Conflicting findings about the association between
leprosy and TLR1 variants N248S and I602S have been reported. Here, we performed case-control and family based studies, followed by replication in 2 case-control populations from Brazil, involving 3162 individuals. Results indicated an association between TLR1 248S and
leprosy in the case-control study (SS genotype odds ratio [OR], 1.81; P = .004) and the family based study (z = 2.02; P = .05). This association was consistently replicated in other populations (combined OR, 1.51; P < .001), corroborating the finding that 248S is a susceptibility factor for
leprosy. Additionally, we demonstrated that peripheral blood mononuclear cells (PBMCs) carrying 248S produce a lower
tumor necrosis factor/
interleukin-10 ratio when stimulated with Mycobacterium leprae but not with
lipopolysaccharide or PAM3cysK4. The same effect was observed after
infection of PBMCs with the Moreau strain of bacillus Calmette-Guerin but not after
infection with other strains. Finally, molecular dynamics simulations indicated that the
Toll-like receptor 1 structure containing 248S
amino acid is different from the structure containing 248N. Our results suggest that TLR1 248S is associated with an increased risk for
leprosy, consistent with its hypoimmune regulatory function.