الفهرس 
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Abstract
Introduction Leprosy is an ancient bacterial disease that, although curable, continues to be a significant health problem in many parts of the world. HD results from infection with the M.leprae bacilli, which produces a chronic infection in humans that affects mainly peripheral nerves and skin but may also affect other sites such as the eyes, mucous membranes, bones, and testes producing a spectrum of clinical phenotypes. Inflammasomes are multimeric complexes that activates pro-caspase-1, which then proceeds to cleave multiple substrates including the proinflammatory cytokines IL-1β and IL-18. It is formed in response to a variety of physiological and pathogenic stimuli. Inflammasome activation is an essential component of the innate immune response and is critical for the clearance of pathogens or damaged cells. According to types of PRRs present in individual inflammasomes, they can be classified NLR, absent in ALR, and pyrin inflammasomes. NLRC4, a member of NLR family, was originally described by Poyet and colleagues as a pro-apoptotic protein. Activation of the NLRC4 inflammasome appears to activate several different host signaling events such as caspase-1 , the primary protease responsible for converting proIL-1β and IL-18 to active, secreted IL-1β and IL-18 respectively leading eventually to pyroptosis. The main aim of this study was to highlight the role of NLRC4 in the pathogenesis of leprosy by evaluating its blood level in patients. Patients and Methods A prospective study was conducted in Dermatology and Venereology Department, Tanta University Hospital and leprosaria. The study was carried upon 40 patients of leprosy (group A) and 30 healthy individuals of both sexes (group B). The duration of the study ranged from 6-12 months. Six ml of venous blood sample was taken from each patient and serum level of NLRC4 was assayed by using commercial kit supplied by sun red bio catalogue number SRB-T-82522, Shanghai, China. This kit was based on standard sandwich ELISA technology. Results • group A included 40 patient with leprosy; 19(47.5%) females and 21(52.5%) males. Their ages ranged from 12-62 years with mean ± SD 40.05± 9.93 years. They were divided according to their clinical types to TT included 12 (30%) patients , BL included 14(35%) patients and LL that included 14(35%) patients. • group B included 30 healthy persons with matched sex and age served as control. They included 10(33.3%) females and 20(66.7%) males. Their ages ranged from 13-62years with mean ± SD 34.10 ±11.27 years. There was no statistically significant difference as regard to age and sex between the studied groups. • Slit skin smear was done for patients in the leprosy group (group A) and according to their bacillary index, they were divided into paucibacillary group that included 12(30 %) patients and multibacillary group that included 28 (70 %) patients. • As regard the serum NLRC4 level in the studied groups; in group A,it ranged from 0.9 to 5.7 ng/ml with mean+SD 2.41±1.14 ng/ml. While in group B, it ranged from 0.1 to 5.6 ng/ml with mean+SD 1.27+1.59 ng/ml. NLRC4 serum level showed a statistically significant increase in leprosy patients (group A) compared to control group (group B) (p=0.001). • In the paucibacillary group, NLRC4 serum level ranged from 0.9 to 1.8 ng/ml with mean+SD 1.43±0.28ng/ml. While in the multibacillary group, it ranged from 1.2 to 5.7 ng/ml with mean+SD 2.83±1.11 ng/ml. NLRC4 serum level showed a statistically significant increase in multibacillary patients compared to paucibacillary patients (p=0.001).There was a statistically significant difference among the three studied groups, regarding the serum level of NLRC4 (p=0.001). • In leprosy patients, statistically significant positive correlations were found between serum level of NLRC4 and both (bacillary index and duration of leprosy ). Also statistically significant positive correlations were found between serum level of NLRC4 and (number of nerves affected and degree of disability). There was a positive statistically significant correlation between the serum level of NLRC4 and age of the studied patients of leprosy.