PDF(Pubmed)
Abstract：
Leprosy is a neglected tropical disease (NTD) that continues to burden low- and middle-income countries (LMICs), despite being eliminated as a public health concern by the World Health Organization (WHO) in 2000. The causative agents, Mycobacterium leprae and Mycobacterium lepromatosis, affect nearly 200,000 individuals globally each year, with over 19,000 new cases detected in the Americas in 2020 alone. Canada has experienced an increasing incidence of leprosy, due to rising levels of travel and migration from endemic areas, reaching over 37,000 individuals with leprosy by the end of 2020. Patients experience a spectrum of signs and symptoms including hypopigmented cutaneous macules alongside peripheral neuropathy including peripheral neuropathic pain (PNP) and disabling sensory neuropathies. Despite the development of effective and curative therapeutics via multidrug therapy (MDT), many barriers to treatment adherence and effective immunological control of the pathogen challenge the care of patients with leprosy. Socioeconomic barriers, such as disability-related social stigma and often undiagnosed nutritional deficiencies, have resulted in heightened disease severity. PNP therapeutics are associated with significant side effects and remain ineffective as the majority of individuals will not experience a greater than 30% reduction of symptoms. Nutrient supplementation is known to be instrumental in reducing host oxidative stress, strengthening the immune system and mitigating comorbidities. Likewise, dietary lifestyle interventions known to be physiologically beneficial have recently emerged as powerful tools conferring neuroprotective effects, potentially mitigating PNP severity. However, a significant knowledge gap concerning the effect of adequate nutrition on host immunological control of leprosy and PNP severity exists. Further evaluation of this relationship will provide key insight into the pathogenesis of leprosy, strengthening the current body of literature.
摘要：
麻风病是一种被忽视的热带病，继续给低收入和中等收入国家带来负担，尽管世界卫生组织（WHO）在2000年将其作为公共卫生问题消除。病原体，麻风分枝杆菌和麻风分枝杆菌，每年影响全球近20万人，仅在2020年，美洲就发现了超过19,000例新病例。加拿大麻风病发病率不断上升,由于流行地区的旅行和移民水平上升，到2020年底，超过37,000名麻风病人。患者经历一系列体征和症状，包括色素沉着的皮肤黄斑和周围神经病，包括周围神经性疼痛（PNP）和致残的感觉神经病变。尽管通过多药治疗（MDT）开发了有效和治愈性的疗法，治疗依从性和病原体有效免疫控制的许多障碍挑战了麻风病患者的护理。社会经济障碍，例如与残疾相关的社会耻辱和经常无法诊断的营养缺乏，导致疾病严重程度升高。PNP疗法与显著的副作用相关并且仍然无效,因为大多数个体将不会经历大于30%的症状减少。众所周知，营养补充有助于减少宿主的氧化应激，增强免疫系统和减轻合并症。同样，已知对生理有益的饮食生活方式干预最近已成为赋予神经保护作用的强大工具，可能减轻PNP严重程度。然而,关于充足营养对麻风病宿主免疫控制和PNP严重程度的影响存在显著的知识差距。对这种关系的进一步评估将为麻风病的发病机理提供关键见解，加强当前的文学主体。
