for TLR2 and TLR4 in the pathogenesis of this important complication of leprosy.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Antibiotics, Antitubercular / therapeutic use
  • DNA, Complementary / biosynthesis
  • Drug Therapy, Combination
  • Female
  • Gene Expression
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunohistochemistry
  • Leprosy / drug therapy*
  • Leprosy / genetics
  • Leprosy / mortality
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Prednisolone / therapeutic use
  • Toll-Like Receptor 2 / drug effects
  • Toll-Like Receptor 2 / genetics
  • Toll-Like Receptor 2 / metabolism
  • Toll-Like Receptor 2 / physiology*
  • Toll-Like Receptor 4 / drug effects
  • Toll-Like Receptor 4 / genetics
  • Toll-Like Receptor 4 / metabolism
  • Toll-Like Receptor 4 / physiology*
  • Young Adult

Substances

  • Antibiotics, Antitubercular
  • DNA, Complementary
  • Glucocorticoids
  • TLR2 protein, human
  • TLR4 protein, human
  • Toll-Like Receptor 2
  • Toll-Like Receptor 4
  • Prednisolone
  • Methylprednisolone