THE INFLUENCE OF THALIDOMIDE ON THE CLINICAL AND IMMUNOLOGICAL MANIFESTATION OF ERYTHEMA-NODOSUM LEPROSUM
THE INFLUENCE OF THALIDOMIDE ON THE CLINICAL AND IMMUNOLOGICAL MANIFESTATION OF ERYTHEMA-NODOSUM LEPROSUM
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DOI：
10.1093/infdis/168.2.408
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发表时间：
1993-08-01
影响因子：
6.4
通讯作者：
SARNO, EN
中科院分区：
文献类型：
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作者：
SAMPAIO, EP;KAPLAN, G;SARNO, EN
评价了麻风结节性红斑（ENL）的免疫学和临床表现及其对沙利度胺治疗的反应。在诊断时从瘤型麻风患者获得的血清中测定循环肿瘤坏死因子-α（TNF-α）水平。在多药治疗期间、ENL发作时和沙利度胺治疗期间。全身性ENL患者的血清TNF α水平最高。其在沙利度胺治疗期间显著降低。无反应患者的血清TNF α与轻度流感样症状和局部炎性病变相关。血清干扰素-γ（IFN-γ）也在TNF α水平高的患者中升高。沙利度胺治疗不仅降低了血清TNF α水平和临床症状，而且减少了多形核白细胞和T细胞的真皮浸润。细胞间粘附分子1和主要组织相容性复合物II类抗原在表皮角质形成细胞上的表达也下调。这些结果表明，沙利度胺诱导的ENL临床症状的缓解与TNF α水平的降低相关。
Immunologic and clinical manifestations of erythema nodosum leprosum (ENL) and their response to thalidomide therapy were evaluated. Circulating tumor necrosis factor-alpha (TNFalpha) levels were assayed in serum obtained from lepromatous leprosy patients at diagnosis. during multidrug therapy, at the onset of ENL episodes, and during treatment with thalidomide. Patients with systemic ENL demonstrated the highest serum TNFalpha levels. which decreased significantly during thalidomide treatment. Serum TNFalpha in nonreactional patients was associated with mild flu-like symptoms and local inflammatory lesions. Serum interferon-gamma (IFN-gamma) was also elevated in patients with high TNFalpha levels. Thalidomide therapy reduced not only serum TNFalpha levels and the clinical symptoms but also the dermal infiltration of polymorphonuclear leukocytes and T cells. The expression of intercellular adhesion molecule 1 and major histocompatibility complex class II antigens on the epidermal keratinocytes was also down-regulated. These results indicate that the thalidomide-induced alleviation of clinical symptoms of ENL was associated with a reduction of TNFalpha levels.