Effective Treatment of Erythema Nodosum Leprosum with Thalidomide Is Associated with Immune Stimulation

Halslett, Patrick A. J.; Roche, Paul; Butlin, C. Ruth; Macdonald, Murdo; Shrestha, Niraj; Manandhar, Rakesh; Lemaster, Joe; Hawksworth, Rachel; Shah, Mahesh; Lubinsky, A. Steven; Albert, Matthew; Worley, Jason; Kaplan, Gilla
December 2005
Journal of Infectious Diseases;12/15/2005, Vol. 192 Issue 12, p2045
Academic Journal
The immunomodulatory drug thalidomide is the treatment of choice for erythema nodosum leprosum (ENL), an inflammatory cutaneous and systemic complication of multibacillary leprosy. To elucidate the mechanism of action of thalidomide in this syndrome, we prospectively investigated 20 patients with ENL who were treated with thalidomide for 21 days. All patients responded to treatment, with the majority of them having complete resolution of cutaneous lesions within 7 days. This response was associated with a marked but transient increase in ex vivo mitogen-induced expression of interleukin (IL)-2 and interferon-γ by CD4+ and CD8+ T cells that was observed on treatment day 7, but these returned to pretreatment levels by day 21. Plasma tumor necrosis factor-α levels were not high at baseline, and they increased modestly during treatment. Plasma levels of IL-12 increased steadily during thalidomide treatment. Hence, the therapeutic effect of thalidomide in ENL appears to be associated with transient immune stimulation, which suggests that the drug may promote an active immunoregulatory response.


Related Articles

  • ENL developing 10 years after leprosy treatment masquerading as atypical-mycobacterial infection. Malhotra, K.; Kulshreshtha, D.; Shukla, S.; Husain, N. // QJM: An International Journal of Medicine;Nov2015, Vol. 108 Issue 11, p905 

    No abstract available.

  • Lepra: sepsis en paciente con reacción tipo II. Reporte de un caso. Escalante Gómez, Edinson Enrique; Trout Guardiola, Guillermo Orlando; Oliva Martínez, Juan David; Mejía Murillo, Francisco Javier // MedUNAB;ago-nov2012, Vol. 15 Issue 2, p123 

    Leprosy is an infectious disease of chronic, characterized by extensive skin involvement, neuropathy associated with low mortality rates, but with a high rate of disability. It is caused by infection with the bacillus, Mycobacterium leprae. Although known since ancient times is considered a...

  • A framework to identify gene expression profiles in a model of inflammation induced by lipopolysaccharide after treatment with thalidomide. Paiva, Renata T; Saliba, Alessandra M; Fulco, Tatiana O; de Souza Sales, Jorgenilce; Serra de Carvalho, Daniel; Sampaio, Elizabeth P; Lopes, Ulisses G; Sarno, Euzenir N; Nobre, Flavio F // BMC Research Notes;2012, Vol. 5 Issue 1, p292 

    Background: Thalidomide is an anti-inflammatory and anti-angiogenic drug currently used for the treatment of several diseases, including erythema nodosum leprosum, which occurs in patients with lepromatous leprosy. In this research, we use DNA microarray analysis to identify the impact of...

  • Th1-Th2 Paradigm: Insights from Leprosy. Modlin, Robert L. // Journal of Investigative Dermatology;Jun94, Vol. 102 Issue 6, p828 

    The mechanism by which T cells and cytokines regulate immune processes in skin can be investigated by studying patients with leprosy. The disease, caused by the obligate intracellular bacterium Mycobacterium leprae, forms a spectrum. At one pole, patients with tuberculoid leprosy are...

  • What's wrong with this patient? Spencer, Linda; Collins, Helen Lippman // RN;Apr90, Vol. 53 Issue 4, p41 

    Presents the case of a patient diagnosed with Hansen's disease or leprosy. Signs and symptoms; Diagnosis and treatment of leprosy; Ways to prevent the spread of the disease.

  • Special action projects for the elimination of leprosy.  // Weekly Epidemiological Record;7/18/2003, Vol. 78 Issue 29, p254 

    Reports on the launching of special action projects for the elimination of leprosy in 1995. Encouragement of national programs to review the geographical coverage of multidrug therapy (MDT) services.

  • A Message from the Editor. Reed, Laurence D. // Public Health Reports;Mar/Apr2008, Vol. 123 Issue 2, p109 

    The article discusses various reports published within the issue including articles on leprosy or Hansen's disease, coordinated by Drs. Brian Bennett, David Parker and Mark Robson.

  • Leprosy: A Photographic Essay. Parker, David L. // Public Health Reports;Mar/Apr2008, Vol. 123 Issue 2, p225 

    A photo essay which portrays the more advanced condition of leprosy is presented.

  • LEPROSY: An ancient scourge--a continuing problem. Thomas, Betty J. // RN;Mar75, Vol. 38 Issue 3, p47 

    Presents information on leprosy. Epidemiology; Pathogenesis; Types of leprosy; Treatment.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics