The relationship between transforming growth factor-β with erythema nodosum leprosum recurring events based on immunoglobulin M anti-phenolic glycolipid-1 and cortisol

Muhammad Syafei Hamzah



Objective To examine the relationship between transforming growth factor (TGF)-β with recurrent erythema nodosum leprosum (ENL) based on the anti-phenolic glycolipid (PGL)-1 IgM antibody and cortisol in leprosy patients.


Methods This research included 44 patients of leprosy MB type; 22 leprosy patients with recurrent ENL reactions as subjects and 22 patients with nonrecurring reaction as controls. We examined the serum levels of TGF-β by ELISA using Human TGF-β Bio legend kit (USA), anti-PGL-1 IgM antibody with the Laboratory of Leprosy Institute of Tropical Disease kit, Airlangga University Surabaya, and cortisol using Stress Xpress Cortisol EIA kit (StressMarq Canada).


Results There were 22 subjects with recurrent ENL reaction (16 male, 6 female, mean age 34.9 year). Mean TGF-β was 62.6 ± 30.4 pg/ml, the IgM anti PGL-1 was 2029 ±1687 µg/ml, and the cortisol was 6.61 ± 1.99 µg/dl, and 22 subjects nonrecurring reaction as controls (15 male, 7 female, mean age 47 year) the mean of TGF-β level was 47.2 ± 23 pg/ml, anti PGL-1 IgM antibody was 629 ±1043 µg/ml and the cortisol was 5.07 ± 2.01 µg/dl. The t-independent statistic test the influence of leprosy MB type group to the recurrent ENL reaction and the un-recurrent ENL patients to TGF-β, IgM anti-PGL-1 and cortisol had p value = 0.015, 0.001 and 0.035 (p <0.05), respectively implying significant difference between subjects and controls. The result of logistic binary test of TGF-β, IgM anti-PGL-1 and cortisol was 0.25, 0.016 and 0.771. This means that IgM anti-PGL-1 has correlation as variable of TGF-β with recurrent ENL.


Conclusion There was significant difference between the levels of TGF-β, anti-PGL-1 IgM antibody and cortisol in leprosy patients with the recurrent ENL reaction and those with nonrecurring ENL reaction. There was a correlation between the levels of TGF-β with recurrent ENL based on the IgM anti-PGL-1. The increasing levels of TGF-β and IgM anti-PGL-1 level on patients with leprosy MB type can be a predictor of the recurrent reaction.



ENL, TGF-β, IgM anti-PGL-1, cortisol, leprosy, erythema nodosum leprosum

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