Hosts:

• Prof. Camila Pupe, Universidade Federal Fluminense, Brazil
• Prof. Wilson Marques Jr., University of São Paulo School of Medicine – Ribeirão Preto

Guests:

• Prof. Osvaldo Nascimento, Emeritus Professor of Neurology, Universidade Federal Fluminense, Brazil
• Prof. Satish V. Khadilkar, Dean and Head of Neurology, Bombay Hospital Institute of Medical Sciences, Mumbai, India

In this installment of the PNS Podcast Series on Leprosy Awareness, Professors Camila Pupe and Wilson Marques Jr. are joined by two internationally recognized experts—Prof. Osvaldo Nascimento and Prof. Satish Khadilkar—to explore the clinical spectrum of leprosy neuropathy.

From the common to the rare, this episode highlights how leprosy manifests in the nervous system, emphasizing why early recognition and vigilance are critical for preventing permanent disability. Transcript: https://pnsociety.com/wp-content/uploads/PNS_Podcast_Ep4_Clinical_Presentations_Leprosy_Neuropathy_corrected_transcript.pdf

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

In this first part of this special two-part series of the PNS Leprosy Awareness podcast, hosts Dr. Camila Pupe (Federal University of Uberlândia, Brazil) and Dr. Wilson Marques Jr. (University of São Paulo, Brazil) explore the fundamental biology of nerve involvement in leprosy. They are joined by:

• 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:

• Why M. leprae uniquely targets Schwann cells (neurotropism)
• The concept of Schwann cell plasticity and how the bacterium hijacks repair pathways Mechanisms of demyelination and early nerve damage
• The role of reprogramming in bacterial survival, dissemination, and chronic infection
• Insights into the balance between host defense, bacterial manipulation, and nerve pathology

This conversation bridges molecular biology and clinical science, providing a rare look into how leprosy continues to inform our understanding of peripheral nerve disease. Stay tuned for Part 2, where the discussion turns to real-world pathology findings and translational implications.

Transcript: https://account.pnsociety.com/files/Resources/Leprosy_Awarenes_Ep3_Part_1_7Oct2025.docx

In the second episode of our Leprosy Awareness series, we discuss one of the most complex and fascinating aspects of leprosy: classification and immunology, a topic connecting science, diagnosis, and clinical care. We're joined by guests Prof. Marco Andrey, dermatologist, leprologist and researcher at USP - Ribeirao Preto, Brazil and President of the Brazilian Society of Hansenology and by Prof. Ben Naafs, a globally respected tropical dermatologist with contributions on the reactions, spectrum, and immune response are fundamental for our modern understanding of leprosy. Transcript

Show Hosts:

Camila Pupe, MD, PhD Universidade Feral Fluminense Associate Professor of Neurology - UFF. Member of Junior Committee and International Outreach, Membership and Diversity Committee of the Peripheral Nerve Society. Wilson Marques, Jr, MD, PhD School of Medicine of Ribeirão Preto, University of São Paulo

Here are links to additional information:

• Geluk A, van Meijgaarden KE, Franken KL, Subronto YW, Wieles B, Arend SM, Sampaio EP, de Boer T, Faber WR, Naafs B, Ottenhoff TH. Identification and characterization of the ESAT-6 homologue of Mycobacterium leprae and T-cell cross-reactivity with Mycobacterium tuberculosis. Infect Immun. 2002 May;70(5):2544-8. doi: 10.1128/IAI.70.5.2544-2548.2002. PMID: 11953394; PMCID: PMC127910.
• Nogueira MR, Latini AC, Nogueira ME. The involvement of endothelial mediators in leprosy. Mem Inst Oswaldo Cruz. 2016 Oct;111(10):635-641. doi: 10.1590/0074-02760160122. Epub 2016 Oct 3. PMID: 27706378; PMCID: PMC5066329.
• Trindade MA, Benard G, Ura S, Ghidella CC, Avelleira JC, Vianna FR, Marques AB, Naafs B, Fleury RN. Granulomatous reactivation during the course of a leprosy infection: reaction or relapse. PLoS Negl Trop Dis. 2010 Dec 21;4(12):e921. doi: 10.1371/journal.pntd.0000921. PMID: 21200422; PMCID: PMC3006134.
• Costa WDL, de Oliveira AM, Aguilar GJ, Dos Santos LMAC, Dos Santos LRA, Donato DCB, Foresto F, Frade MAC. A review of software and mobile apps to support the clinical diagnosis of Hansen disease. JMIR Dermatol. 2023 Aug 18;6:e47142. doi: 10.2196/47142. PMID: 37594779; PMCID: PMC10474501.
• Salgado CG, Pinto P, Bouth RC, Gobbo AR, Messias ACC, Sandoval TV, Dos Santos AMR, Moreira FC, Vidal AF, Goulart LR, Barreto JG, da Silva MB, Frade MAC, Spencer JS, Santos S, Ribeiro-Dos-Santos Â. miRNome expression analysis reveals new players in leprosy immune physiopathology. Front Immunol. 2018 Mar 9;9:463. doi: 10.3389/fimmu.2018.00463. PMID: 29593724; PMCID: PMC5854644.
• Bernardes Filho F, Silva CML, Voltan G, Leite MN, Rezende ALRA, de Paula NA, Barreto JG, Foss NT, Frade MAC. Active search strategies, clinicoimmunobiological determinants and training for implementation research confirm hidden endemic leprosy in inner São Paulo, Brazil. PLoS Negl Trop Dis. 2021 Jun 14;15(6):e0009495. doi: 10.1371/journal.pntd.0009495. PMID: 34125854; PMCID: PMC8224878.

