Identification of sensitive indicators in immune response for leprosy affected patients: An observational clinical study of safety and immunogenicity of influenza vaccine.

ABSTRACT: Cured leprosy patients have special physical conditions, which could pose challenges for safety and immunogenicity after immunization. We performed an observational clinical study aimed to identify the safety and immunogenicity of influenza vaccine in cured leprosy patients. A total of 65 participants from a leprosarium were recruited into leprosy cured group or control group, and received a 0.5 ml dose of the inactivated split-virion trivalent influenza vaccine and a follow-up 28 days proactive observation of any adverse events. Hemagglutination and hemagglutination inhibition test was performed to evaluate serum antibody titer, flow cytometry was conducted to screen of cytokines level. The total rate of reactogenicity was 0.0% [0/41] in leprosy cured group and 37.5% [9/24] in control group. The seroconversion rate for H1N1 was difference between leprosy cured group and control group (41.83% vs 79.17%, P = .0082), but not for H3N2 (34.25% vs 50.00%, P = .4468). At day 0, leprosy cured group have relatively high concentration of interleukin-6, interleukin-10, tumor necrosis factor, interferon-γ, and interleukin-17 compared to control group. The interleukin-2 concentration increased 2 weeks after vaccination compared to pre-vaccination in leprosy cured group, but declined in control group (0.92 pg/ml vs -0.02 pg/ml, P = .0147). Leprosy cured group showed a more rapid down-regulation of interleukin-6 when influenza virus was challenged compared to control group (-144.38 pg/ml vs -11.52 pg/ml, P < .0001). Subgroup analysis revealed that the immunization administration declined interleukin-17 concentration in Tuberculoid type subgroup, but not in Lepromatous type subgroup or control group. Clinically cured leprosy patients are relatively safe for influenza vaccine. Leprosy cured patient have immune deficit in producing antibody. Interleukin-6 and interleukin-17 were 2 sensitive indicators in immune response for leprosy affected patients. The identification of indicators might be help management of leprosy and used as predictive markers in leprosy early symptom monitoring.

Borderline tuberculoid leprosy with upgrading Type 1 reaction in a HIV seropositive patient, after antiretroviral therapy: an immune reconstitution inflammatory syndrome.

A case of borderline tuberculoid (BT) leprosy with upgrading Type 1 reaction, in a HIV seropositive patient, 7 weeks after starting highly active antiretroviral therapy, as an immune reconstitution inflammatory syndrome (IRIS), is reported.

Modulating the immune response by oral zinc supplementation: a single approach for multiple diseases.

Zinc is required for multiple cellular tasks, and especially the immune system depends on a sufficient availability of this essential trace element. During the last decades, many studies attempted to affect the outcome of various diseases by zinc supplementation. These efforts either aimed at supporting immunity by zinc administration or at correcting a loss of zinc secondary to the disease to restore the zinc-dependent functions of the immune system. This review aims to summarize the respective findings and to discuss possible molecular mechanisms by which zinc could influence viral, bacterial, and parasitic infections, autoimmune diseases, and the response to vaccination. Zinc supplementation in diseases such as diarrhea, chronic hepatitis C, shigellosis, leprosy, tuberculosis, pneumonia, acute lower respiratory infection, and leishmaniasis seems beneficial. In contrast, the results for the common cold and malaria are still not conclusive, and zinc was ineffective in most vaccination and rheumatoid arthritis studies. For AIDS and type 1 diabetes, zinc supplementation may even be a risk factor for increased mortality or deterioration of the glucose metabolism, respectively. In these cases, zinc supplementation should be used with care and limited to clearly zinc-deficient individuals.

Borderline tuberculoid leprosy: an immune reconstitution phenomenon in a human immunodeficiency virus-infected person.

Two months after starting highly active antiretroviral treatment (HAART), an individual with human immunodeficiency virus type 1 (HIV-1) infection and profound CD4+ T lymphocytopenia developed several erythematous plaques on his face, which were due to borderline tuberculoid leprosy with reversal reaction. The temporal association between the development of these lesions and changes in blood CD4+ lymphocyte count and plasma HIV-1 load observed during HAART strongly suggests that the presentation of leprosy resulted from immune reconstitution.

Effect of peroxidase on the development of experimental leprosy in mice after intraplantar infection.

Lyophilized horseradish peroxidase (activity 100 U/mg) administered per os in a dose of 100-200 mg/kg fodder enhanced bactericidal activity of phagocytes in mice experimentally infected with Mycobacterium leprae, which manifested in suppression of M. leprae growth in comparison with untreated controls.

Negative observations on immunological side effects of rifampin and dapsone in mice.

The in vivo effects of rifampin and dapsone on immunological responses were investigated using mice immunized with sheep erythrocytes. The number of cells producing antibody was not affected by a clinical (1 CD) or a threefold excess dose (3 CD) of the drugs administered for ten days. A similar result was obtained in an experiment using a mouse strain known to be low responders to the antigen. Induction of suppressor cells acting on antibody production was not influenced by 3 CD or 6 CD of the drugs. Neither delayed-type hypersensitivity nor induction of the suppressor cell population acting on delayed hypersensitivity was affected by 3 CD of the drugs. Phagocytosis of sheep erythrocytes by peritoneal cells and the growth of a tumor were not altered by 6 CD of the drugs.

[Thalidomide in dermatology]. / Thalidomid in der Dermatologie.

Based on present publications we review indications of the therapy of dermatoses with thalidomide as well as possible mechanisms of action and side effects of this drug. In reactional states of leprosy the use of thalidomide is established. Further indications are chronic cutaneous lupus erythematosus, prurigo nodularis, and eventually recurrent aphthosis and certain photodermatoses not responding to usual treatment. Therapeutical trials of thalidomide in diseases in which such a treatment is only occasionally or not at all mentioned in the literature will be reported. Concerning the mechanisms of action emphasis is put on a possible immunosuppression by thalidomide. Among the side effects the thalidomide neuropathy is stressed.

[Levamisole, stimulant of the immune system in animal and man (author's transl)]. / Le lévamisole, stimulant du système immunitaire chez l'animal et chez l'homme

Levamisole, a drug initially used for its antihelminthic properties has been recently emphasized when Renoux proved its immunostimulating effects in mice en 1971. Since this date, numerous publications concerned the immunological activity of this drug in animals and men. These come to the conclusion that levamisole is capable of restoring cellular immunity as demonstrated by clinical and biological tests (restoration of delayed skin hypersensitivity, increase of the percentage of rosette forming cells and PHA transformed cells). In men, its seems possible to confirm the therapeutic activity of this molecule in a wide range of disease with suspected or proven immunological deficiency. In different forms of cancer, when most of the tumor volume is first reduced, levamisole therapy significantly increases both remission and survival. In auto immune diseases (rheumatoid arthritis, systemic lupus erythematosus), levamisole seems to be strikingly effective. In viral infections (zoster, recurrent herpes, aphthous stomatitis) levamisole is able to reduce the duration of outbreaks and prolong the disease free interval. Finally, encouraging results have been obtained in patients with lepromatous leprosis. Other conditions, where an immunological deficiency is suspected are under study with levamisole therapy. This low molecular weight synthetic drug is perhaps the first pharmacological agent which acts on the host defense mechanisms.