Subject(s)
Lepromin/classification , Lepromin/immunology , Erythema Nodosum , Leprosy, Borderline/classification , Leprosy, Borderline/diagnosis , Leprosy, Tuberculoid/classification , Leprosy, Tuberculoid/diagnosis , Leprosy, Lepromatous/diagnosis , Sulfones/administration & dosage , Sulfones/adverse effects , Clofazimine/administration & dosage , Clofazimine/adverse effects , Diagnosis, Differential , Leprosy , Mycobacterium leprae/classification , Mycobacterium leprae/ultrastructure , Rifampin/administration & dosage , Rifampin/adverse effectsABSTRACT
Before the discovery of armadillo as a susceptible animal the source of M.leprae was limited and hence the use of lepromin was not common in the field. In recent times, the soluble antigens of armadillo-derived M.leprae have been used extensively in the field. Although the results of the study show that these antigens do not differentiate always a susceptible form from the resistant form, they are able to segregate the polar forms of leprosy. In a given field situation the criteria for diagnosis is so stressed that leprosy is overdiagnosed and within one year of follow up nearly half the number of cases are noted as not leprosy. Hence, in such situations lepromin reaction would be definitely a poor correlate with the type of leprosy. However, in hospital based studies the lepromin reaction has always been and would remain useful in confirming the classification (Sengupta et al 1984). Lepromins and M.leprae soluble antigens have gone through extensive standardization procedures. As these antigens contain mostly common mycobacterial antigens along with the M.leprae-specific antigens, these antigens are unable to specifically diagnose M.leprae infection. After purification of M.leprae from infected armadillo tissue, it was expected that the soluble antigen of M.leprae would probably be as useful as tuberculin. However, this was not found to be true in case of lepromin. Specificity for M.leprae has been noted in the epitopes (antigenic sites) on cross reacting molecules (12 kd, 18 kd, 28 kd, 35 kd, 36 kd) of mycobacteria (Ivanyi et al 1983; Watson 1989). These specific epitopes, if synthesized, could be of use as skin test antigens for determining M.leprae infection.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Antigens, Bacterial/classification , Humans , Hypersensitivity, Delayed/diagnosis , Lepromin/classification , Leprosy/diagnosis , Mycobacterium leprae/immunology , Reference Standards , SolubilityABSTRACT
Estudou-se a reaçao de Mitsuda em 37 pacientes portadores de hanseníase, sendo 18 da forma tuberculóide reacional e 19 da forma dimorfa reacional, sob o ponto de vista clínico, histológico e baciloscópico, com leituras realizadas aos 30, 60, 90, e 120 dias, com o objetivo de se tentar identificar uma forma da outra. A maioria dos pacientes tuberculóides reacionais apresentou reaçao de Mitsuda positiva +. As reaçoes de Mitsuda diminuíram com o tempo nos dois grupos, sendo mais persistentes no grupo tuberculóide reacional. A baciloscopia aos 30 dias foi negativa ou houve presença de raros bacilos em 77,78 por cento dos casos tuberculóides reacionais. Conclui-se que os tuberculóides reacionais possuem uma maior capacidade de clareamento bacilar que os dimorfos reacionais e que a reaçao de Mitsuda pode ser útil na identificaçao dessas duas formas e, inclusive, sugerir sua evoluçao quanto ao diagnóstico e quanto à terapêutica