Pathophysiology of nerve damage in leprosy, part 2

In the second part of this episode, the focus shifts from molecular mechanisms to real-world pathology. Hosts Dr. Camila Pupe and Dr. Wilson Marques Jr. welcome back:

• Professor Anuraa Rambukkana – whose groundbreaking research on Schwann cell reprogramming has transformed our understanding of how Mycobacterium leprae targets and reshapes peripheral nerves.
• Dr. Bruno Dornelas – Neuropathologist at the Federal University of Uberlândia, with extensive experience in leprosy pathology.

Discussion highlights include:

• Histopathological patterns across the Ridley-Jopling spectrum (from tuberculoid to lepromatous forms)
• How pathology findings correlate with bacterial mechanisms and immune response
• Predictors of relapse and treatment failure (e.g., persistent lymphocytic infiltrates, foamy granulomas, bacillary index, and anti-PGL-1 serology)
• Challenges in defining "cure" and monitoring patients post-MDT
• The need for better diagnostic tools for early and atypical presentations
• Future translational directions, including regenerative strategies inspired by bacterial-host interactions

This episode underscores the spectrum nature of leprosy neuropathy, the importance of long-term monitoring, and opportunities for innovation in therapy and diagnostics.

Transcript