{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:32:59Z","timestamp":1792737179472,"version":"4.5.0"},"reference-count":108,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T00:00:00Z","timestamp":1725580800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Leprosy is a chronic infectious condition and the main cause of neuropathy that occurs brought on by <jats:italic>M. leprae<\/jats:italic>. It is known that the biological characteristics of the human host, such as the immunological ones, have a higher influence on the pathology of this disease than the intrinsic mechanisms of the bacterium. The objective of this work was to review the scientific knowledge about the relationship between immunopathology and the severity of leprosy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review following the PRISMA 2020 recommendations was conducted in the PUBMED, LILACS, SciELO and Science Direct databases using articles in English, Portuguese or Spanish between January 2011 and May 2022 with the descriptors \u201cLeprosy\/Immunology\u201d, \u201cCytokines\u201d and \u201c<jats:italic>Mycobacterium leprae<\/jats:italic>\u201d. A methodological quality assessment was carried out using the JBI checklists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 49 articles were included. There is a relationship of greater severity of infection associated with lower release of MHC molecules in response to PGL-1 that inhibit the promotion of resolving T lymphocytes arising from dendritic cells (DCs) stimulation. In addition, the differentiation of macrophage phenotypes dependent on the activation of PRRs can define activation and the distinct type of T helper (Th) cells involved according to severity. Activated CD8+ T cells also have distinct types at the appropriate poles of the disease, and B cells show at the most severe pole of the LL, specific induction of IgA and more Treg-type CD8+ T cells that further contribute to T cell anergy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Therefore, the adaptive immune system aggravates nerve damage and defines the type of leprosy, while the innate immune system is considerably more significant in the onset of nerve damage, symptomatic of the initial presentation of illness and in several critical immune responses, including inflammation and elimination of dead <jats:italic>M. leprae<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2024.1416177","type":"journal-article","created":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T04:25:18Z","timestamp":1725596718000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["An update on leprosy immunopathogenesis: systematic review"],"prefix":"10.3389","volume":"15","author":[{"given":"Marcos Jess\u00e9 Abrah\u00e3o","family":"Silva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroliny Soares","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiago Pinto","family":"Brasil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Karoliny","family":"Alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Everaldina Cordeiro","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiane Cunha","family":"Frota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla Val\u00e9ria Batista","family":"Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana Nepomuceno Gondim Costa","family":"Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.86.2.142","article-title":"Current knowledge on Mycobacterium leprae transmission: a systematic literature review","volume":"86","author":"Bratschi","year":"2015","journal-title":"Leprosy Rev"},{"key":"B2","doi-asserted-by":"publisher","first-page":"181089","DOI":"10.1155\/2012\/181089","article-title":"Leprosy: an overview of pathophysiology","volume":"2012","author":"Bhat","year":"2012","journal-title":"Interdiscip Perspect Infect Dis"},{"key":"B3","article-title":"Global leprosy (Hansen disease) update, 2019: time to step-up prevention initiatives\u2013Situation de la l\u00e8pre (maladie de Hansen) dans le monde, 2019: le moment est venu d\u2019intensifier les initiatives de pr\u00e9vention","volume":"95","year":"2020","journal-title":"Weekly Epidemiological Record= Relev\u00e9 \u00e9pid\u00e9miologique hebdomadaire"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000001660","article-title":"Hansen disease (leprosy) and Armadillo exposure in Arkansas: a case series","volume":"42","author":"Carlock","year":"2020","journal-title":"Am J Dermatopathology"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.47276\/lr.74.2.120","article-title":"Assessing socio-economic factors in relation to stigmatization, impairment status, and selection for socio-economic rehabilitation: a 1-year cohort of new leprosy cases in north Bangladesh","volume":"74","author":"Withington","year":"2003","journal-title":"Leprosy Rev"},{"key":"B6","volume-title":"World report on disability 2011","year":"2011"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0271883","article-title":"Determinant factors of leprosy-related disability; comparison of acceleration failure time and parametric shared frailty models","volume":"18","author":"Masresha","year":"2023","journal-title":"PloS One"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1038\/316450a0","article-title":"Genes for the major protein antigens of the leprosy parasite Mycobacterium leprae","volume":"316","author":"Young","year":"1985","journal-title":"Nature"},{"key":"B9","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1590\/s0037-86822010000100005","article-title":"Risk factors for physical disability at diagnosis of 19,283 new cases of leprosy","volume":"43","author":"Moschioni","year":"2010","journal-title":"Rev Soc Bras Med Trop"},{"key":"B10","first-page":"1978","article-title":"Classification of leprosy","author":"Ridley","year":"1978","journal-title":"Window in leprosy. 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