logging in or signing up UPUPDATES IN THE PATHOPHYSIOLOGY OF LEPROSY doczay Download Post to : URL : Related Presentations : Let's Connect Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 1045 Category: Education License: All Rights Reserved Like it (0) Dislike it (0) Added: March 13, 2012 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript UPDATES IN THE PATHOPHYSIOLOGY OF LEPROSY: UPDATES IN THE PATHOPHYSIOLOGY OF LEPROSY DR.MUHAMMAD UZAIR KHAN WAZIRINTRODUCTION: INTRODUCTION Chronic Granulomatous Disease Mycobacterium leprae Affecting peripheral nerves and skin Discovered by Armauer Hansen in 1873 MYCOBACTERIUM LEPRAE: MYCOBACTERIUM LEPRAE Slow growing acid fast Rods No in-vitro cultivation First bacterium disease in humans Humans and Armadillos are only known natural hosts Pathophysiology: Pathophysiology Incubation period 6 months to 40 years or longer Average incubation period 2-5 years for tuberculoid leprosy, 8-12 years for lepromatous leprosy Affinity for macrophages and Schwann cellsCONT…: CONT… TLR2/1 recognise leprae lipoproteins Monocytes differentiate into macrophages & dendritic cell IL-12 & IL-2 production T lympocytes , expansion of a/b CD8 & natural killer cells INF لا- stimulates bactericidal mechanismsCONT…: CONT… Low Immunity Clonal anergy or active suppression of T-cells Defective or low production of IL-2 Defective Macrophage antigen recognition, presentation & KillingCONT…: CONT… NERVE DAMAGE Activation of TLR2 & TLR1 on schwaan cells Bind to G domain of the alpha-chain of laminin 2 in the basal lamina. CMI activation Apoptosis Activation of the ErbB2 receptor tyrosine kinaseCONT…: CONT… Expression of Cell Mediated Immunity Extant of Bacillary spread and multiplication Appearance of Immunological complications Nerve damage and its complicationsExtant of Bacillary spread & multiplication : Extant of Bacillary spread & multiplication Lepromatous Leprosy Spread to superficial & cool sites Eyes, Upper Respiratory mucosa, Testes, small muscles and bones of hand, feet & face, peripheral nerves & skin Tuberculoid Leprosy Bacilliary multiplication restricted No bacilli foundImmunological complications: Immunological complications TYPE I REACTION Upgrading and reversal reaction During 1 st 6 months Overproduction of Th1 –type cytokines Severe nerve damage Erythematous , red, raised, shinny, warm Immunological Complications…: Immunological Complications… ENL Inc. Th2 response Circulating immune complexes Immunoglobulins and complement in the lesion Increase T-cell response, inc. CD4 cells Inc. IL-2 receptors, IL-6 & TNF-aRecent Advances: Recent Advances Live bacilli suppresses DC and T-cell interaction TLR2/1 activated by Th-1 reaction, Th2 inhibits activation Helminthic co-infection and leprosy Inc. Th2 response & suppresses Th1 type immunity Dec. level of INF- لا , two fold inc. in IL-4 & IL-10 Facilitate leprae inf. Or progression to severe formCont…: Cont… Association with HLA (HLA-DRB1 & HLA-DQA) A fame shift mutation in NOD2 gene, having predisposition to Crohn’s diseaseTHANK YOU : THANK YOULeprosy (Hansen’s Disease) : Leprosy (Hansen’s Disease) You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.