A longitudinal study of immunologic reactivity in leprosy patients treated with immunotherapy.
More than 150 leprosy patients treated with multidrug therapy (MDT) plus immunotherapy (IMT) with a mixture of heat-killed Mycobacterium leprae plus live BCG were studied in relation to humoral and cell-mediated immune responses. Many previously had received prolonged sulfone monotherapy. Patients received 2 to 10 doses of IMT in a period of 1 to 3 years, depending upon their clinical form of leprosy. The patients were followed up for 5 to 10 years with repeated determinations of antibody levels to phenolic glycolipid-I; lymphoproliferative (LTT) responses to soluble extract of M. leprae, to whole bacilli and to BCG, skin-test responses and bacterial indexes (BIs). After MDT plus IMT there was a statistically significant decrease of antibody levels in the multibacillary (MB) group. The BI decreased proportionally to the ELISA results. LTT increased to M. leprae antigens, especially to soluble extract, in a high percentage of these patients (34% of LL patients positive). Lepromin positivity in MB patients increased from 5% initially positive to 75% at the cut-off during this follow up. These results show substantial early and persistent cell-mediated reactivity to M. leprae in many MB patients treated with MDT-IMT, confirming and expanding previously published data.
Rada
E
E
Instituto de Biomedicina, Caracas, Venezuela.
Ulrich
M
M
Aranzazu
N
N
Santaella
C
C
Gallinoto
M
M
Centeno
M
M
Rodriguez
V
V
Convit
J
J
D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial; D001428:Bacterial Vaccines / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004797:Enzyme-Linked Immunosorbent Assay; D006017:Glycolipids / Q000276:immunology; D006801:Humans; D006968:Hypersensitivity, Delayed; D007075:Immunoglobulin M / Q000097:blood; D007916:Lepromin / Q000276:immunology; D007917:Leprostatic Agents / Q000627:therapeutic use; D007918:Leprosy / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology / Q000628:therapy*; D015439:Leprosy, Borderline / Q000276:immunology / Q000628:therapy; D015440:Leprosy, Lepromatous / Q000276:immunology / Q000628:therapy; D015441:Leprosy, Tuberculoid / Q000276:immunology / Q000628:therapy; D008137:Longitudinal Studies; D008213:Lymphocyte Activation; D009163:Mycobacterium bovis / Q000276:immunology; D009166:Mycobacterium leprae / Q000276:immunology* / Q000302:isolation & purification
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001428:Bacterial Vaccines; D006017:Glycolipids; D007075:Immunoglobulin M; D007917:Leprostatic Agents; C060596:anti-leprosy vaccine; C045169:phenolic glycolipid I, Mycobacterium leprae; D007916:Lepromin