Combined multidrug and Mycobacterium w vaccine therapy in patients with multibacillary leprosy.
Immunotherapy with Mycobacterium w vaccine was attempted in patients with borderline-borderline, borderline lepromatous (BL), or lepromatous leprosy (LL) to determine whether immunization can hasten recovery and reduce treatment time by invigorating cell-mediated immunity. Mycobacterium w, a nonpathogenic, rapidly growing, atypical mycobacterium, shares a number of common B and T cell determinants with Mycobacterium leprae and Mycobacterium tuberculosis. Patients receiving the vaccine had rapid clinical improvement and accelerated bacteriologic clearance. After treatment with vaccine for 2 years, 13 of 31 BL and LL patients were bacteriologically negative as were 5 of 25 controls. Vaccinated patients had one of two distinct histologic features, either an upgrading in the disease spectrum or complete clearance of granuloma. Some 80% of lepromin conversions were in BL and LL patients who received vaccine versus none and 14.3% of BL and LL controls, respectively. Thirteen of 17 vaccinated LL patients were released from treatment after 2 years in contrast to 2 of 15 controls.
Zaheer
S A
SA
Microbiology Division, National Institute of Immunology, Jit Singh Marg, New Delhi, India.
Mukherjee
R
R
Ramkumar
B
B
Misra
R S
RS
Sharma
A K
AK
Kar
H K
HK
Kaur
H
H
Nair
S
S
Mukherjee
A
A
Talwar
G P
GP
D001428:Bacterial Vaccines / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D016233:Immunotherapy, Active; D007917:Leprostatic Agents / Q000627:therapeutic use*; D015439:Leprosy, Borderline / Q000188:drug therapy / Q000628:therapy*; D015440:Leprosy, Lepromatous / Q000188:drug therapy / Q000628:therapy*; D009170:Nontuberculous Mycobacteria / Q000276:immunology*; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome
D001428:Bacterial Vaccines; D007917:Leprostatic Agents; C060596:anti-leprosy vaccine