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NFκB activation in cutaneous lesions of leprosy is associated with development of multibacillary infection

Identifieur interne : 006B43 ( Ncbi/Merge ); précédent : 006B42; suivant : 006B44

NFκB activation in cutaneous lesions of leprosy is associated with development of multibacillary infection

Auteurs : Carlos G. Wambier [Brésil] ; Leandra Naira Z. Ramalho [Brésil] ; Marco Andrey C. Frade [Brésil] ; Norma T. Foss [Brésil]

Source :

RBID : PMC:4173660

Abstract

Background

Nuclear factor kappa B (NFκB) transcription factors play a central role in controlling the expression of genes involved in inflammatory reactions, proliferation, and survival of human cells. However, the in situ evaluation of NFκB activity in leprosy has not been completed previously. The aim of this study was to determine whether NFκB activity correlates with susceptibility or resistance to Mycobacterium leprae infection in biopsies from skin lesions of 38 patients with the clinical and laboratory diagnosis of leprosy.

Methods

The NFκB activation profile was evaluated in biopsies from skin lesions of 38 patients with the clinical and laboratory diagnosis of leprosy. NFκB activation was evaluated and quantified by Southwestern histochemistry, and its activation index (range, 0–4) was calculated according to the percentage of nuclear positivity by the histochemistry. Activation index >1 was considered representative of activation of NFκB.

Results

Fifteen patients (39.5%) demonstrated activated NFκB. Multibacillary leprosy was associated with activated NFκB (54.5%, P=0.028). Borderline leprosy was most strongly associated with NFκB activation (80%), with an odds ratio of 32.7 (P=0.016). These clinical forms are characterized by increased susceptibility to M. leprae and by immunological instability. Activation of NFκB was absent in the granulomas in tuberculoid leprosy, which represents an effective inflammatory reaction pattern against M. leprae.

Conclusion

These results indicate that NFκB activation could favor susceptibility and immunological instability to M. leprae infection, potentially by the stimulation of phagocytosis and the regulation of apoptotic mechanisms of infected cells, leading to the proliferation of this intracellular bacillus. Further studies are needed to evaluate if inhibition of NFκB activation in multibacillary leprosy could favor resistance and an effective granulomatous immune response.


