Elevated Pentraxin-3 Concentrations in Patients With Leprosy: Potential Biomarker of Erythema Nodosum Leprosum

J Infect Dis. 2017 Dec 19;216(12):1635-1643. doi: 10.1093/infdis/jix267.

Abstract

Background: Leprosy, the leading infectious cause of disability worldwide, remains a major public health challenge in the most severely affected countries despite the sharp decline in new cases in recent years. The search for biomarkers is essential to achieve a better understanding of the molecular and cellular mechanisms underlying the disease.

Methods: Pentraxin-3 (PTX3) analyses of sera from 87 leprosy patients with or without reactions were conducted via enzyme-linked immunosorbent assay. In situ identification of PTX3 in skin lesion was confirmed by quantitative reverse-transcription polymerase chain reaction, immunohistochemistry, and immunofluorescence assays.

Results: We found that PTX3 serum levels were higher in multibacillary patients when evaluated before the onset of acute erythema nodosum leprosum (ENL) and persistently elevated during reaction. Thalidomide treatment reduced PTX3 in the serum 7 days after starting treatment. In situ analyses have also demonstrated enhancement of PTX3 in ENL lesions and showed that treatment with thalidomide reduced its expression and the prominent neutrophilic infiltrate, a hallmark of the disease.

Conclusions: In summary, our study provides in vivo evidence that PTX3 is enhanced during ENL but not in reversal reaction and provides a new molecular target in ENL pathogenesis.

Keywords: ENL; PTX3; biomarker; leprosy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / analysis*
  • C-Reactive Protein / analysis*
  • C-Reactive Protein / genetics
  • Case-Control Studies
  • Child
  • Enzyme-Linked Immunosorbent Assay
  • Erythema Nodosum / diagnosis*
  • Erythema Nodosum / pathology*
  • Female
  • Fluorescent Antibody Technique
  • Humans
  • Immunohistochemistry
  • Leprostatic Agents / administration & dosage
  • Leprosy, Lepromatous / diagnosis*
  • Leprosy, Lepromatous / pathology*
  • Male
  • Middle Aged
  • Real-Time Polymerase Chain Reaction
  • Reverse Transcriptase Polymerase Chain Reaction
  • Serum Amyloid P-Component / analysis*
  • Serum Amyloid P-Component / genetics
  • Skin / pathology
  • Thalidomide / administration & dosage
  • Young Adult

Substances

  • Biomarkers
  • Leprostatic Agents
  • Serum Amyloid P-Component
  • PTX3 protein
  • Thalidomide
  • C-Reactive Protein