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Structural and functional changes in the microcirculation of lepromatous leprosy patients - Observation using orthogonal polarization spectral imaging and laser Doppler flowmetry iontophoresis.

Abstract Leprosy is a chronic granulomatous infection of skin and peripheral nerves caused by Mycobacterium leprae and is considered the main infectious cause of disability worldwide. Despite the several studies regarding leprosy, little is known about its effects on microvascular structure and function in vivo. Thus, we have aimed to compare skin capillary structure and functional density, cutaneous vasomotion (spontaneous oscillations of arteriolar diameter), which ensures optimal blood flow distribution to skin capillaries) and cutaneous microvascular blood flow and reactivity between ten men with lepromatous leprosy (without any other comorbidity) and ten age- and gender-matched healthy controls. Orthogonal polarization spectral imaging was used to evaluate skin capillary morphology and functional density and laser Doppler flowmetry to evaluate blood flow, vasomotion and spectral analysis of flowmotion (oscillations of blood flow generated by vasomotion) and microvascular reactivity, in response to iontophoresis of acetylcholine and sodium nitroprusside. The contribution of different frequency components of flowmotion (endothelial, neurogenic, myogenic, respiratory and cardiac) was not statistically different between groups. However, endothelial-dependent and -independent vasodilatations elicited by acetylcholine and sodium nitroprusside iontophoresis, respectively, were significantly reduced in lepromatous leprosy patients compared to controls, characterizing the existence of microvascular dysfunction. These patients also presented a significant increase in the number of capillaries with morphological abnormalities and in the diameters of the dermal papilla and capillary bulk when compared to controls. Our results suggest that lepromatous leprosy causes severe microvascular dysfunction and significant alterations in capillary structure. These structural and functional changes are probably induced by exposure of the microvascular bed to chronic inflammation evoked by the Mycobacterium leprae.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title plos one
Publication Year Start




PMID- 28419120
OWN - NLM
STAT- In-Process
DA  - 20170418
LR  - 20170418
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 4
DP  - 2017
TI  - Structural and functional changes in the microcirculation of lepromatous leprosy 
      patients - Observation using orthogonal polarization spectral imaging and laser
      Doppler flowmetry iontophoresis.
PG  - e0175743
LID - 10.1371/journal.pone.0175743 [doi]
AB  - Leprosy is a chronic granulomatous infection of skin and peripheral nerves caused
      by Mycobacterium leprae and is considered the main infectious cause of disability
      worldwide. Despite the several studies regarding leprosy, little is known about
      its effects on microvascular structure and function in vivo. Thus, we have aimed 
      to compare skin capillary structure and functional density, cutaneous vasomotion 
      (spontaneous oscillations of arteriolar diameter), which ensures optimal blood
      flow distribution to skin capillaries) and cutaneous microvascular blood flow and
      reactivity between ten men with lepromatous leprosy (without any other
      comorbidity) and ten age- and gender-matched healthy controls. Orthogonal
      polarization spectral imaging was used to evaluate skin capillary morphology and 
      functional density and laser Doppler flowmetry to evaluate blood flow, vasomotion
      and spectral analysis of flowmotion (oscillations of blood flow generated by
      vasomotion) and microvascular reactivity, in response to iontophoresis of
      acetylcholine and sodium nitroprusside. The contribution of different frequency
      components of flowmotion (endothelial, neurogenic, myogenic, respiratory and
      cardiac) was not statistically different between groups. However,
      endothelial-dependent and -independent vasodilatations elicited by acetylcholine 
      and sodium nitroprusside iontophoresis, respectively, were significantly reduced 
      in lepromatous leprosy patients compared to controls, characterizing the
      existence of microvascular dysfunction. These patients also presented a
      significant increase in the number of capillaries with morphological
      abnormalities and in the diameters of the dermal papilla and capillary bulk when 
      compared to controls. Our results suggest that lepromatous leprosy causes severe 
      microvascular dysfunction and significant alterations in capillary structure.
      These structural and functional changes are probably induced by exposure of the
      microvascular bed to chronic inflammation evoked by the Mycobacterium leprae.
FAU - Treu, Curt
AU  - Treu C
AD  - Laboratorio de Pesquisas Clinicas e Experimentais em Biologia Vascular, Centro
      Biomedico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio
      de Janeiro, Brazil.
FAU - de Souza, Maria das Gracas Coelho
AU  - de Souza MDGC
AD  - Laboratorio de Pesquisas Clinicas e Experimentais em Biologia Vascular, Centro
      Biomedico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio
      de Janeiro, Brazil.
FAU - Lupi, Omar
AU  - Lupi O
AD  - Departamento de Dermatologia, Universidade Federal do Estado do Rio de Janeiro
      (Uni-Rio), Rio de Janeiro, Rio de Janeiro, Brazil.
FAU - Sicuro, Fernando Lencastre
AU  - Sicuro FL
AD  - Laboratorio de Pesquisas Clinicas e Experimentais em Biologia Vascular, Centro
      Biomedico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio
      de Janeiro, Brazil.
FAU - Maranhao, Priscila Alves
AU  - Maranhao PA
AD  - Laboratorio de Pesquisas Clinicas e Experimentais em Biologia Vascular, Centro
      Biomedico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio
      de Janeiro, Brazil.
FAU - Kraemer-Aguiar, Luiz Guilherme
AU  - Kraemer-Aguiar LG
AD  - Laboratorio de Pesquisas Clinicas e Experimentais em Biologia Vascular, Centro
      Biomedico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio
      de Janeiro, Brazil.
AD  - Ambulatorio de Obesidade, Policlinica Piquet Carneiro, Departamento de Medicina
      Interna, Faculdade de Ciencias Medicas, Centro Biomedico, Universidade do Estado 
      do Rio de Janeiro, Rio de Janeiro, Brazil.
FAU - Bouskela, Eliete
AU  - Bouskela E
AD  - Laboratorio de Pesquisas Clinicas e Experimentais em Biologia Vascular, Centro
      Biomedico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio
      de Janeiro, Brazil.
LA  - eng
PT  - Journal Article
DEP - 20170418
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
EDAT- 2017/04/19 06:00
MHDA- 2017/04/19 06:00
CRDT- 2017/04/19 06:00
PHST- 2016/10/28 [received]
PHST- 2017/03/30 [accepted]
AID - 10.1371/journal.pone.0175743 [doi]
AID - PONE-D-16-40126 [pii]
PST - epublish
SO  - PLoS One. 2017 Apr 18;12(4):e0175743. doi: 10.1371/journal.pone.0175743.
      eCollection 2017.

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