In Situ Type 1 Cytokine Gene Expression and Mechanisms Associated with Early Leprosy Progression

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Abstract
We explored the prognostic value of in situ cytokine patterns in 39 patients with single-skin-lesion paucibacillary leprosy before single-dose therapy, with 3 years of follow-up. Interferon (IFN)–γ, interleukin (IL)–12, IL-10, IL-4, tumor necrosis factor (TNF)–α, and macrophage inflammatory protein (MIP)–1α mRNA was quantified in skin biopsy samples at diagnosis, and Mycobacterium leprae DNA was detected in 51.4% of cases. Type 1 immunity predominance with measurable IFN-γ and undetectable IL-4, which is indicative of effective cell-mediated immunity, is compatible with both the reversal reactions (33.3%) and the resolution of lesions (64.1%) observed. A positive correlation between IL-12 and IFN-γ indicated type 1 polarization via IL-12. The TNF-α/MIP-1α correlation implied the TNF-α induction of chemokines, which is important for granuloma formation. Positive correlations between key regulatory cytokines—IL-10 and IFN-γ, IL-10 and IL-12, and IL-10 and TNF-α—suggests that there may be some level of an intralesional pro- or anti-inflammatory mechanism essential in avoiding immunopathology

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