Url:
DOI: 10.2147/JIR.S62562
PubMed: 25258550
PubMed Central: 4173660

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PMC:4173660

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<title>Methods</title>
<p>The NFκB activation profile was evaluated in biopsies from skin lesions of 38 patients with the clinical and laboratory diagnosis of leprosy. NFκB activation was evaluated and quantified by Southwestern histochemistry, and its activation index (range, 0–4) was calculated according to the percentage of nuclear positivity by the histochemistry. Activation index >1 was considered representative of activation of NFκB.</p>
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<p>Fifteen patients (39.5%) demonstrated activated NFκB. Multibacillary leprosy was associated with activated NFκB (54.5%,
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=0.028). Borderline leprosy was most strongly associated with NFκB activation (80%), with an odds ratio of 32.7 (
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<italic>M. leprae</italic>
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<italic>M. leprae</italic>
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<p>These results indicate that NFκB activation could favor susceptibility and immunological instability to
<italic>M. leprae</italic>
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<journal-id journal-id-type="nlm-ta">J Inflamm Res</journal-id>
<journal-id journal-id-type="iso-abbrev">J Inflamm Res</journal-id>
<journal-id journal-id-type="publisher-id">Journal of Inflammation Research</journal-id>
<journal-title-group>
<journal-title>Journal of Inflammation Research</journal-title>
</journal-title-group>
<issn pub-type="epub">1178-7031</issn>
<publisher>
<publisher-name>Dove Medical Press</publisher-name>
</publisher>
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<article-id pub-id-type="pmid">25258550</article-id>
<article-id pub-id-type="pmc">4173660</article-id>
<article-id pub-id-type="doi">10.2147/JIR.S62562</article-id>
<article-id pub-id-type="publisher-id">jir-7-133</article-id>
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<subj-group subj-group-type="heading">
<subject>Original Research</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>NFκB activation in cutaneous lesions of leprosy is associated with development of multibacillary infection</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Wambier</surname>
<given-names>Carlos G</given-names>
</name>
<xref ref-type="aff" rid="af1-jir-7-133">1</xref>
<xref ref-type="corresp" rid="c1-jir-7-133"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Ramalho</surname>
<given-names>Leandra Naira Z</given-names>
</name>
<xref ref-type="aff" rid="af2-jir-7-133">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Frade</surname>
<given-names>Marco Andrey C</given-names>
</name>
<xref ref-type="aff" rid="af1-jir-7-133">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Foss</surname>
<given-names>Norma T</given-names>
</name>
<xref ref-type="aff" rid="af1-jir-7-133">1</xref>
</contrib>
</contrib-group>
<aff id="af1-jir-7-133">
<label>1</label>
Division of Dermatology, Department of Internal Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil</aff>
<aff id="af2-jir-7-133">
<label>2</label>
Department of Pathology, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil</aff>
<author-notes>
<corresp id="c1-jir-7-133">Correspondence: Carlos G Wambier, Division of Dermatology, Department of Internal Medicine, Hospital of Clinics, Ribeirão Preto School of Medicine, University of São Paulo, Avenue Bandeirantes 3900, 4th floor, Ribeirão Preto, São Paulo, Brazil, 14048-900, Tel/Fax +55 16 3602 2447, Email
<email>cwambier@usp.br</email>
</corresp>
</author-notes>
<pub-date pub-type="collection">
<year>2014</year>
</pub-date>
<pub-date pub-type="epub">
<day>25</day>
<month>8</month>
<year>2014</year>
</pub-date>
<volume>7</volume>
<fpage>133</fpage>
<lpage>138</lpage>
<permissions>
<copyright-statement>© 2014 Wambier et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License</copyright-statement>
<copyright-year>2014</copyright-year>
<license>
<license-p>The full terms of the License are available at
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.</license-p>
</license>
</permissions>
<abstract>
<sec>
<title>Background</title>
<p>Nuclear factor kappa B (NFκB) transcription factors play a central role in controlling the expression of genes involved in inflammatory reactions, proliferation, and survival of human cells. However, the in situ evaluation of NFκB activity in leprosy has not been completed previously. The aim of this study was to determine whether NFκB activity correlates with susceptibility or resistance to
<italic>Mycobacterium leprae</italic>
infection in biopsies from skin lesions of 38 patients with the clinical and laboratory diagnosis of leprosy.</p>
</sec>
<sec>
<title>Methods</title>
<p>The NFκB activation profile was evaluated in biopsies from skin lesions of 38 patients with the clinical and laboratory diagnosis of leprosy. NFκB activation was evaluated and quantified by Southwestern histochemistry, and its activation index (range, 0–4) was calculated according to the percentage of nuclear positivity by the histochemistry. Activation index >1 was considered representative of activation of NFκB.</p>
</sec>
<sec>
<title>Results</title>
<p>Fifteen patients (39.5%) demonstrated activated NFκB. Multibacillary leprosy was associated with activated NFκB (54.5%,
<italic>P</italic>
=0.028). Borderline leprosy was most strongly associated with NFκB activation (80%), with an odds ratio of 32.7 (
<italic>P</italic>
=0.016). These clinical forms are characterized by increased susceptibility to
