Demyelination in Peripheral Nerves: Much to Learn from Leprosy Neuropathy

Abstract

Copyright: © 2016 Mietto BS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Leprosy is a chronic infectious disorder of the peripheral nervous system (PNS) caused by the infection of non-neuronal nerve cells, preferentially Schwann cells and resident macrophages, by Mycobacyerium leprae (ML) [1]. There is growing evidence suggesting that damage to the myelin sheath is due to a disturbed Schwann cell response in conjunction with immune cell participation [2-4]. Although demyelination is not easily found in neuropathic leprosy nerve biopsies (Figure 1), nerve conduction studies routinely used in leprosy referral centers indicate that demyelination occurs during most leprosy reactional episodes [5]. Moreover, nerve conduction analyses show that part of these patients recover from previous lesions after 6-month corticosteroid treatment (Jardim MR personal communication). Other drugs that favor re-myelination are worth being investigated (Figure 1).