Журнал инфектологии (Jan 2024)
Prediction of the risk of recurrence of the leprosy process
Abstract
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.
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