<italic>M. leprae</italic>
and by immunological instability. Activation of NFκB was absent in the granulomas in tuberculoid leprosy, which represents an effective inflammatory reaction pattern against
<italic>M. leprae</italic>
.</p>
</sec>
<sec>
<title>Conclusion</title>
<p>These results indicate that NFκB activation could favor susceptibility and immunological instability to
<italic>M. leprae</italic>
infection, potentially by the stimulation of phagocytosis and the regulation of apoptotic mechanisms of infected cells, leading to the proliferation of this intracellular bacillus. Further studies are needed to evaluate if inhibition of NFκB activation in multibacillary leprosy could favor resistance and an effective granulomatous immune response.</p>
</sec>
</abstract>
<kwd-group>
<title>Keywords</title>
<kwd>transcription factors</kwd>
<kwd>nuclear factor kappa B</kwd>
<kwd>immunomodulation</kwd>
<kwd>
<italic>Mycobacterium leprae</italic>
</kwd>
<kwd>leprosy resistance</kwd>
<kwd>leprosy susceptibility</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group>
<fig id="f1-jir-7-133" position="float">
<label>Figure 1</label>
<caption>
<p>Representative photomicrographs of skin biopsies submitted for Southwestern histochemistry for detection of activated NFκB (original magnification 200×).</p>
<p>
<bold>Notes:</bold>
Arrows demonstrate purple nuclear staining. Detection was quantified by an NFκB activation index, which values ranged from zero to four. (
<bold>A</bold>
) NFκB activation index of 0: no nuclear staining (negative control); (
<bold>B</bold>
) NFκB activation index of 1: up to 10% nuclear staining in sparse lymphocytes from a tuberculoid lesion; (
<bold>C</bold>
) NFκB activation index of 2: 11%–25% nuclear staining in cells from a superficial lymphohistiocytic infiltrate and fibroblasts (arrows) from a borderline tuberculoid lesion; (
<bold>D</bold>
) NFκB activation index of 3: 26%–50% nuclear staining in cells from a perivascular and perineural inflammatory infiltrate, involving the superficial and mid dermis. There was staining of histiocytes, lymphocytes, fibroblasts, and vascular endothelium (arrow tip) from a lepromatous lesion; (
<bold>E</bold>
) NFκB activation index of 4: >50% nuclear staining in cells from a dense perineural and perivascular inflammatory infiltrate. There was staining of fibroblasts, histiocytes, and lymphocytes from a borderline lesion.</p>
<p>
<bold>Abbreviation:</bold>
NFκB, nuclear factor kappa B.</p>
</caption>
<graphic xlink:href="jir-7-133Fig1"></graphic>
</fig>
<table-wrap id="t1-jir-7-133" position="float">
<label>Table 1</label>
<caption>
<p>Data from 38 leprosy patients evaluated for activation of NFκB</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top" rowspan="1" colspan="1"></th>
<th align="left" valign="top" rowspan="1" colspan="1">n (%)</th>
<th align="left" valign="top" rowspan="1" colspan="1">NFκB index median (range)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Activated NFκB n (%)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Fisher’s exact
<italic>P</italic>
-value</th>
</tr>
</thead>
<tbody>
<tr>
<td colspan="5" align="left" valign="top" rowspan="1">Age group</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> <18 years</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (10.5)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (0–2)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (25.0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.480</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> 18–60 years</td>
<td align="left" valign="top" rowspan="1" colspan="1">22 (57.9)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (0–3)</td>
<td align="left" valign="top" rowspan="1" colspan="1">6 (27.3)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.071</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> >60 years</td>
<td align="left" valign="top" rowspan="1" colspan="1">12 (31.6)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2 (0–4)</td>
<td align="left" valign="top" rowspan="1" colspan="1">8 (66.7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.025
<xref ref-type="table-fn" rid="tfn1-jir-7-133">*</xref>
</td>
</tr>
<tr>
<td colspan="5" align="left" valign="top" rowspan="1">Sex</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Male</td>
<td align="left" valign="top" rowspan="1" colspan="1">22 (57.9)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1.5 (0–3)</td>
<td align="left" valign="top" rowspan="1" colspan="1">11 (50)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.11</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Female</td>
<td align="left" valign="top" rowspan="1" colspan="1">16 (42.1)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (0–4)</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (25)</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" align="left" valign="top" rowspan="1">Leprosy classification</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Tuberculoid</td>
<td align="left" valign="top" rowspan="1" colspan="1">7 (18.4)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (0–1)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0.0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.019
<xref ref-type="table-fn" rid="tfn1-jir-7-133">*</xref>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Borderline tuberculoid</td>
<td align="left" valign="top" rowspan="1" colspan="1">9 (23.7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (0–2)</td>
<td align="left" valign="top" rowspan="1" colspan="1">3 (33.3)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.490</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Borderline</td>
