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Effects of Prednisolone Treatment on Cytokine Expression in Patients with Leprosy Type 1 Reactions

机译：泼尼松龙对麻风1型反应患者细胞因子表达的影响

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Leprosy type 1 reactions (T1R) are due to increased cell-mediated immunity and result in localized tissue damage. The anti-inflammatory drug prednisolone is used for treatment, but there is little good in vivo data on the molecular actions of prednisolone. We investigated the effect of prednisolone treatment on tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), IL-10, and transforming growth factor β1 (TGF-β1) mRNA and protein expression in blood and skin biopsies from 30 patients with T1R in India. After 1 month of prednisolone treatment the sizes of the skin granulomas were reduced, as were the grades of cells positive for TNF-α and IL-10 in skin lesions. Increased production of TGF-β1 was seen in skin lesions after 6 months of prednisolone treatment. Expression of mRNA for TNF-α, IL-1β, and TGF-β1 was reduced, whereas no change in IL-10 mRNA expression was detected during treatment. The circulating cytokine profiles were similar in patients with and without T1R, and prednisolone treatment had no detectable effects on cytokine expression in the blood. The data emphasize the compartmentalization of pathology in T1R and the importance of the immune response in the skin. Clinical improvement and cytokine expression were compared. Surprisingly, patients with improved skin and nerve function and patients with nonimproved skin and nerve function had similar cytokine profiles, suggesting that clinical improvement is not directly mediated by the cytokines studied here. This in vivo well-controlled study of the immunosuppressive effects of prednisolone showed that the drug does not switch off cytokine responses effectively.
机译：麻风1型反应（T1R）是由于细胞介导的免疫力增强，导致局部组织损伤。抗炎药泼尼松龙用于治疗，但关于泼尼松龙分子作用的体内数据很少。我们调查了泼尼松龙治疗对血液和皮肤活检组织中肿瘤坏死因子α（TNF-α），白细胞介素1β（IL-1β），IL-10和转化生长因子β1（TGF-β1）mRNA和蛋白质表达的影响来自印度的30名T1R患者。泼尼松龙治疗1个月后，皮肤肉芽肿的大小减小，皮肤病变中TNF-α和IL-10阳性的细胞等级也降低。泼尼松龙治疗6个月后，皮肤损伤中TGF-β1的产量增加。 TNF-α，IL-1β和TGF-β1的mRNA表达降低，而在治疗过程中未检测到IL-10 mRNA表达的变化。有和没有T1R的患者中循环细胞因子的分布相似，泼尼松龙治疗对血液中细胞因子的表达没有可检测的影响。数据强调了T1R中病理的分隔以及皮肤中免疫反应的重要性。比较临床改善和细胞因子表达。令人惊讶的是，具有改善的皮肤和神经功能的患者和没有改善的皮肤和神经功能的患者具有相似的细胞因子谱，这表明临床改善不是直接由此处研究的细胞因子介导的。泼尼松龙的免疫抑制作用的体内对照研究表明，该药物不能有效地关闭细胞因子的反应。

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