Effect of Zinc Supplementation on Adenosine Deaminase Activity in Leprosy.

Serum Adenosine Deaminase (ADA) acts as marker of cellular immunity and its activity is found to be altered in various diseases in which there is a cell mediated immune response (CMI) including leprosy. The role of zinc is well established in the development and maintainence of immunocompetence and its supplementation activates the immune response in particular Tlymphocytes and monocytes in several ways. The aim of the study was planned to evaluate the effect of nutritional zinc supplementation on cell mediated immune response by investigating the pre and post intervention serum ADA levels after oral zinc sulphate supplementation in leprosy patients. A total of 49 cases, 30 Tuberculoid Leprosy (TT) and 19 Lepromatous Leprosy (LL) patients, within the age group of 25-60 years were enrolled in the study along with 30 age matched healthy controls. Serum ADA was estimated in all the subjects before and after (2 months and 4 months) oral zinc supplementation. Pre intervention serum ADA level was observed to be significantly increased in both the TT and LL (p<0.001) groups as compared to controls, revealing raised immunological activity in the patients. After oral zinc sulphate supplementation serum ADA re-evaluation was done in 38 cases. A highly significant (p < 0.001 ) rise in ADA level was registered in the post intervention period (4 months supplementation) in TT cases with a moderately significant (p< 0.05) increase in LL cases, indicating the ability of oral zinc therapy to affectively alter the cell mediated immune response in leprosy.

Reactional states in multibacilary hansen disease patients during multidrug therapy

It is well known that reactions are commonplace occurrences during the course of leprosy disease. Stigmatization may even be attributable to reactions which are also responsible for the worsening of neural lesions. A cohort of 162 newly-diagnosed baciloscopically positive patients from the Leprosy Care Outpatient Clinic of the Oswaldo Cruz Foundation (FIOCRUZ) was selected for this study. While 46% of the multibacillary (MB) patients submitted to the 24 fixed-dose multidrug therapy (MDT) regimen suffered reactions during treatment, it was found that all MBs were susceptible and that constant attention and care were required at all times. Fourteen per cent were classified as BB, 52% as BL, and 33% as LL. None of the variables under study, such as, sex, age, clinical form, length of illness, length of dermatological lesions, baciloscopic index (BI), or degree of disability proved to be associate with reaction among the patients studied. Reversal Reaction (RR) occurred in 45%, and Erythema Nodosum Leprosum (ENL) occurred in 55%. Among BB patients who developed reactions (15 patients), 93% presented RR; while among the LL patients who developed reactions (34 patients), 91% presented ENL. Likewise, ENL was very frequent among those with disseminate lesions, while RR was most often observed in patients with segmentary lesions. RR was also most likely to occur during the initial months of treatment. It was demonstrated that the recurrence rate of ENL was significantly higher than that of RR. Neither grade of disability nor BI was shown to be associated with RR and ENL reaction. However, the RR rate was significantly higher among patients showing BI 3

Mouse foot-pad studies with M. leprae--effect of desoxy fructo serotonin (DFS) and related compounds.

Mouse foot-pad experiments were carried out to study the effects of DFS and related compounds on the multiplication of M. leprae. Of the 25 cases clinically suspected Dapsone resistance, 8 were found resistant and 14 sensitive to Dapsone by mouse foot-pad experiments. Six were resistant to DFS and 16 were sensitive. Desoxy fructo 5-hydroxy tryptophane as well as Nutrition Antileprosy (NAL) diet were also found effective in suppressing the growth of M. leprae in mouse foot-pad. Of the two liposoluble derivatives of DFS tested (DFS LS-I and DFS LS-II), DFS LS-II was found more effective in suppressing the growth of M. leprae in foot-pads of mice.