Protein profile of leprosy patients with plantar ulcers from the Eastern Amazon region

Background:Studies investigating the nutritional status of patients with leprosy and plantar ulcers are sparse.Therefore,the objective of this study was to describe the protein profile of leprosy patients with plantar ulcers from the Eastern Amazon region.Methods:A case record form was created for 75 patients with leprosy(31 with plantar ulcers and 44 without plantar ulcers)with the following data:sociodemographic characteristics,clinical form of leprosy,presence or absence of plantar ulcers,and nutritional assessment using anthropometry consisting of the measurement of body mass index,arm circumference,arm muscle circumference,and triceps skinfold.Levels of blood albumin,transferrin,and C-reactive protein(CRP)were also measured.Data regarding protein intake were obtained using a Food Frequency Questionnaire.Results:Plantar ulcers occurred more frequently in male patients(67.7%),patients aged 40-49 years(mean±SD:47.3±8.0 years),and patients receiving 300 or 600 USD(71.0%).The mean weight and height of patients were 71.6±11.4 kg and 1.62±0.1 m,respectively.High levels of CRP were detected in 51.6%of leprosy patients with plantar ulcers and only 9.1%of patients without plantar ulcers(P<0.001).Nutritional depletion of transferrin was observed in 14.3%of patients with paucibacillary leprosy and 44.3%of patients with multibacillary leprosy(P=0.0447).Most patients had normal levels of serum albumin(74.2%with plantar ulcers and 77.3%without plantar ulcers).Conclusions:Most leprosy patients with plantar ulcers have normal levels of serum albumin and transferrin and high CRP levels,which indicates the presence of an inflammatory process.Our findings suggest the need to monitor patients with leprosy to prevent the occurrence of plantar ulcers and to provide adequate treatment for patients with existing plantar ulcers.

Prevalence of autoantibodies against cellular antigens in patients with HIV and leprosy coinfection in the Amazon region

Background:Infectious agents can activate self-reactive T cells.In general,infections trigger various mechanisms,including a lack of auto-tolerance,induction of costimulatory molecules on antigen presenting cells,and molecular simulation,in addition to cross-reactions between microbial antigens and self-antigens.HIV and leprosy coinfections lead to self-immunity with the production of autoantibodies.However,not enough data on the immune behaviour associated with this coinfection are available.Therefore,this study focused on the detection of autoantibodies against cellular antigens(AACA)in individuals with HIV and leprosy coinfection in the Amazon region.Methods:Patients were distributed into four groups according to their infections:(i)coinfection with HIV and leprosy(n=23),(ii)infection with leprosy(n=33),(iii)infection with HIV/AIDS(n=25),and(iv)healthy blood donor controls(n=100).AACA were identified by indirect immunofluorescence and the samples were tested using a commercial diagnosis kit containing the antinuclear antibody HEp-2.Results:Morphologically,all stages of cell division were assessed in addition to the morphological features associated with the nuclear matrix,nucleolus,mitotic spindle,and cytoplasm.There was a high prevalence of AACA in the coinfection group(47.8%,n=11)when compared with the control group of healthy blood donors(2.0%).The results showed predominantly cytoplasmic staining in all groups analysed,and no difference was observed between the presence or absence of AACA and the leprosy forms(paucibacillary and multibacillary)in the coinfection group.Conclusions:The results of this study show that despite the tendency of coinfected patients to have higher levels of autoantibodies,no correlation was observed between clinical and laboratorial variables and morbidity associated with HIV and leprosy coinfections or the levels of AACA in the serum of coinfected patients.These data are important to elucidate this complex relationship between HIV and leprosy and thus improve the follow-up of these patients.