<td align="left" valign="top" rowspan="1" colspan="1">5 (13.2)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2 (1–4)</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (80.0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.069</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Borderline lepromatous</td>
<td align="left" valign="top" rowspan="1" colspan="1">8 (21.1)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1.5 (1–3)</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (50.0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.385</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Lepromatous</td>
<td align="left" valign="top" rowspan="1" colspan="1">9 (23.7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (0–3)</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (44.4)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.510</td>
</tr>
<tr>
<td colspan="5" align="left" valign="top" rowspan="1">WHO classification</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Multibacillary</td>
<td align="left" valign="top" rowspan="1" colspan="1">22 (57.9)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2 (0–4)</td>
<td align="left" valign="top" rowspan="1" colspan="1">12 (54.5)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.028
<xref ref-type="table-fn" rid="tfn1-jir-7-133">*</xref>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Paucibacillary</td>
<td align="left" valign="top" rowspan="1" colspan="1">16 (42.1)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (0–2)</td>
<td align="left" valign="top" rowspan="1" colspan="1">3 (18.8)</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" align="left" valign="top" rowspan="1">Biopsy acid-fast bacilli (Fite–Faraco stain)</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Present</td>
<td align="left" valign="top" rowspan="1" colspan="1">29 (76.3)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (0–4)</td>
<td align="left" valign="top" rowspan="1" colspan="1">13 (44.8)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.208</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Absent</td>
<td align="left" valign="top" rowspan="1" colspan="1">9 (23.7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (0–2)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2 (22.2)</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">Total</td>
<td align="left" valign="top" rowspan="1" colspan="1">38 (100.0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (0–4)</td>
<td align="left" valign="top" rowspan="1" colspan="1">15 (39.5)</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>
<bold>Note:</bold>
</p>
</fn>
<fn id="tfn1-jir-7-133">
<label>*</label>
<p>
<italic>P</italic>
<0.05.</p>
</fn>
<fn id="tfn2-jir-7-133">
<p>
<bold>Abbreviations:</bold>
n, number of patients; NFκB, nuclear factor kappa B; WHO, World Health Organization.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="t2-jir-7-133" position="float">
<label>Table 2</label>
<caption>
<p>Logistic regression analysis of activated NFκB according to leprosy classification, adjusted by age group and sex</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top" rowspan="1" colspan="1"></th>
<th align="left" valign="top" rowspan="1" colspan="1">Activated NFκB n (%)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Odds ratio</th>
<th align="left" valign="top" rowspan="1" colspan="1">95% CI</th>
<th align="left" valign="top" rowspan="1" colspan="1">
<italic>P</italic>
-value</th>
</tr>
</thead>
<tbody>
<tr>
<td colspan="5" align="left" valign="top" rowspan="1">Age group</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> <18 years</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (25.0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> 18–60 years</td>
<td align="left" valign="top" rowspan="1" colspan="1">6 (27.3)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.12</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.01–3.06</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.205</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> >60 years</td>
<td align="left" valign="top" rowspan="1" colspan="1">8 (66.7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1.20</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.06–25.34</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.905</td>
</tr>
<tr>
<td colspan="5" align="left" valign="top" rowspan="1">Sex</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Male</td>
<td align="left" valign="top" rowspan="1" colspan="1">11 (50)</td>
<td align="left" valign="top" rowspan="1" colspan="1">4.53</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.64–32.03</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.129</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Female</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (25)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" align="left" valign="top" rowspan="1">Leprosy classification</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Tuberculoid or borderline tuberculoid</td>
<td align="left" valign="top" rowspan="1" colspan="1">3 (33.3)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1</td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
<td align="left" valign="top" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Borderline</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (80.0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">32.70</td>
<td align="left" valign="top" rowspan="1" colspan="1">1.92–557.49</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.016
<xref ref-type="table-fn" rid="tfn3-jir-7-133">*</xref>