Learn more about the Peripheral Nerve Society at www.pnsociety.com. Subscribe now! Spotify | Apple | iHeartRadio PNS Podcast Statement The purpose of this podcast is to educate and inform. The content of this podcast does not constitute medical advice and is not intended to function as a substitute for a healthcare practitioner's judgement, patient care or treatment. The views and opinions expressed by the participants in this podcast do not necessarily reflect those of the Peripheral Nerve Society (PNS).

This is the first episode of our special leprosy awareness series, where we explore the science, history, and the clinical perspective behind one of the most disturbing diseases of all time, leprosy. In this episode, we take a deep dive into the history, stigma, and current epidemiology of leprosy. We are honored to have as our guest, an outstanding physician and public health leader, Dr. Vera Andrade. Dr. Andrade has dedicated her career to leprosy, working with national programs and international organizations, such as the World Health Organization. Dr. Andrade is interviewed by Dr. Camila Pupe and Dr. Wilson Marques. Transcript

Vera Andrade, MD, PhD Public Health Specialist, Epidemiologist, and Consultant in Neglected Tropical Diseases State Health Department of Rio de Janeiro (SESRJ) and the World Health Organization (WHO) – Retired Medical doctor with extensive national and international experience in public health. Retired from the State Health Department of Rio de Janeiro (SESRJ) and the World Health Organization (WHO). Specialist in Public Health, Leprology, and Infectious and Parasitic Diseases, with a Master's and PhD in Public Health from Fundação Oswaldo Cruz (FIOCRUZ). Extensive knowledge of the Brazilian Unified Health System (SUS) and experience in health programs across Africa and Asia. Recognized for dedication and competence in controlling communicable diseases and promoting global public health. Camila Pupe, MD, PhD Universidade Feral Fluminense Associate Professor of Neurology - UFF. Member of Junior Committee and International Outreach, Membership and Diversity Committee of the Peripheral Nerve Society. Wilson Marques, Jr, MD, PhD School of Medicine of Ribeirão Preto, University of São Paulo

Here are links to additional information:

• Sczmanski AS, Pazin L, Sakae TM, Mazon J. Analysis of the clinical and epidemiological profile of leprosy in Brazil and Major Regions. An Bras Dermatol. 2025 Jun 18;100(4):501127. doi: 10.1016/j.abd.2025.501127. Epub ahead of print. PMID: 40554354; PMCID: PMC12213943.
• Lages, D.d.S.; Maciel, I.C.L.; Vidal, S.L.; Lana, F.C.F. Spatial, Social and Serological Factors in the Prevalence and Risk of Leprosy in Areas of High Endemicity: An Integrative Review. Infect. Dis. Rep. 2025, 17, 57. https://doi.org/10.3390/idr17030057
• Zhang, K., Zhang, W., & Lu, H. (2025). Global Trends in the Incidence, Prevalence and Disability-Adjusted Life Years of Leprosy from 1990 to 2019: An Age-Period-Cohort Analysis Using the Global Burden of Disease Study 2019. Clinical, Cosmetic and Investigational Dermatology, 18, 883–898. https://doi.org/10.2147/CCID.S508600
• Santacroce L, Del Prete R, Charitos IA, Bottalico L. Mycobacterium leprae: A historical study on the origins of leprosy and its social stigma. Infez Med. 2021 Dec 10;29(4):623-632. doi: 10.53854/liim-2904-18. PMID: 35146374; PMCID: PMC8805473.

Learn more about the Peripheral Nerve Society at www.pnsociety.com. Subscribe now! Spotify | Apple | iHeartRadio PNS Podcast Statement The purpose of this podcast is to educate and inform. The content of this podcast does not constitute medical advice and is not intended to function as a substitute for a healthcare practitioner's judgement, patient care or treatment. The views and opinions expressed by the participants in this podcast do not necessarily reflect those of the Peripheral Nerve Society (PNS).

Launching this summer! The Peripheral Nerve Podcast is the official podcast of the Peripheral Nerve Society (PNS). In each multi-episode series, we fully explore a topic, bringing in expert guests from around the world to share their insights, illuminate the subject and provide practical knowledge for clinicians and basic scientists. As an international organization, we strive to provide insight into topics from a global perspective, shedding light on issues unique to various regions.

Learn more about the Peripheral Nerve Society at www.pnsociety.com.

Subscribe now! Spotify | Apple | iHeartRadio

PNS Podcast Statement

The purpose of this podcast is to educate and inform. The content of this podcast does not constitute medical advice and is not intended to function as a substitute for a healthcare practitioner's judgement, patient care or treatment. The views and opinions expressed by the participants in this podcast do not necessarily reflect those of the Peripheral Nerve Society (PNS).