Immunohistochemical and ultrastructural study of the microvasculature in skin lesions of leprosy patients

الملخص EN

Background / Aim : Leprosy is a chronic bacillary disease with a spectrum of cutaneous responses ranging from lepromatous to tuberculoid poles.

The inflammatory response in leprosy is intimately concerned with the microvasculature.

However, few studies were performed on the cutaneous microvaculature in leprosy.

The aim of this work is to study the microvacular changes in the skin lesions of leprosy patients immune-histochemically and ultrastructurally in order to demonstrate their possible role in dissemination of Mycobacterium leprae and the pathogenesis of the disease. Patients and methods : This study was conducted on 30 leprosy patients; 15 with lepromatous leprosy and 15 with tuberculoid leprosy.

Seven subjects were included as a control group.

For each participant, a punch skin biopsy was taken and divided into 2 equal parts that were used in the immunohistochemical study for CD34 and the ultrastructural study. Results : Immunohistochemical study for CD34 showed that the mean microvessel density in skin lesions of lepromatous leprosy patients showed statistically significant increase compared to those of tuberculoid leprosy patients (P<0.001) and the control group (P < 0.001).

There was no statistically significant difference in the mean microvessel density between tuberculoid leprosy patients and the control group.

Ultrastructurally, skin lesions of lepromatous leprosy patients showed no changes of the lining endothelial cells (EC) of the blood vessels and vascular lumina were patent.

This was in contrast to the blood vessels in skin lesions of tuberculoid leprosy patients which showed proliferation and hypertrophy of the EC and narrowing of the lumina. Conclusion : Angiogenesis is more in skin lesions of lepromatous leprosy patients compared to those of tuberculoid leprosy patients.

This may pave the way for using the angiogenesis inhibitors as an additional treatment, especially in lepromatous leprosy, to potentiate the therapeutic effect of the currently used multidrug therapy.