Abstract
The purpose of this study was to evaluate the effects of a delayed-type cell-mediated immune response to Mycobacterium tuberculosis antigen on the Mycobacterium leprae load in the skin of leprosy patients. Twelve patients with the lepromatous form of leprosy have been injected intradermally with 5 units of the purified protein derivative of tuberculin (PPD). Ten individuals responded with areas of induration ranging from 12 to 21 mm in diameter, and two were unresponsive (less than 10 mm). Twenty-one days thereafter, the injected and control sites were biopsied, and the histology, number of acid-fast bacilli, nature and phenotype of the emigrant cells, and ultrastructural characteristics of the lesions were evaluated. Eight of the 10 responding patients showed reductions in the number of acid-fast bacilli by factors ranging from 5 to 10,000. Two responders and both nonresponders exhibited no discernible decline in the number of organisms. The reduction in bacillary load was correlated with an intense mononuclear cell infiltrate, the maintenance of a high CD4+ T-cell/CD8+ T-cell ratio, the formation of granulomata, and the extensive destruction of previously parasitized macrophages.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Convit J., Pinardi M. E., Rodríguez Ochoa G., Ulrich M., Avila J. L., Goihman M. Elimination of Mycobacterium leprae subsequent to local in vivo activation of macrophages in lepromatous leprosy by other mycobacteria. Clin Exp Immunol. 1974 Jun;17(2):261–265. [PMC free article] [PubMed] [Google Scholar]
- Convit J., Ulrich M., Aranzazu N., Castellanos P. L., Pinardi M. E., Reyes O. The development of a vaccination model using two microorganisms and its application in leprosy and leishmaniasis. Lepr Rev. 1986 Dec;57 (Suppl 2):263–273. doi: 10.5935/0305-7518.19860080. [DOI] [PubMed] [Google Scholar]
- Draper P. The bacteriology of Mycobacterium leprae. Tubercle. 1983 Mar;64(1):43–56. doi: 10.1016/0041-3879(83)90050-8. [DOI] [PubMed] [Google Scholar]
- Engleman E. G., Warnke R., Fox R. I., Dilley J., Benike C. J., Levy R. Studies of a human T lymphocyte antigen recognized by a monoclonal antibody. Proc Natl Acad Sci U S A. 1981 Mar;78(3):1791–1795. doi: 10.1073/pnas.78.3.1791. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Evans R. L., Wall D. W., Platsoucas C. D., Siegal F. P., Fikrig S. M., Testa C. M., Good R. A. Thymus-dependent membrane antigens in man: inhibition of cell-mediated lympholysis by monoclonal antibodies to TH2 antigen. Proc Natl Acad Sci U S A. 1981 Jan;78(1):544–548. doi: 10.1073/pnas.78.1.544. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Job C. K. Isopathic phenomenon in lepromatous leprosy. A reappraisal. Int J Lepr Other Mycobact Dis. 1969 Oct-Dec;37(4):365–371. [PubMed] [Google Scholar]
- Kaplan G., Cohn Z. A. The immunobiology of leprosy. Int Rev Exp Pathol. 1986;28:45–78. [PubMed] [Google Scholar]
- Kaplan G., Luster A. D., Hancock G., Cohn Z. A. The expression of a gamma interferon-induced protein (IP-10) in delayed immune responses in human skin. J Exp Med. 1987 Oct 1;166(4):1098–1108. doi: 10.1084/jem.166.4.1098. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kaplan G., Nusrat A., Witmer M. D., Nath I., Cohn Z. A. Distribution and turnover of Langerhans cells during delayed immune responses in human skin. J Exp Med. 1987 Mar 1;165(3):763–776. doi: 10.1084/jem.165.3.763. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kaplan G., Van Voorhis W. C., Sarno E. N., Nogueira N., Cohn Z. A. The cutaneous infiltrates of leprosy. A transmission electron microscopy study. J Exp Med. 1983 Oct 1;158(4):1145–1159. doi: 10.1084/jem.158.4.1145. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kaplan G., Witmer M. D., Nath I., Steinman R. M., Laal S., Prasad H. K., Sarno E. N., Elvers U., Cohn Z. A. Influence of delayed immune reactions on human epidermal keratinocytes. Proc Natl Acad Sci U S A. 1986 May;83(10):3469–3473. doi: 10.1073/pnas.83.10.3469. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lepay D. A., Steinman R. M., Nathan C. F., Murray H. W., Cohn Z. A. Liver macrophages in murine listeriosis. Cell-mediated immunity is correlated with an influx of macrophages capable of generating reactive oxygen intermediates. J Exp Med. 1985 Jun 1;161(6):1503–1512. doi: 10.1084/jem.161.6.1503. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McInnes A., Rennick D. M. Interleukin 4 induces cultured monocytes/macrophages to form giant multinucleated cells. J Exp Med. 1988 Feb 1;167(2):598–611. doi: 10.1084/jem.167.2.598. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McLean I. W., Nakane P. K. Periodate-lysine-paraformaldehyde fixative. A new fixation for immunoelectron microscopy. J Histochem Cytochem. 1974 Dec;22(12):1077–1083. doi: 10.1177/22.12.1077. [DOI] [PubMed] [Google Scholar]
- Modlin R. L., Hofman F. M., Taylor C. R., Rea T. H. T lymphocyte subsets in the skin lesions of patients with leprosy. J Am Acad Dermatol. 1983 Feb;8(2):182–189. doi: 10.1016/s0190-9622(83)70021-6. [DOI] [PubMed] [Google Scholar]
- Ridley D. S. A logarithmic index of bacilli in biopsies. 2. Evaluation. Int J Lepr Other Mycobact Dis. 1967 Apr-Jun;35(2):187–193. [PubMed] [Google Scholar]
- Ridley D. S., Hilson G. R. A logarithmic index of bacilli in biopsies. I. Method. Int J Lepr Other Mycobact Dis. 1967 Apr-Jun;35(2):184–186. [PubMed] [Google Scholar]
- 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]
- Schuler G., Romani N., Steinman R. M. A comparison of murine epidermal Langerhans cells with spleen dendritic cells. J Invest Dermatol. 1985 Jul;85(1 Suppl):99s–106s. doi: 10.1111/1523-1747.ep12275566. [DOI] [PubMed] [Google Scholar]
- Schwarting R., Stein H., Wang C. Y. The monoclonal antibodies alpha S-HCL 1 (alpha Leu-14) and alpha S-HCL 3 (alpha Leu-M5) allow the diagnosis of hairy cell leukemia. Blood. 1985 Apr;65(4):974–983. [PubMed] [Google Scholar]
- 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]