Indian Journal of Medical Research

ORIGINAL ARTICLE
Year
: 2015  |  Volume : 142  |  Issue : 6  |  Page : 681--689

Is CXCL10/CXCR3 axis overexpression a better indicator of leprosy type 1 reaction than inducible nitric oxide synthase?


Ira Sharma1, Avninder Singh2, Ashwani K Mishra2, LC Singh2, V Ramesh3, Sunita Saxena2 
1 National Institute of Pathology (ICMR), New Delhi; Symbiosis International University, Pune, India
2 National Institute of Pathology (ICMR), New Delhi, India
3 Department of Dermatology, Venereology & Leprology, VMMC & Safdarjung Hospital, New Delhi, India

Correspondence Address:
Avninder Singh
National Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi 110 029
India

Background & objectives: Leprosy type 1 reactions (T1R) are acute episodes of immune exacerbation that are a major cause of inflammation and nerve damage. T1R are diagnosed clinically and supported by histopathology. No laboratory marker is currently available that can accurately predict a T1R. Increased plasma and tissue expression of inducible nitric oxide synthase (i-NOS) and chemokine CXCL10 have been demonstrated in T1R. We studied the gene expression and immunoexpression of i-NOS, CXCL10 and its receptor CXCR3 in clinically and histopathologically confirmed patients with T1R and compared with non-reactional leprosy patients to understand which biomarker has better potential in distinguishing reaction from non-reaction. Methods: Gene expression of i-NOS, CXCL10 and CXCR3 was studied in 30 skin biopsies obtained from patients with borderline tuberculoid (BT), mid-borderline (BB) and borderline lepromatous (BL) leprosy with and without T1R by real-time PCR. Further validation was done by immunhistochemical expression on 60 borderline leprosy biopsies with and without T1R. Results: Of the 120 patients histopathological evaluation confirmed T1R in 65 (54.2%) patients. CXCR3 gene expression was significantly (P<0.05) higher in BT- and BB-T1R patients compared to those without T1R. The CXCL10 gene expression was significantly higher (P<0.05) in BB leprosy with T1R but the difference was not significant in patients with BT with or without T1R. Immunoexpression for CXCR3 was significant in both BB-T1R and BB (P<0.001) and BT and BT-T1R (P<0.001). Immunoexpression of CXL10 was significant only in differentiating BB from BB-T1R leprosy (P<0.01) and not the BT cases. i-NOS immunoexpression was not useful in differentiating reactional from non-reactional leprosy. Interpretation & conclusions: Both CXCL10 and CXCR3 appeared to be useful in differentiating T1R reaction in borderline leprosy while CXCR3 alone differentiated BT from BT-T1R. CXCR3 may be a potentially useful immunohistochemical marker to predict an impending T1R.


How to cite this article:
Sharma I, Singh A, Mishra AK, Singh L C, Ramesh V, Saxena S. Is CXCL10/CXCR3 axis overexpression a better indicator of leprosy type 1 reaction than inducible nitric oxide synthase?.Indian J Med Res 2015;142:681-689


How to cite this URL:
Sharma I, Singh A, Mishra AK, Singh L C, Ramesh V, Saxena S. Is CXCL10/CXCR3 axis overexpression a better indicator of leprosy type 1 reaction than inducible nitric oxide synthase?. Indian J Med Res [serial online] 2015 [cited 2020 Oct 21 ];142:681-689
Available from: https://www.ijmr.org.in/article.asp?issn=0971-5916;year=2015;volume=142;issue=6;spage=681;epage=689;aulast=Sharma;type=0