Wrist involvement in Hansen's disease.

We performed a neurological and radiological study of the wrists of 58 patients with Hansen's disease and 60 age-matched healthy control subjects. Significant differences (p < 0.01) were found between the groups in the carpal glenoid sector, the radial physeal widening index, the carpal ulnar distance, the carpal index and in distal radio-ulnar discrepancy. Comparison of the results in three subgroups of leprous patients with sensory impairment (group A-1), motor deficit (A-2) and no neurological impairment (A-3), showed significant differences (p < 0.01) between group A-1 and the other two. This suggests that in these patients the changes in the carpus and radiocarpal joint may be caused by neuropathic arthropathy of the wrist. Our findings are of particular interest since there are few reports of neuropathic arthropathy in non-weight-bearing joints.

Screening gene expression libraries for epitopes recognized in Mycobacterium leprae by mouse T cells.

Parasite expression libraries have so far been screened with antibodies, DNA probes or T cell clones. Immunity to many parasites, such as Mycobacterium leprae, is largely mediated by T cells, and so the screening of such libraries for T cell epitopes is an important step toward the development of effective vaccines and diagnostic reagents. A new method for screening of lambda gt11 libraries with uncloned T cell populations is presented here, which takes advantage of the fact that the recombinant proteins contain beta-galactosidase as their leader peptide; this allows them to be semipurified by means of anti-beta-galactosidase antibodies coated on the bottom of microtiter plate wells, within which a proliferation assay can then be carried out. Optimum conditions for the assay were determined, using the M. leprae 18-kDa antigen as a test antigen.

IgG and IgM antibodies immunoreacting with a 2,3-diacyl trehalose-2'-sulphate in sera from leprosy patients.

The distribution of IgG and IgM antibodies immunoreacting with the sulpholipid I (SLI) and sulpholipid IV (SLIV) of Mycobacterium tuberculosis was examined in sera from leprosy patients. It was found that the immunological reactions correlated with the clinical spectrum of leprosy; and in multibacillary patients, antibody titres declined in response to successful treatment. The serological patterns were similar to the PGL I patterns, however, the IgG responses towards the sulpholipids were predominant over the IgM responses in the case of the sulpholipid antigens.

Immunological response to homologous and heterologous phenolic glycolipid antigens in tuberculosis and leprosy.

The occurrence of IgM antibodies immunoreacting in an ELISA test with five phenolic-glycolipids (GPL) antigens (PGL-Tb 1, from M. tuberculosis; PGL-I, from M. leprae; PGK-K-I, from M. kansasii; Mycoside G, from M. marinum; and Mycoside B, from M. bovis), was examined in the sera of 46 tuberculous patients, 48 multibacillary leprosy patients, 40 paucibacillary leprosy patients and in 134 healthy controls. The sensitivity (97.9) and the specificity (91.8) observed in tuberculous patients with the homologous antigen PGL-Tb 1 underlined the interest of this antigen for case finding in tuberculosis epidemiology. The sensitivity and the specificity observed in multibacillary leprosy patients, respectively 91.7 and 91.8, and in paucibacillary leprosy patients, respectively, 35.0 and 91.7, confirmed the limited value of homologous antigen PGL-I for the serological case finding of leprosy patients in endemic areas with a strong incidence of paucibacillary leprosy forms. The data obtained with the heterologous PGL antigens in tuberculosis and multibacillary leprosy serology were higher than those observed in healthy controls and in paucibacillary leprosy patients. However the ELISA using the heterologous antigens was not useful in diagnosis of active tuberculosis or multibacillary leprosy forms. Healthy controls showed low immunoreactivity against PGL antigens, with the exception of mycoside B.