Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF
CROSSMARK LOGO Buy Reprints
PDF

Translate this page into:

Letters in Response to Previous Publication
ARTICLE IN PRESS
doi:
10.25259/IJDVL_808_2021

Authors’ reply

Biology Team, Lauro de Souza Lima Institute, São Paulo, Brazil
Immunology Team, Lauro de Souza Lima Institute, São Paulo, Brazil
Microbiology Team, Lauro de Souza Lima Institute, São Paulo, Brazil
Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
Epidemiology Service,Lauro de Souza Lima Institute, Bauru, São Paulo, Brazil
Rehabilitation Team, Lauro de Souza Lima Institute, Bauru, São Paulo, Brazil
Corresponding author: Dr. Fátima Regina Vilani-Moreno, Lauro de Souza Lima Institute, Rod. Comte. João Ribeiro de Barros, Km 225/226, 17034-971, Bauru, São Paulo, Brazil. frvmoreno@gmail.com
Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Vilani-Moreno FR, Brito-de-Souza VN, Silva SM, Barbosa AS, Sartori BG, Campanelli AP, et al. Authors’ reply. Indian J Dermatol Venereol Leprol, doi: 10.25259/IJDVL_808_2021

Sir,

We thank the authors of the letter1 for their interesting comments on our article.2

We developed this study to evaluate serum levels of some mediators involved in the innate and adaptative immune response of leprosy patients with erythema nodosum leprosum, since this reaction leads to severe peripheral nerve damage and physical incapacity as well as pain and malaise that deprive patients from social and economic interactions. Thus, the identification of possible serum immunomarkers for erythema nodosum leprosum could open new strategies for treatment and prevention, avoiding or reducing the nerve damage that impairs severely the quality of life of leprosy patients.

In our study, of special interest was the observation of the high serum levels of interleukin 6 (IL-6) at M0 (at the beginning of reaction) compared with M1 (one month later) and with untreated multibacillary leprosy patients without erythema nodosum leprosum (control with leprosy: CTRL), similar to the studies reported in the literature.3-7 In addition, we observed higher serum levels of IL-6 in patients with severe erythema nodosum leprosum than in those with moderate or mild reaction. Considering that the IL-6 levels decreased after the remission of the reaction of erythema nodosum leprosum, we suggest that this cytokine has a role in erythema nodosum leprosum episodes and could be used as a marker for erythema nodosum leprosum in multibacillary leprosy patients.

We agree with the authors regarding the importance of evaluating the serum levels of IL-6 in patients with type I reaction together with erythema nodosum leprosum patients, as realised by Sousa et al.6 and Saini et al.8 In fact, we emphasise that our intention in our study was to evaluate and to follow-up erythema nodosum leprosum patients for two years after the initial erythema nodosum leprosum reaction. In this regard, the follow-up of 13 erythema nodosum leprosum patients showed that 11 had new episodes of erythema nodosum leprosum, reinforcing the importance of identifying biomarkers that may indicate early development of reaction. Another important point to consider is the use of IL-6 as prognostic marker to erythema nodosum leprosum. For this purpose, it is necessary to follow the levels of this cytokine in a cohort of multibacillary leprosy patients and observe if patients that develop erythema nodosum leprosum present an increased level of IL-6 before the reaction. If a prognostic role of IL-6 is confirmed, it will enable us to take early prophylactic or therapeutics measures to prevent or minimise the damage due to the reaction.

Finally, we would like to thank the authors for the valuable comments and their kind attention to our article.

Financial support and sponsorship

Paulista Foundation against Hansen’s disease

Conflicts of interest

There are no conflicts of interest.

References

  1. , . Differential expression of interleukin-6 in leprosy reactions. Indian J Dermatol Venereol Leprol doi= 10.25259/IJDVL_687_2021
    [CrossRef] [PubMed] [Google Scholar]
  2. , , , , , , et al. Increased serum levels of interleukin-6 in erythema nodosum leprosum suggest its use as a biomarker. Indian J Dermatol Venereol Leprol. 2021;87:190-8.
    [CrossRef] [PubMed] [Google Scholar]
  3. , , , , , . Pentoxifylline decreases in vivo and in vitro tumor necrosis fator-alpha (TNF-alpha) production in lepromatous leprosy patients with erythema nodosum leprosum (ENL) Clin Exp Immunol. 1998;111:300-8.
    [CrossRef] [PubMed] [Google Scholar]
  4. , , , , , . Circulating cytokines profiles in leprosy patients. Lepr Rev. 2007;78:223-30.
    [CrossRef] [PubMed] [Google Scholar]
  5. , , , , , , et al. Potential plasma markers of Type 1 and Type 2 leprosy reactions: A preliminary report. BMC Infect Dis. 2009;9:75.
    [CrossRef] [PubMed] [Google Scholar]
  6. , , , , , , et al. Genetic and immunological evidence implicates interleukin 6 as a susceptibility gene for leprosy Type 2 reaction. J Infect Dis. 2012;205:1417-24.
    [CrossRef] [PubMed] [Google Scholar]
  7. , , , , , , et al. Genetic polymorphisms of the IL6 and NOD2 genes are risk factors for inflammatory reactions in leprosy. PLoS Negl Trop Dis. 2017;11:e0005754.
    [CrossRef] [PubMed] [Google Scholar]
  8. , , , . Leprosy reactions show increased Th17 cell activity and reduced FOXP3+ Tregs with concomitant decrease in TGF-β and increase IL-6. PLoS Negl Trop Dis. 2016;10:e0004592.
    [CrossRef] [PubMed] [Google Scholar]

Fulltext Views
395

PDF downloads
40
View/Download PDF
Download Citations
BibTeX
RIS
Show Sections