Leprosy Mailing List – January 8, 2025
Ref.: (LML) Vit D and self-healing in HD on LML
From: Ben Naafs, Munnekeburen, the Netherlands
Dear Pieter,
On January 4th Joel Almeida presented the following contribution : Vit D and self-healing in HD on LML
Self-healing without sequelae happens in 80% of all infected people because the antigens cause only temporary damage (Shetty, Antia, Pranab Das). However, these 80% cannot harbor M. leprae in their cells (macrophages, Schwann cells). This has nothing to do with Vit D.
What Almeida describes in a senior people home, happens with people working in a leprosy hospital too. (Experience from ALERT AHRI [Ethiopia]). Eighty % will never develop leprosy. For the other 20%, it is the CMI (cell-mediated immunity), depending on the environmental exposure to M. leprae antigenic determinants and the route of the infection (via nose or skin). And sure, the innate immunity has its place as well. (Here Vit D surely is a contributor).
The action of Vit D is not at all clear: it may help via the cathelicidin axis to kill intracellular microbes, but it can also increase inflammation and in this way increase damage. (The number of Vit D receptors is likely as important as is the genetic configuration of these receptors). Just having enough Vit D available is not a guarantee. Too much may even cause brain problems.
I agree drugs may lower Vit D levels as well. Half of the world's population has a Vit D deficiency. Poverty seems to be a main risk.
Indeed, live and dead bacilli have different antigenic determinants. That influences the immune reaction as well as the way of infection through the nose and the skin. Infection via the nose may give tolerance, via the skin an enhanced CMI. Antibacterial treatment does not cause a reaction (Known since the 1970th (ALERT and AHRI). It may even prevent but it may also accelerate it.
I doubt whether Vit D suppletion will indeed diminish the damage. If so, it would be a solution.
With kind regards
Ben
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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