Dramatic secukinumab-mediated improvements in refractory leprosy-related neuritis via the modulation of T helper 1 (Th1) and T helper 17 (Th17) immune pathways

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Patrícia Shu Kurizky, Jorgeth de Oliveira Carneiro da Motta, Natanael Victor Furtunato Bezerra, Marcia Carolline dos Santos Sousa, Danilo Corazza, Taiana Karla dos Santos Borges, Ciro Martins Gomes
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2021
• Subjects: Leprosy; Interleukin-17; Neuritis; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1590/0037-8682-0336-2021; https://doaj.org/article/cd4de9e0735b483ca611b12563209808

Abstract A 39-year-old woman was diagnosed with relapsed multibacillary leprosy and refractory neuritis. Here, we describe an evident loss of therapeutic effectiveness after the third pulse of corticosteroids, which may be attributed to tachyphylaxis and the posterior modulation of interferon- γ (IFN-γ), tumor necrosis factor- α (TNF-α,) interleukin-17A (IL-17A), and IL-12/23p40 after the induction phase of secukinumab. In this case, plasma cytokine analysis showed that secukinumab induced a reduction in IL-17 concomitant with impressive clinical improvements in the patient’s neural function. Interestingly, secukinumab induced reductions in cytokines related to Th1 responses and earlier stages of the Th17 response, including IL-23/12.