</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Borderline lepromatous</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (50.0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">4.86</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.47–50.21</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.185</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Lepromatous</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (44.4)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1.77</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.20–15.83</td>
<td align="left" valign="top" rowspan="1" colspan="1">0.608</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>
<bold>Note:</bold>
</p>
</fn>
<fn id="tfn3-jir-7-133">
<label>*</label>
<p>
<italic>P</italic>
<0.05.</p>
</fn>
<fn id="tfn4-jir-7-133">
<p>
<bold>Abbreviations:</bold>
CI, confidence interval; NFκB, nuclear factor kappa B; n, number of patients.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="t3-jir-7-133" position="float">
<label>Table 3</label>
<caption>
<p>Distribution of NFκB activation indexes by leprosy classification and WHO classification</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top" rowspan="2" colspan="1">Leprosy classification</th>
<th colspan="6" align="left" valign="top" rowspan="1">NFκB activation indexes
<hr></hr>
</th>
</tr>
<tr>
<th align="left" valign="top" rowspan="1" colspan="1">0
<break></break>
n (%)</th>
<th align="left" valign="top" rowspan="1" colspan="1">1
<break></break>
n (%)</th>
<th align="left" valign="top" rowspan="1" colspan="1">2
<break></break>
n (%)</th>
<th align="left" valign="top" rowspan="1" colspan="1">3
<break></break>
n (%)</th>
<th align="left" valign="top" rowspan="1" colspan="1">4
<break></break>
n (%)</th>
<th align="left" valign="top" rowspan="1" colspan="1">Activated NFκB (>1)
<break></break>
n (%)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">Tuberculoid (n=7)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (14)</td>
<td align="left" valign="top" rowspan="1" colspan="1">6 (86)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0)</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">Borderline tuberculoid (n=9)</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (44)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2 (22)</td>
<td align="left" valign="top" rowspan="1" colspan="1">3 (33)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">3 (33)</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">Borderline (n=5)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (20)</td>
<td align="left" valign="top" rowspan="1" colspan="1">2 (40)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (20)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (20)</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (80)</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">Borderline lepromatous (n=8)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (50)</td>
<td align="left" valign="top" rowspan="1" colspan="1">3 (38)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (13)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (50)</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1">Lepromatous (n=9)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (11)</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (44)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (11)</td>
<td align="left" valign="top" rowspan="1" colspan="1">3 (33)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">4 (44)</td>
</tr>
<tr>
<td colspan="7" align="left" valign="top" rowspan="1">WHO classification</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Paucibacillary (n=16)</td>
<td align="left" valign="top" rowspan="1" colspan="1">5 (31)</td>
<td align="left" valign="top" rowspan="1" colspan="1">8 (50)</td>
<td align="left" valign="top" rowspan="1" colspan="1">3 (19)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">0 (0)</td>
<td align="left" valign="top" rowspan="1" colspan="1">3 (19)</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="1" colspan="1"> Multibacillary (n=22)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (5)</td>
<td align="left" valign="top" rowspan="1" colspan="1">9 (41)</td>
<td align="left" valign="top" rowspan="1" colspan="1">6 (27)</td>
<td align="left" valign="top" rowspan="1" colspan="1">5 (23)</td>
<td align="left" valign="top" rowspan="1" colspan="1">1 (5)</td>
<td align="left" valign="top" rowspan="1" colspan="1">12 (55)</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn5-jir-7-133">
<p>
<bold>Abbreviations:</bold>
NFκB, nuclear factor kappa B; n, number of patients; WHO, World Health Organization.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>Brésil</li>
</country>
<region>
<li>État de São Paulo</li>
</region>
<settlement>
<li>São Paulo</li>
</settlement>
<orgName>
<li>Université de São Paulo</li>
</orgName>
</list>
<tree>
<country name="Brésil">
<region name="État de São Paulo">
<name sortKey="Wambier, Carlos G" sort="Wambier, Carlos G" uniqKey="Wambier C" first="Carlos G" last="Wambier">Carlos G. Wambier</name>
</region>
<name sortKey="Foss, Norma T" sort="Foss, Norma T" uniqKey="Foss N" first="Norma T" last="Foss">Norma T. Foss</name>
<name sortKey="Frade, Marco Andrey C" sort="Frade, Marco Andrey C" uniqKey="Frade M" first="Marco Andrey C" last="Frade">Marco Andrey C. Frade</name>
<name sortKey="Ramalho, Leandra Naira Z" sort="Ramalho, Leandra Naira Z" uniqKey="Ramalho L" first="Leandra Naira Z" last="Ramalho">Leandra Naira Z. Ramalho</name>
</country>
</tree>
</affiliations>
</record>

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HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 006B43 | SxmlIndent | more

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{{Explor lien
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