Immunologic responses in patients with lepromatous leprosy

Immunologic responses were measured in 46 patients with lepromatous leprosy. These patients were not distinguishable from controls on the basis of responses to soluble intradermal antigens, sensitization to contactants, peripheral blood T- and B-cell percentages, in vitro lymphocyte responses to a mitogen, or the prevalence of autoantibodies. Generalized immunologic abnormalities in patients with lepromatous leprosy are neither predisposing causes nor necessary accompaniments of lepromatous leprosy, but are probably remote sequellae of the illness. By implication, the generalized immunologic abnormalities reported in other diseases are likely to be remote sequellae of the particular illness.

Sôbre a reação de Mitsuda

O problema da correlação entre as respostas macroscópicas e histológicas à inoculação de lepromina é discutido no presente trabalho, chegando-se à conclusão de que os resultados obtidos através do estudo de amostras de doentes de lepra não podem ser aplicados a populações sadias. Chama-se a atenção para o fato de que ainda não foi demonstrado terem agentes sensibilizantes, tais como o BCG ou as inoculações repetidas de lepromina, a capacidade de transformar indiv¡duos histológicamente Mitsuda negativos em Mitsuda positivos. Também não parece provado que as reações positivas ao teste leprom¡nico possam ocorrer na ausência de hipersensibilização por M. tuberculosis e/ou M. leprae, ou outro agente semelhante. A suposição de que as LR +++ observadas em indiv¡duos sadios devam corresponder invariávelmente a reações histológicamente positivas pode causar tendenciosidades.

Studies of the lepromin test. Variations in the results of the Mitsuda Test observed in cases of leprosy of the neuro-macular type

A study has been made of the variations in the results of the lepromin test in cases the neural type, demonstrated by repeated testing of the same cases in different circumstances There apper to be at least five possible factores which, acting singly or in combination, may influence the result of the test. These different factors are: variations in clinical activity, variations in bacteriological findings, variations in the time year at which the test is done, deterioration of the lepromin on keeping, and the use of different lots of lepromin Our stdy has shown that the two most important factors are the variations in clinical activity and tima of the yaer at which the test is done

Observations on the leprolin (Mitsuda) reaction

The leprolin (Mitsuda) test in the hands of leprosy workers in different parts of the world has given fairly consistent results along certain lines. However, the mechanism of the reaction is still very imperfectly understood, and for this reason its true significance can not be fully evaluated. The present report covers certain work done in an effort to obtain a further understanding of its nature. The results of this study suggest that a positive reaction depends on the presence of sessile antibodies attached to the cells in the dermis. Efforts either to stimulate or to exhaust these hypothetical antibodies by repeated injections of the test material at varying intervals were unsuccessful, but the experiments in this respect were not entirely satisfactory because of insufficiency of material. A positive leprolin reactive in a case of the cutaneous type of the disease may be considered a favorable prognostic sign, but it is not necessarily a guarantee that the case will improve to the bacillus-free stage within a reasonable time. Among bacteriologically found to relapse. The usual negative result of the leprolin test among cutaneous-type lepers seems to be based on positive or specific anergy, though we have failed to demonstrate the presence of hypothetical substances analogous to the anticutines shown by Picker and Loewenstein to exist in tuberculosis. On the other hand the negative result in infants and young children seems probably to be nonspecific. The leprolin and the tuberculina reactions have some points in common, but they are so dissimilar in certain important respects that in all probabilitty they are fundamentally different. Neither can be transmitted by passive transfer and both are more delayed than the usual cutaneous tests. However, one of their imortant differences lies in the fact that the leprolin reaction has been found to be positive in most normal adults, whether they have been in contact with the leprosy or not, whereas the tuberculin reaction is positive only in those who have acquired an infection. Furthermore, the tuberculin reaction is usually at its maximum and is read at the end of 48 hours; the leprolin reaction is much more delayed and is ordinarily read at the end of the second week...