Comparative Study of Markers of Oxidative Stress in Treated and Untreated Leprosy Cases of Pakistan

Abstract

Leprosy is a persisting disease, mostly infect outlying nerves and skin, produced by Mycobacterium leprae. It is completely curable with modern treatment known as multi drug therapy (MDT). Leprosy is not a killing disease but is a crippling disease and if not treated early and properly, may form deformities. The number of permanently disable Leprosy cases was estimated in 1995 which was two to three million. Leprosy Patients not only bear physical problems but also social, economic and mental disturbance. In females these problems are more in many countries in the world. Leprosy might be endemic in low socio economical countries. Where as immigrants are responsible for transmission of leprosy in high national income countries. The signs and symptoms may be ignored in the early stages until visible disabilities have not occurred. Hypopigmented or hyperpigmented skin lesions, involvement of outlying nerves and skin are initial signs. This bacterium mostly attacks men as compared to women.Until coming of AIDS, leprosy was the most feared infectious disease globally. It is still considered to be dreadful infectious disease, so normal healthy people try to avoid and breakup all kind of links to these patients. Leprosy affected females are lesser chance to report early due to domestic responsibilities. Classification of leprosy patients is necessary to ensure the treatment plan and duration of treatment to minimize the relapse, disabilities and deformities. vi Cases were divided in two groups, Paucibacillary and Multibacillary, followed WHO guide lines. 1 – 5 skin lesions is regarded as PB with no acid fast rods on the smear and skin lesions more than 5 is regarded as MB. A positive bacterial index classifies the patient as MB, regardless of the number of skin lesions with bacteria visible on a smear. An imbalance in formation and elimination of reactive oxygen species is known as oxidative stress. For calculation of oxidative stress, there is common biochemical markers known as malondialdehyde. Reactive oxygen species are responsible for distruction of fatty and proteinous tissues of body, polyunsaturated fatty acids are damaged and it results malondialdehyde formation. In living organism malondialdehyde is presumptive biomarker for fat degredation which enhanced due to strss. The free radicals are scavenge through major antioxidant enzyme known as SOD. This enzyme is present in various fractions in body to overcome oxidative damage by elimination of superoxide radicals In our study we have found mean MDA values in both MB and PB leprosy were significant increased (p<0.001) when compared to control. This proved that in leprosy patients, there is increased lipid peroxidation due to free radical induced injury. Several studies have reported significant increase of MDA levels in leprosy. In this study we have also found mean SOD level significantly decreased in PB (p<0.001) and significant decreased in MB leprosy (p<0.001) when compared to the control vii In this study mean serum values of Malondialdehyde was increased, Superoxide Dismutase was decreased especially in untreated MB leprosy when compared with treated MB, PB leprosy groups and control group. Thus it was concluded that oxidative stress was more marked in untreated leprosy group when compared with treated leprosy group as well as control group. Findings provide awareness regarding therapeutic use of anti-oxidant supplementation for the management of oxidative stress in both untreated MB, PB and treated MB,PB leprosy patients to provide rid of oxidative stress and improve the quality of life of ailing leprosy patients