Endothelial activation is associated with albuminuria in multibacillary leprosy

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Louise Donadello Tessarolo, Gdayllon Cavalcante Meneses, Gabriela Freire Bezerra, Thaiany Pereira da Rocha, Isabella Evelyn Prado de Azevedo, Geraldo Bezerra Silva Junior, Maria Araci Andrade Pontes, Elizabeth De Francesco Daher, Alice Maria Costa Martins
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2021
• Subjects: Leprosy; Endothelium; Kidney disease; Albuminuria; Paucibacillary leprosy; Multibacillary leprosy; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic; Rho
• Online Access: https://doi.org/10.1590/s1678-9946202163044; https://doaj.org/article/9c63b029a9064260947d7f2da16e5edf

ABSTRACT Leprosy may present kidney and endothelial abnormalities, being a risk factor for complications. However, the involvement of renal and vascular endothelia has been poorly investigated. We aimed to investigate if the levels of systemic endothelial biomarkers are associated with kidney abnormalities and the clinical forms of leprosy. This is a cross-sectional study with leprosy patients enrolled in January 2017 to December 2018, before the initiation of the multidrug therapy. Leprosy-associated clinical and epidemiological data were collected. Two groups were investigated: Paucibacillary (PB) and Multibacillary (MB) infections, for the comparisons. Serum and urine samples were obtained for laboratory analysis. In serum samples, were evaluated the endothelial biomarkers VCAM-1 and ICAM-1. In total, 101 leprosy patients were included, the mean age was 48±١٥ years and 71 (70%) were male. The multibacillary form occurred in 81 cases (80%), among which 22 had the Virchowian form. Serum creatinine was more elevated in the MB group than in PB patients. In addition, VCAM-1 was elevated in the MB group and was correlated with the bacteriological index (rho = 0.372, p <0.01), the duration of disease symptoms (rho = 0.234, p = 0.04), and the number of skin lesions (rho = 0.468, p <0.001). Moreover, in MB patients who presented albuminuria >15 mg/g of creatinine, VCAM-1 showed a significant correlation with increased albuminuria and improved the correlation with the number of skin lesions (rho= 0.563, p=0.010). In conclusion, higher systemic VCAM-1 levels were associated with the multibacillary clinical form of leprosy and with increased albuminuria. Prospective studies are necessary to establish a cause-effect and evaluate the preventive role of these biomarkers to improve the clinical care.