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. 1995 May;63(5):1848–1854. doi: 10.1128/iai.63.5.1848-1854.1995

Cellular immune response to Mycobacterium leprae infection in human immunodeficiency virus-infected individuals.

E P Sampaio 1, J R Caneshi 1, J A Nery 1, N C Duppre 1, G M Pereira 1, L M Vieira 1, A L Moreira 1, G Kaplan 1, E N Sarno 1
PMCID: PMC173234  PMID: 7729894

Abstract

The immune responses to Mycobacterium leprae and other mycobacterial antigens were studied in 11 leprosy patients with concurrent human immunodeficiency virus type 1 (HIV-1) infection. Three patients manifested borderline lepromatous leprosy, and eight patients had borderline tuberculoid (BT) leprosy. Despite the low CD4+ T-cell count in the peripheral blood, no histologic or phenotypic change in the cellular infiltrate in either the lepromatous or tuberculoid lesions was observed when compared with HIV-1-negative patients. Lepromatous lesions contained heavily parasitized macrophages and few CD8+ T cells. Lesions from the patients with BT leprosy showed extensive CD4+ T-cell infiltration despite a significant reduction in CD4+ T-cell counts in the peripheral blood. No acid-fast bacilli were detected in the tuberculoid lesions. HIV-1 infection did not alter the lack of response in lepromatous leprosy to M. leprae antigens either in vitro or in vivo. In contrast, the skin test response to M. leprae antigens as well as the in vitro lymphoproliferative responses to mycobacterial antigens that are usually seen in patients with tuberculoid leprosy were abrogated in the BT HIV-1+ patients. However, production of gamma interferon in response to the same stimuli was preserved in most of the patients. Analysis of cytokine gene expression showed activation of additional cytokine genes in the unstimulated peripheral blood cells of patients with both leprosy and HIV-1 infections as compared with cells from patients with leprosy alone. These results suggest that granuloma formation in leprosy can be independent of the impaired CD4+ T-cell response of the HIV-1 infection. Furthermore, in HIV-1+ individuals with M. leprae infection, activation of cytokine genes is observed even when the circulating CD4+ T-cell count is significantly reduced.

