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Am. J. Trop. Med. Hyg., 74(6), 2006, pp. 1076-1077
Copyright © 2006 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


CYCLOOXYGENASE 2 EXPRESSION IN VESSELS AND NERVES IN REVERSAL REACTION LEPROSY

CARLO PESCE*, MYRIAM GRATTAROLA, STEFANO MENINI, AND PAOLO FIALLO
DISTBIMO, University of Genoa Medical School, Genoa, Italy; DISSAL, University of Genoa Medical School, Genoa, Italy

 

ABSTRACT

Tissue expression of cyclooxygenase (COX)2, an inducible enzyme synthesizing eicosanoids in inflammation, was studied in reversal reaction (RR) leprosy in comparison with nonreactionary leprosy. COX2 was consistently expressed in cells of the mononuclear-macrophage lineage across the leprosy spectrum. Only in RR, the following two additional sites showed COX2 expression in the dermis and subcutis: 1) microvessels and 2) nerve bundles and isolated nerve fibers. The same sites also express vascular endothelial growth factor (VEGF). This is in keeping with experimental models relating VEGF to COX2 expression, with VEGF enhancing prostaglandin production through COX2 stimulation and prostaglandin synthase expression. We postulate that selective COX2 inhibitors, which are currently used in several inflammatory conditions, could be considered for RR treatment to reduce acute symptoms caused by tissue edema and possibly prevent long-term nerve damage, the main complication of RR.

Received November 14, 2005. Accepted for publication February 19, 2006.

* Address correspondence to Carlo Pesce, DISTBIMO, University of Genoa Medical School, Largo Benzi 10, Pad. IV, 16132 Genova, Italy. E-mail: pesce{at}unige.it

Note: Supplemental figures of non-reactional BT leprosy can be found online at www.ajtmh.org.

Authors’ addresses: Carlo Pesce, Myriam Grattarola, and Stefano Menini, DISTBIMO, University of Genoa Medical School, Largo Benzi 10, Pad. IV, 16132 Genova, Italy, E-mails: pesce{at}unige.it, mygrattarola{at}yahoo.it, and meninistefano{at}tin.it; Paolo Fiallo, Sezione di Dermatologia Sociale, DISSAL, University of Genoa Medical School, Viale Benedetto XV 7, 16132 Genova, Italy, E-mail: paolo.fiallo{at}hsanmartino.liguria.it.

Reprint requests: Carlo Pesce, DISTBIMO, University of Genoa Medical School, Largo Benzi 10, Pad. IV, 16132 Genova, Italy. E-mail: pesce{at}unige.it.




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Copyright © 2006 by the American Society of Tropical Medicine and Hygiene.