Leprosy Mailing List – February 26th, 2011
Ref: Summary of the published reports on the use of cyclosporine
From: Scollard D., Baton Rouge , LA , USA
Salvatore,
In response to Antonio’s question, here is a summary of the published reports on the use of cyclosporine from our review in 2006. The references for its use in ENL are given below the table.
Best wishes,
David
David M. Scollard, M.D., Ph.D.
Chief, Clinical Branch
National Hansen’s Disease Programs
Tel: 225-756-3713
FAX: 225-756-3819
e-mail: DScollard@hrsa.gov
Web: www.hrsa.gov/hansens
Source:
CLINICAL MICROBIOLOGY REVIEWS, Apr. 2006, p. 338–381 Vol. 19, No. 2. .338–381, 2006
The Continuing Challenges of Leprosy
D. M. Scollard,* L. B. Adams, T. P. Gillis, J. L. Krahenbuhl, R. W. Truman, and D. L. Williams
Laboratory Research Branch, National Hansen’s Disease Programs,
Louisiana State University-SVM, Baton Rouge , Louisiana 70803
Table 8. Effects of Immunosuppressive Agents on Leprosy Reactions.
Agent | Primary Mechanisms of Action | Effect on Type 1 Reaction | Effect on Type 2 Reaction |
Thalidomide | Multiple dose-related mechanisms: inhibits TNF, stimulates IL-2, inhibits IgM response (333, 362) | 0 (166) | ++++ (275, 276, 367, 404) |
Methotrexate | Anti-metabolite inhibiting lymphoid and myeloid proliferation (56) | nd a | ++ (202) |
Cyclosporin A | Inhibits IL-2 and other cytokines (27, 147, 211, 250) | ++ (64. 116, 421) | +/- (226, 261, 283, 418, 421) |
Azathioprine | Purine antagonist; inhibits lymphocyte proliferation; exact mechanism unknown (27, 147) | +b (246) | + b (243) |
Pentoxifylline | Inhibits TNF and other cytokines (321, 395) | +/- (82, 275) | +/- (82, 276, 287, 331) |
Mycophenolate mofetil | Blocks guanosine nucleotides, inhibiting proliferation of T- and B-cells (27, 147) | nd a | 0 (47) |
Corticosteroids | Blocks transcription factors AP-1 and NF6B; Inhibit synthesis of many pro-inflammatory cytokines (203, 341) | ++++ (283) | +++ (276) |
- nd = no data available
- Effect observed only in combination with prednisolone
(References are enclosed in parentheses)
Kumar, B., S. Dogra, and I. Kaur. 2004. Epidemiological characteristics of leprosy reactions: 15 years experience from north India . Int J Lepr Other Mycobact Dis72:125-33.
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