Cutaneous cryptococcosis and molluscum contagiosum occurring in the same lesion in a patient with AIDS.

Patients with acquired immunodeficiency syndrome (AIDS) are susceptible to a wide range of pathogens due to profound defect in cell-mediated immunity. The co-existence of different diseases within the same lesion is a feature of human immunodeficiency virus (HIV) infection. We describe co-existent cutaneous cryptococcosis and molluscum contagiosum in the same lesion in a patient with the acquired immunodeficiency syndrome.

Urinary excretion of renal brush border membrane enzymes in leprosy patients--effect of multidrug therapy.

Renal function at the brush border membrane level has been studied using characteristic enzymes, such as alkaline phosphatase, leucine-aminopeptidase and gamma-glutamyl transpeptidase. Urinary enzyme studies were performed using leprosy patients, classified on the basis of bacteriological index (BI>3; n=20, BI<3; n=12, BI-ve; n=10) and compared with control subjects (n=10). The role of enzymuria in monitoring WHO-recommended multidrug therapy (MDT) has been evaluated in these patients. A significant increase in the enzyme activities (p<0.01), as well as significant (p<0.01) proteinurea in 24-hour urine samples of both the smear positive groups (BI>3, BI<3) prior to therapy compared to control subjects, indicates proximal tubular functional impairment at brush border membrane level. In the smear negative (BI-ve) group, no significant difference was observed in enzyme activities as compared with the control group. In a follow-up study (BI>3;n=13, BI<3; n=4) the activities of all the enzymes decreased significantly in all the groups when compared to a corresponding untreated group. The follow-up study was not carried out on the smear negative group. The surprising finding was the differential behaviour of r-glutamyl transpeptidase, whose activity increased significantly (p<0.01) even after therapy in BI>3 group when compared with untreated patients. However in a detailed work-up including hepatic and renal function tests, the serum biochemistry was found to be normal both before and after therapy. Urinary excretion of brush border enzymes seems to be related to bacterial load, and their potential in studying the effect of MDT remains unclear.

Transport of amino-acids across renal brush border membrane vesicles in Mycobacterium leprae infected Swiss albino mice--effect of Convit vaccine.

Brush border membrane vesicles prepared from kidneys of Mycobacterium leprae infected (non-vaccinated) and vaccinated-infected Swiss albino mice were used to assess the effect of Convit's combined vaccine (BCG + M. leprae) on amino acid transport activity across the tubular basement membrane. The protective effect of Convit's vaccine was more pronounced with respect to the uptake of L-alanine than L-aspartate. Uptake of L-lysine showed no significant difference in the different groups. Footpad counts followed characteristic growth curves in the non-vaccinated infected group but showed a lag in the development of peak levels in the vaccinated group. Further Convit's vaccine appeared to have a protective effect on renal impairment in the mouse model of leprosy in the initial stages of infection only, as indicated by the transient reversal of amino acid uptake and a diminution in the footpad counts induced by M. leprae infection. No significant (P > 0.05) protective effect of the vaccine was found in the advanced disease state.

Adenosine triphosphate content of Mycobacterium leprae by percoll buoyant density centrifugation.

Thirty nine untreated patients of bacilliferous leprosy with a mean bacteriological index of 4.8 and morphological index of 1.3% formed the study group. Adenosine triphosphate assay was carried out by (i) enzyme treatment method in 18 patients and (ii) percoll buoyant density gradient method in 21 patients. ATP content obtained by percoll buoyant density gradient method was significantly higher than that obtained by enzyme treatment method. Percoll buoyant density centrifugation for purification and isolation of bacilli from human leproma is simplier, quicker and can serve as an alternate method of enzyme treatment.

Respiratory burst metabolic status of macrophages in experimental leprosy.

Peritoneal macrophages from uninfected controls and Mycobacterium leprae infected Swiss albino mice were studied for their respiratory burst (RB) activity at different time intervals. The RB metabolic activity of macrophages declined significantly after 3 month infection using latex (p less than 0.001) and M. leprae (p less than 0.01) as stimuli. However, significant rise (p less than 0.001) in the oxidative metabolic activity was seen at 6 and 9 months postinfection period on stimulation with both the stimuli. The sharp rise in the oxidative metabolic status at peak period of infection in the experimental animals suggests that the macrophages are functionally normal though M. leprae is unable to trigger the respiratory burst sufficiently.

Does Convit vaccine (BCG + Mycobacterium leprae) afford protection against biochemical changes in renal brush border membrane in experimental leprosy?

Renal functional status in Mycobacterium leprae infected mice can be best studied by examining the enzymatic status of brush border membrane vesicles from proximal convoluted tubule. The role of vaccination in modulation of the renal status brought by the disease has been studied using this technique. The characteristic marker enzymes of renal brush border membrane--namely alkaline phosphatase, leucine aminopeptidase and gamma-glutamyl transpeptidase decreased significantly (p less than 0.01) in due course in M. leprae infection over a period of 9 months. The combined vaccine (BCG + M. leprae) may have a protective effect on renal abnormalities only in the initial stages of infection as indicated by a significant rise in enzymatic levels. However, no significant (p greater than 0.05) protective effect of vaccine was found in a more advanced disease state after 9 months in infected mice.

Renal brushborder membrane vesicle. Study of marker enzymes and uptake of nutrients in Mycobacterium leprae infected mice.

The renal brush border membrane vesicles (BBMV) were used to elucidate the early biochemical functional status during the course of experimental M. leprae infection in mice. The activities of the characteristic brush-border enzymes viz: alkaline phosphatase, leucine amino peptidase and gamma-glutamyl transpeptidase were found to be significantly decreased (p less than 0.001) at 3 and 6 months after infection. The transport of nutrients viz: D-glucose, L-alanine, L-lysine and L-aspartate across BBMV showed similar pattern. The activity of brush border enzymes and transport of nutrients across the membrane returned to normal at 9 months post-infection suggesting regeneration of the brush border membrane.

Lymphocytotoxins in leprosy.

Lymphocytotoxic antibodies (LCAs) were assayed in serum samples from 60 patients of leprosy spectrum before starting multi-drug therapy (MDT). Seventeen healthy volunteers without any history of viral infection provided control samples. Post treatment follow up samples were also included in the study. In all pretreatment sera of LL, BL and BT/TT patients the levels of LCAs were elevated, the figures were 39.05 +/- 23.87, 44.89 +/- 20.74 and 34.16 +/- 17.50 respectively. With treatment a significant fall in LcAs production was observed in all types of leprosy patients.

Urinary excretion of renal brush-border enzymes in lepromatous leprosy--a preliminary investigation.

Activities of the brush-border enzymes, alkaline phosphatase, maltase, leucine aminopeptidase, and gamma-glutamyl transpeptidase, were measured in urine samples of 25 lepromatous leprosy patients and an equal number of age-matched healthy controls. None of the patients were shown to be suffering from any other systematic disease. The enzymatic activities were shown to be significantly elevated in leprosy patients when compared to controls.