Prediction of the risk of recurrence of the leprosy process

The aim of the study was to study the degree of neutrophil granulocyte myeloperoxidase activity in peripheral blood of patients with leprosy in order to predict the possible recurrence of the infectious process.
Materials and methods. Electron grams of biopsies of the affected skin and blood smears of 8 (5 women and 3 men) patients with borderline (BB), 9 (6 women and 3 men) patients with subpolar lepromatous (LLs) and 7 (4 women and 3 men) patients with polar lepromatous (LLr) were used as the object of the study forms of leprosy. At the ultramicroscopic level, the degree of MP activity detected by the electron-cytochemical method in the Mf of biopsies of the affected skin, both first registered before the start of therapy and with the activation of the process during treatment, was taken into account. The percentage of mitochondria with MP Mf activity relative to the MP of inactive cells was calculated. In peripheral blood smears, the activity of neutrophilic granulocytes (NG) MP was evaluated by the mean cytochemical coefficient (SCC).
Results. It was found that in patients with the highest percentage of peroxidase-active mitochondria (79-92%), the presence of MP activity on the membranes of phagosomes and in the electron-transparent zone (around M. leprae) correlated with rapid and persistent regression of the leprosy process and long periods of relapse-free period, which was determined by comparing the data of medical histories with the results obtained in during our research. It was found that in patients without relapse with forms of BB and LLs leprosy, the activity of MP in neutrophils was 1.3 times higher (p<0.05), and the percentage of peroxidase-active mitochondria was 3 times higher (p<0.01) compared with these indicators of patients with relapse of the disease. When comparing the studied markers of groups of patients without relapse with the form of leprosy LLp, the degree of MP NG activity increased by 1.4 times (p<0.05), the percentage of mitochondria with MP Mf activity increased by 3 times (p<0.01) relative to patients with relapses.
Conclusion. Thus, the determination of myeloperoxidase activity of neutrophil granulocytes of peripheral blood can act as a prognostic marker for determining the effectiveness of anti-leprosy therapy and the risk of relapses of the disease during and after treatment.

1. Al-Mendalawi M. Multidrug-resistant tuberculosis and leprosy: An unsolved mystery. Lung India. 2017;34(6):579.

2. Fava VM, Dallmann-Sauer M, Schur E. Genetics of leprosy: today and beyond. Human Genetics. 2020;139:835-846.

3. Orlov Yu.P., Sviridov S.V., Kakulya E.N. // Klinicheskoe pitanie i metabolizm. – 2021. – T. 2, № 2. – S. 66-79.

4. Klebanoff SJ, Kettle AJ, Rosen H, et al. Myeloperoxidase: a front-line defender against phagocytosed microorganisms. Leukoc Biol. 2013;93(2):185-98.

5. Rosa TLSA, Marques MAM, DeBoard Z, et al. Reductive Power Generated by Mycobacterium leprae Through Cholesterol Oxidation Contributes to Lipid and ATP Synthesis. Front Cell Infect Microbiol. 2021;28(11):709972.

6. Smokes V, Tavares IF, Pignataro et al. Neutrophils in leprosy. Frontiers in Immunology. 2019;10:495.

7. Hilda DN, Das S, Tripathi S, et al. The role of neutrophils in tuberculosis: a bird’s-eye view. Innate Immunity. 2020;26(4):240-247.

8. Paths VE, Christopher M, Budiamal S. Leprosy and the immune system: A look at the innate immune system. IJL: Indian Journal of Leprosy. 2021;93:391-403.

9. Diman A, Talukdar S, Chaubey GK, et al. Regulation of the macrophage cell surface by GAPDH changes the internalization of LL-37 and subsequent effects in the cell. Journal of Innate Immunity. 2023;15(1):581-598.

10. Margraf A, Lowell KA, Zarubok A. Neutrophils in acute inflammation: modern concepts and translational consequences. Blood, Journal of the American Society of Hematology. 2022;139(14):2130-2144.

11. Kalagarla S, Aluri R, Soka S, et al. The effectiveness of fluorescence microscopy in comparison with modified FaiteFaraco staining in skin biopsy samples of patients with leprosy is a comparative study. International Journal of Dermatology. 2022;61(5):595-599.

12. Abrahamson DR. The Graham and Karnovsky Horseradish Peroxidase Ultrastructural Method: A Premier JHC Citation Classic. J. Histochem Cytochem. 2023;71(1):43-45.

13. Gajer G. E`lektronnaya citoximiya Pod red. N.T.Rajxlina, Perevod na russkij yazy`k izd-va Mir. 1974. 488 s.

14. Korablyeva TR, Senchuk IV, Ageeva EE. Modification of the Method for Determining Myeloperoxidase in Blood Neutrophils. KnE Life Sciences. 2021;298-304.

15. Filatov O.Yu., Nazarov V.A // Patogenez. – 2020. – T.18, № 4. – S. 4-15.

16. Notarangelo LD, Uzel G, Rao VK. Primary immunodeficiencies: novel genes and unusual presentations. Hematology 2014, the American Society of Hematology Education Program Book. 2019;1:443-448.

17. Pal’chun V.T., Kryukov A.I., Gurov A.V., Dubovaya T.K., Ermolaev A.G. // Meditsinskiy sovet. – 2020. –№16. –S.150-159.

18. Maslov A.K., Yushchenko A.A. // Vestnik novykh meditsinskikh tekhnologiy. – 2009. – Т. ХVI, № 2 – S. 223-225.

19. Prince M, Masuda T, Wheeler MA, et al. Microglia and macrophages associated with the central nervous system – from the origin to the modulation of the disease. Annual Review of Immunology. 2021;39:251-277.