title: Combined multidrug and Mycobacterium w vaccine therapy in patients with multibacillary leprosy.
abstract: 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.
authors.affiliation: Microbiology Division, National Institute of Immunology, Jit Singh Marg, New Delhi, India.
authors.forename: S A
authors.initials: SA
authors.lastname: Zaheer
authors.forename: R
authors.initials: R
authors.lastname: Mukherjee
authors.forename: B
authors.initials: B
authors.lastname: Ramkumar
authors.forename: R S
authors.initials: RS
authors.lastname: Misra
authors.forename: A K
authors.initials: AK
authors.lastname: Sharma
authors.forename: H K
authors.initials: HK
authors.lastname: Kar
authors.forename: H
authors.initials: H
authors.lastname: Kaur
authors.forename: S
authors.initials: S
authors.lastname: Nair
authors.forename: A
authors.initials: A
authors.lastname: Mukherjee
authors.forename: G P
authors.initials: GP
authors.lastname: Talwar
mesh_terms: 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
chemical_list: D001428:Bacterial Vaccines; D007917:Leprostatic Agents; C060596:anti-leprosy vaccine