Multi Drug Therapy- Combination of Structural Inhibitors to Eradicate Leprosy

Being persistant infection, caused by Mycobacterium leprae, Leprosy is affecting about 50, 000 annually. It affects Schwann cells (the glial cells of peripheral nervous system) and macrophages. Its long incubation period (5-7 years) classify leprosy as paucibacillary (PB) and multibacillary (MB) depending on the bacillary load. Recent advances have been made in developing molecular diagnostics, in identifying and designing highly effective treatment. MULTI DRUG THERAPY (MDT) has revamped leprosy with the combination of rifampicin, clofazimine and dapsone (MB patients) and rifampicin and dapsone (PB patients). Various new agents like fluroquinolones (moxifloxacin), rifapentine, macrolides and monocycline in varying combination have also proved their potency. Drugs like thalidomide analogues, pentoxifyline, selectively inhibit cytokine and control type-2 reactions (erythema nodosum leprosum reaction) which have association with deposition of tissue and circulation of immune complex. Present study discusses about the high potential effect of MDT over other treatments through complex structural comparison and their interactions.