Fibrosis: a distinguishing feature in the pathology of neural leprosy.

Abstract:

BACKGROUND:Fibrosis in the peripheral nerve is the end stage of leprous neuropathy and the cause of the resulting permanent neural function impairments. Preventive measures to avoid this irreversible pathological state are a relief strategy for leprosy sufferers. OBJECTIVES:The present study describes the frequency of fibrosis along with its characterisation and pathogenic development. METHODS:Six-hundred-and-thirteen nerve samples were sorted from 278 neural leprosy (NL) and 335 non-leprosy neuropathy patients (ON). The total number of samples was histologically examined by routine staining methods (haematoxylin-eosin, Wade staining and Gomori's trichrome) and fibrosis was evaluated via semi-quantitative estimation. FINDINGS:Fibrosis was most frequent in the NL group (33% against 0.4% in ON) while fibrosis in association with endoneurial microfasciculation was found in 38 (41.3%) of the NL samples in the examination of semithin sections. Pericytic activation in the perivascular environment was confirmed to be the source of the fibroblasts and perineurial cells delimiting microfascicles. End-stage fibrosis in leprosy displays an arrangement of microfascicles devoid of neural components (i.e., Schwann cells and axons) lined by an intermediate phenotype of fibroblastic-perineurial cells filled with bundles of collagen fibres. MAIN CONCLUSIONS:The present study underscores that fibrosis is frequently the severe end stage of neural leprosy NL pathogeny after analysing the notably distinct development of fibrosis within the neural environment.

journal_name

Mem Inst Oswaldo Cruz

authors

Antunes SLG,Jardim MR,Vital RT,Pascarelli BMO,Nery JADC,Amadeu TP,Sales AM,da Costa EAF,Sarno EN

doi

10.1590/0074-02760190056

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

e190056

eissn

0074-0276

issn

1678-8060

pii

S0074-02762019000100339

journal_volume

114

pub_type

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