Preface

Chapter 8 **Genetic Variation in Pattern-Recognition Receptors and**

Karina Talita de Oliveira Santana Jorge and Frederico Marianetti

**Association with Leprosy 143**

Soriani

**VI** Contents

The purpose of this book is to expand the knowledge and investigations of a disease feared by humanity since biblical times. Leprosy was once related to sin and thought to be caused by heredity or curses. Unfortunately, these stigmatizations still persist. This book about lep‐ rosy encompasses its nature, etiology, epidemiology, clinical studies, diagnosis, molecular techniques and treatment, which are still challenging research worldwide.

This book's goal is to contribute to science: the immunological, molecular and genetic ad‐ vances that have been made in the management of leprosy. It contains important informa‐ tion in a clear, concise, and precise way about the history, epidemiology, pathology, diagnostic methods and genetic implications described for the disease, with the intention of emphasizing that leprosy remains a complex disease and of interest to public health. For this reason, the study of leprosy continues to represent a great challenge to humanity, because despite maintaining its control, it has not yet been possible to interrupt its chain of transmis‐ sion. Public health agencies need to join forces to achieve eradication.

Here you will find important information about leprosy, dealing with major issues such as the characteristics of the etiological agent, the host's immune response and its updating in epidemiology, diagnosis and treatment. In addition the book studies the difficulty of early detection of the disease that has led to the search for existing techniques for its use in diag‐ nosis, as well as the need to give importance to molecular methodologies, since the genetic study of *Mycobacterium leprae* has allowed the detection of genes or specific sequences for drug identification and resistance.

The studies in this book will also give insight into the investigations of the participation of genetic factors that are involved in the susceptibility and immunopathogenesis of the dis‐ ease, since the microorganism expresses a series of components involved in the pathogen– host interaction and its association of different genetic variants in the recognition of the clin‐ ical manifestations of leprosy.

With the rapidity of advances in knowledge about leprosy, this book incorporates contribu‐ tions from professionals and experts in the study of *M. leprae* to ensure a broad review and update of each of the chapters presented here, showing perspectives that open new possibil‐ ities to address the study of leprosy and its impact on clinical, immunological, molecular and epidemiological research in the coming years. We hope that this book will be of great interest and expand information on and contribute to relevant aspects of the disease.

> **Wellman Ribón** Senior Researcher, Colciencias Classification Titular Professor, Universidad Industrial de Santander, Columbia

**Chapter 1**

**Provisional chapter**

**Introductory Chapter: Hansen´s Disease – The**

**Introductory Chapter: Hansen´s Disease – The** 

DOI: 10.5772/intechopen.82427

Leprosy has been one of the diseases most feared by mankind and has managed to stigmatize societies for its lamentable symptoms and consequences. It is known since the remote epochs of the Biblical Times, the Middle Ages, the modern era, the Renaissance, and its lyrical poems, dedicated to those patients with leprosy in which their suffering was interpreted as a curse, a divine punishment, or a hereditary disease. The condemnation of those patients diagnosed with Hansen's disease was despair, physical, integral, and social death, promoted by rejection, persecution, and exile, because they had to be expelled and live hiding their shame and physical decomposition, trying to adapt to the spiritual change and its real beauty as the disease spread through their bodies; being recruited forcibly in those "cemeteries for the living" known as leprosaria, leprocomios, or lazaretos were dragging their lives and awaited death face to face; being neglected by a society that considered that the disease was the worst abomination that could exist, and that at the same time it did not know that it was through no

fault of their own that those Hansen's disease patients contracted the disease [1, 2].

were isolated from the horror and repugnance of an uneducated society [3].

Leprosy is a disease believed to be incurable and characterized by marked changes in physical appearance and evolutionary skin lesions affecting the skin, peripheral nerves, and nasal mucosa. It was discovered in 1873 by Gerhard Hansen, who demonstrated that it was an infectious disease and not a curse, helping to establish the fundamental principles of immunology, bacteriology, and also public health and thus putting an end to the idea of leprosy being un-curable. Even so, because of the social stigma and fear, humanity continued to consider those with the disease as cursed pariahs, and the patients had to take refuge in places where those suffering from the same ailment were housed, the lazaretos; hidden there, they

> © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

**Forgotten and Neglected Disease**

**Forgotten and Neglected Disease**

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

Lina Fernández and Wellman Ribón

Lina Fernández and Wellman Ribón

http://dx.doi.org/10.5772/intechopen.82427

**1. Introduction**

#### **Chapter 1 Provisional chapter**

#### **Introductory Chapter: Hansen´s Disease – The Forgotten and Neglected Disease Introductory Chapter: Hansen´s Disease – The Forgotten and Neglected Disease**

DOI: 10.5772/intechopen.82427

Lina Fernández and Wellman Ribón Lina Fernández and Wellman Ribón

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.82427
