# Serum levels of Interleukin-10, Interleukin-6, and leptin in patients with Mycobacterium leprae–Helminth Co-Infections

## TL;DR

This study found that leprosy patients with helminth infections have higher levels of IL-10 and IL-6, suggesting helminths affect immune responses in leprosy.

## Contribution

The study provides new evidence that helminth co-infections in leprosy patients significantly alter serum levels of IL-10 and IL-6.

## Key findings

- 15.6% of leprosy patients had helminth co-infections, primarily with Ascaris lumbricoides and Trichuris trichiura.
- Leprosy patients with helminth infections had significantly higher serum levels of IL-10 and IL-6 compared to those without helminths.
- Leptin levels were not significantly different between leprosy patients with and without helminth co-infections.

## Abstract

Leprosy remains a public health problem in several countries, including Indonesia, due to its surrounding disability, stigma, and discrimination. In leprosy, compromised immune responses frequently affect the occurrence of helminth infections, which are known to contribute to a number of diseases by upregulating T-helper 2. Elevated levels of interleukin (IL)-10, IL-6, and leptin have been associated with helminth infection and leprosy, respectively.

This study aimed to measure the serum levels of IL-10, IL-6, and leptin in leprosy patients with and without helminth co-infections.

A cross-sectional design was used for this observational clinical study. A total of 32 leprosy patients who fulfilled our inclusion and exclusion criteria were recruited. The quantification of IL-10 and IL-6 levels was performed using serum samples with a quantitative sandwich enzyme-linked immunosorbent assay method. Additionally, the quantification of leptin serum was also carried out. The helminth’s eggs were examined using the Kato-Katz technique.

This study revealed that helminth co-infection was present in five out of 32 (15.6%) leprosy patients. The types of helminth found in leprosy patients with helminth infections were Ascaris lumbricoides and Trichuris trichiura, with a mild intensity of infection. For leprosy with helminth infection, the mean IL-10, IL-6, and leptin serum levels were 86.43 pg/ml ± 4.34 pg/ml, 447.42 pg/ml ± 122.15 pg/ml, and 19,272.85 pg/ml ± 4,065.23 pg/ml, respectively. Meanwhile, the mean IL-10, IL-6, and leptin serum levels for leprosy without helminth infection were 72.97 pg/ml ± 14.69 pg/ml, 161.77 pg/ml ± 63.98 pg/ml, and 14,649.07 pg/ml ± 2,002.66 pg/ml, respectively. Based on an independent t-test, the difference in serum levels of IL-10 and IL-6 in leprosy patients with and without helminth infections was p = 0.001 and p = 0.0001, respectively. However, based on the Mann-Whitney test, the serum level of leptin between leprosy patients with and without helminth infections was p = 0.062.

The proportion of helminth infection in leprosy patients is 15.6%. Leprosy patients with helminth infections have considerably greater serum levels of IL-10 and IL-6, suggesting that helminth infection influences leprosy patients’ immunological responses.