Clinical significance of changes in serum proteins, immunoglobulins, and autoantibodies in leprosy.

Changes in the level of acute phase reactants such as C-reactive protein (CRP), serum globulins, and autoantibodies have been reported previously in patients with leprosy, particularly at the lepromatous end of the spectrum. The clinical significance of these findings was investigated by comparing the same parameters of humoral immune function in populations of Australian Aboriginals with stable treated leprosy and relevant contact groups including a) noninfected European sporadic contacts and b) healthy Aboriginal relatives of patients with confirmed leprosy. Raised levels of CRP and immunoglobulins and the higher frequency of autoantibodies seen in leprosy patients compared with sporadic contacts are probably related to differences in the incidence of nonleprous infection rather than to leprosy per se. Comparable results were obtained in the leprosy patients and their family contacts. The data highlight the need to use antigen-specific assays for determining the significance of changes in acute phase reactants and for distinguishing between the primary and secondary effects of Mycobacterium leprae infection.

Electrophoretic pattern of proteins in lepromatous leprosy.

Serum total proteins and the various protein fractions were studied in fifty cases of lepromatous leprosy and in eleven cases of lepromatous leprosy with lepra reaction. The study revealed a significant increase in serum total proteins in both lepromatous leprosy and lepra reaction groups, when compared with normal healthy subjects. The percentage rise was found to be 14.5% and 22.95% for lepromatous leprosy and lepra reaction respectively. The globulin fraction showed a significant elevation, while albumin showed a decrease. Thus a reversal of A/G ratio was observed in both the disease groups. Alpha-1 and Alpha-2 globulins were found to be significantly increased in both the disease groups. Beta globulins did not reveal any significant alteration. It was interesting to note the presence of an additional globulin fraction in seventeen patients of lepromatous leprosy and two cases of lepra reaction. Gammaglobulin showed a significant rise in lepromatous leprosy (56.16%) and in lepra reaction (60.72%). The significance of the above findings are discussed in the light of available literature.

Immunoglobulins in leprosy.

Serum immunoglobulins IgG, IgA and IgM were estimated in 22 lepromatous (LL) patients, 28 tuberculoid (TT), 9 borderline tuberculoid (BT), and 8 borderline lepromatous (BL), and compared with 50 normal healthy adult males belonging to a low socio-economic class. Immunoglobulin IgM was invariably significantly raised in TT, BT and LL subgroups of leprosy patients compared to the control but variation among different subgroups was statistically insignificant. Mean serum IgA levels were also raised in TT, BL and LL subgroups but statistically the rise was not significant. In the BT subgroup, significantly low IgA levels were observed both compared to the control and the other leprosy subgroups. Immunoglobulin G levels were significantly raised only in the LL subgroups compared to the control and the other subgroups of leprosy patients. It is proposed that persistently raised gamma globulins and immunoglobulin G, A and M levels observed in lepromatous leprosy patients could be caused by macrophage blockade hindering the suppressor T-cell mediated homeostatic control for immunoglobulins.

Electrophoresis and immuno electrophoresis in leprosy.

50 cases of leprosy belonging to various subgroups i.e. 10 tuberculoid, 25 lepromatous leprosy, 10 lepra reaction, 5 dimorphic leprosy, and 25 cases or normal individuals were subjected to agar gel electrophoresis. The slides were scanned by densitometry. It showed profound departure from normal in various fractions of electrophoretic patterns. All of them showed rise of gamma globulin. Albumin was markedly decreased in lepromotous leprosy and lepra reaction. In dimorphic leprosy Alfa-1 was decreased. Qualitative immuno electrophoresis was done by using antihuman serum raised in the laboratory, by immunising rabbits. It revealed changes in IgM and IgG arcs. Results are discussed and tried to explain on immunological derangement.

Electrophoretic pattern of serum proteins in leprosy.

Sera collected from 65 patients having various types of leprosy and 20 healthy human beings were studied for the determination of total serum proteins, paper electrophoresis for protein types and albumin globulin ratios. Significant changes in protein equilibrium with the presence of hypoalbuminemia and increases in various globulin fractions (except beta globulin) were observed in patients having lepromatous and dimorphous leprosy. An abnormal protein band was also detected in 3 of 20 cases of lepromatous leprosy. The patients suffering from tuberculoid and polyneuritic leprosy did not show much protein disequilibrium except for mild rises in serum alpha-2 and reductions in serum beta globulins.