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Selected References

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  1. Andrade V. L., Avelleira J. C., Marques A., Vianna F. R., Schechter M. Leprosy as cause of false-positive results in serological assays for the detection of antibodies to HIV-1. Int J Lepr Other Mycobact Dis. 1991 Mar;59(1):125–126. [PubMed] [Google Scholar]
  2. Benson C. A., Ellner J. J. Mycobacterium avium complex infection and AIDS: advances in theory and practice. Clin Infect Dis. 1993 Jul;17(1):7–20. doi: 10.1093/clinids/17.1.7. [DOI] [PubMed] [Google Scholar]
  3. Bjune G., Barnetson R. S., Ridley D. S., Kronvall G. Lymphocyte transformation test in leprosy; correlation of the response with inflammation of lesions. Clin Exp Immunol. 1976 Jul;25(1):85–94. [PMC free article] [PubMed] [Google Scholar]
  4. Blum L., Flageul B., Sow S., Launois P., Vignon-Pennamen M. D., Coll A., Millan J. Leprosy reversal reaction in HIV-positive patients. Int J Lepr Other Mycobact Dis. 1993 Jun;61(2):214–217. [PubMed] [Google Scholar]
  5. Horsburgh C. R., Jr Mycobacterium avium complex infection in the acquired immunodeficiency syndrome. N Engl J Med. 1991 May 9;324(19):1332–1338. doi: 10.1056/NEJM199105093241906. [DOI] [PubMed] [Google Scholar]
  6. Jagadha V., Andavolu R. H., Huang C. T. Granulomatous inflammation in the acquired immune deficiency syndrome. Am J Clin Pathol. 1985 Nov;84(5):598–602. doi: 10.1093/ajcp/84.5.598. [DOI] [PubMed] [Google Scholar]
  7. Kaplan G., Mathur N. K., Job C. K., Nath I., Cohn Z. A. Effect of multiple interferon gamma injections on the disposal of Mycobacterium leprae. Proc Natl Acad Sci U S A. 1989 Oct;86(20):8073–8077. doi: 10.1073/pnas.86.20.8073. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kaplan G., Nusrat A., Sarno E. N., Job C. K., McElrath J., Porto J. A., Nathan C. F., Cohn Z. A. Cellular responses to the intradermal injection of recombinant human gamma-interferon in lepromatous leprosy patients. Am J Pathol. 1987 Aug;128(2):345–353. [PMC free article] [PubMed] [Google Scholar]
  9. Kennedy C., Lien R. A., Stolz E., van Joost T., Naafs B. Leprosy and human immunodeficiency virus infection. A closer look at the lesions. Int J Dermatol. 1990 Mar;29(2):139–140. doi: 10.1111/j.1365-4362.1990.tb04087.x. [DOI] [PubMed] [Google Scholar]
  10. McElrath M. J., Kaplan G., Burkhardt R. A., Cohn Z. A. Cutaneous response to recombinant interleukin 2 in human immunodeficiency virus 1-seropositive individuals. Proc Natl Acad Sci U S A. 1990 Aug;87(15):5783–5787. doi: 10.1073/pnas.87.15.5783. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Myrvang B., Godal T., Ridley D. S., Fröland S. S., Song Y. K. Immune responsiveness to Mycobacterium leprae and other mycobacterial antigens throughout the clinical and histopathological spectrum of leprosy. Clin Exp Immunol. 1973 Aug;14(4):541–553. [PMC free article] [PubMed] [Google Scholar]
  12. Nathan C. F., Kaplan G., Levis W. R., Nusrat A., Witmer M. D., Sherwin S. A., Job C. K., Horowitz C. R., Steinman R. M., Cohn Z. A. Local and systemic effects of intradermal recombinant interferon-gamma in patients with lepromatous leprosy. N Engl J Med. 1986 Jul 3;315(1):6–15. doi: 10.1056/NEJM198607033150102. [DOI] [PubMed] [Google Scholar]
  13. Pönnighaus J. M., Mwanjasi L. J., Fine P. E., Shaw M. A., Turner A. C., Oxborrow S. M., Lucas S. B., Jenkins P. A., Sterne J. A., Bliss L. Is HIV infection a risk factor for leprosy? Int J Lepr Other Mycobact Dis. 1991 Jun;59(2):221–228. [PubMed] [Google Scholar]
  14. Ridley D. S., Jopling W. H. Classification of leprosy according to immunity. A five-group system. Int J Lepr Other Mycobact Dis. 1966 Jul-Sep;34(3):255–273. [PubMed] [Google Scholar]
  15. Sampaio E. P., Kaplan G., Miranda A., Nery J. A., Miguel C. P., Viana S. M., Sarno E. N. The influence of thalidomide on the clinical and immunologic manifestation of erythema nodosum leprosum. J Infect Dis. 1993 Aug;168(2):408–414. doi: 10.1093/infdis/168.2.408. [DOI] [PubMed] [Google Scholar]
  16. Sampaio E. P., Moreira A. L., Sarno E. N., Malta A. M., Kaplan G. Prolonged treatment with recombinant interferon gamma induces erythema nodosum leprosum in lepromatous leprosy patients. J Exp Med. 1992 Jun 1;175(6):1729–1737. doi: 10.1084/jem.175.6.1729. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Sarno E. N., Espinosa M., Sampaio E. P., Vieira L. M., Figueiredo A. A., Miranda C. F., Esquenazi D., Salgado J. L., Nogueira N. Immunological responsiveness to M. leprae and BCG antigens in 98 leprosy patients and their household contacts. Braz J Med Biol Res. 1988;21(3):461–470. [PubMed] [Google Scholar]
  18. Schauf V., Rom W. N., Smith K. A., Sampaio E. P., Meyn P. A., Tramontana J. M., Cohn Z. A., Kaplan G. Cytokine gene activation and modified responsiveness to interleukin-2 in the blood of tuberculosis patients. J Infect Dis. 1993 Oct;168(4):1056–1059. doi: 10.1093/infdis/168.4.1056. [DOI] [PubMed] [Google Scholar]
  19. Van Voorhis W. C., Kaplan G., Sarno E. N., Horwitz M. A., Steinman R. M., Levis W. R., Nogueira N., Hair L. S., Gattass C. R., Arrick B. A. The cutaneous infiltrates of leprosy: cellular characteristics and the predominant T-cell phenotypes. N Engl J Med. 1982 Dec 23;307(26):1593–1597. doi: 10.1056/NEJM198212233072601. [DOI] [PubMed] [Google Scholar]

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