Leprosy Mailing List – August 2, 2015
Ref.: (LML) Smoking and leprosy
From: PK Das, Birmingham, UK
Dear Pieter,
I have noticed an email from Cairns Smith (LML, 31-07-2015), attributing the role of "nicotine" to "immune suppression as the cause of poor wound healing and "a neuro degenerative effect". In the context of the latter Cairns goes as far as concluding that ”the damaging neuronal development both in adults and children that have an effect in leprosy".
With due respect to Cairns, my suggestion is that such "blanketed" concluding remarks should be taken with a pinch of salt. i.e. caution ( although I am aware that Cairns is regarded as living "God Father" in leprosy). As a tiny and frustrated ageing bio-scientist (in the field of leprosy immunopathology, as a limited fashion), I would like to point out that the mechanistic of the effect of Nicotine either in the context of immune suppression and wound healing is not that simplistic as Cairns appear to depict.
Principal studies on the effect of Nicotine were carried out in Cancer metastasis, bone fracture, in in vitro cultured fibroblasts (gingiva) as wound healing model (not a true model) and in cell migration /recruitment. Since it is now well recognised that for effective wound healing a robust recruitment of inflammatory cells (led by macrophage subsets) at the site of wound is a pre-requisite. Indeed Nicotine inhibits such recruitment and thus delays the wound healing. It is therefore expected that heavy smokers among leprosy patients may face to an extra complexity in suffering in the form of ulceration due to delayed wound healing.
Rationally, I would not expect any association between smoking and susceptibility per se to leprosy.
One more point, I would like to state that in my old age I take a special interest on "Nicotinic acetylcholine receptor"(my ancient research on these receptors at least for bed time reading), because one of my close and late Italian friend (successful singer) who was a heavy smoker had to have his both legs amputated, because his traumatised leg bones slowly degenerated due to lack of healing by localised Nicotine deposit. The moral of the story is that leprosy literature is full of personalised enigmatic theories, although they originated sincerely from respective experiences , and one should be aware of it.
Regards to these experts,
Pran
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
 | This email has been checked for viruses by Avast antivirus software. |
No comments:
Post a Comment