[Assessment of the Mitsuda reaction in lepromatous patients inactive before and after immunotherapy]. / Avaliação da reação de Mitsuda em pacientes virchovianos inativos antes eapós imunoterapia.

In this study the immunopotentiator levamisole as well as a mixture of BCG/Mycobacterium leprae were investigated in inactive lepromatous leprosy patients by using the Mitsuda reaction as a parameter. Twenty lepromatous patients ten years ago classified as histologically negative for Mitsuda's test were divided into three groups: five patients that were only retested with Mitsuda antigen; eight patients that received oral levamisol and seven patients that received a mixture of alive BCG plus autoclaved M. leprae. The results indicated that: 1) the levamisole did not alter the reactivity to lepromin in any of the patients studied; 2) neither the changes in the reactivity to lepromin by using the mixture (3 cases) nor those that occurred spontaneously (3 cases) were clear. They properly reflected the natural variation of patients with some degree of resistance to Mycobacterium leprae.

[The Rubino reaction. Criterion for inactivation in lepromatous patients]. / Reação de Rubino. Critério de branqueamento para pacientes virchowianos.

Approximately 55% of active lepromatous patients respond positively to the Rubino reaction. With arrested cases this rate of positivity lowers considerably to about 15%. In an effort to associate this reaction with the presence of bacilli, a study of 796 cases was undertaken. The patients were divided into: a control group, active tuberculoid cases, arrested tuberculoid cases, active borderline cases, arrested borderline cases, active lepromatous cases, and arrested lepromatous cases. The patients were submitted to the following tests: Rubino reaction, presence of cryoglobulins, and VDRL and PCR positivity. By the results obtained we may conclude that: a) A positive Rubino reaction may be present in all the forms of leprosy studied, this reaction having an inverse relationship with the organism's resistance to "M. leprae". b) The Rubino reaction has specificity to leprosy. c) This reaction does not depend on the number of bacilli present in the host. d) A positive Rubino reaction is not related to the presence of cryoglobulins in the serum, nor to VDRL or PCR positivity, nor to the length of time the patient's disease has been arrested. The authors present these findings and suggest that this reaction be used as one of the criteria for determining cure.

[Cellular immunity in leprosy patients]. / Estudo da imunidade celular em pacientes branqueados.

Forty eight clinically arrested lepromatous patients were submitted to several tests to evaluate cellular immunological competence (PPD, Trichophytin, DNCB, determination of the percentage of T lymphocytes in the peripheral blood, and early and late reactions to the lepromin). The results of the Trychophytin test and of the lymphocyte percentage test did not differ from those of the control group, whereas the results to the PPD test were more often positive for the arrested Virchovian cases. All the patients presented positivity to the DNCB test, and none of them showed positivity to the Fernandez reaction. As for the late reaction to the lepromin, all the patients were negative, although in histopathological testing four degrees of reactivity was observed ranging from focal, non specific inflammatory reaction to granulomatous histiocytic with an epithelioid outline. By means of these results the authors were able to confirm that: 1. There is no cross reactivity between the PPD and lepromin tests. 2. Sulfone therapy does not interfere in immunocellular results for the tests employed. 3. Lepromatous patients respond like the general population to the unspecific sensitivity tests utilized. 4. The finding of histiocytic reaction with epithelioid outline in some biopsies of Mitsuda reaction in lepromatous patients, suggests the presence of a sub-population within this group, probably Borderline patients that suffered during the infection's evolution downgrading of theirs clinic and histological characteristics.

[Maintenance of armadillos in captivity and results of the inoculation of Mycobacterium leprae]. / Manutenção de tatus em cativeiro e resultados de inoculaçãso do Mycobacterium leprae.

The authors report their experiences in raising armadillos and the results obtained in inoculating them with M. leprae. They begin by reporting on the origin of the animals, how they were captured, and their efforts until they found the right kind of housing for the armadillos. They also tell of their attempts to develop the correct feeding procedures. The result is the feed used now in their laboratory: chicken feed mixed with bread, eggs, meat and milk. Along with this, they report on the way each animal is registered and the examination it undergoes upon admittance, namely, recording of its weight, rectal temperature, feces examination, hemogram and hemossedimentation. They also tell how animals are immobilized so as to take blood samples for the inoculations. Lastly, they present the results of the inoculations with M. leprae in three armadillos of the Euphractus sexticinctus species and 26 of the Dasypus novemcinctus species, with special reference to an armadillo of the D. novemcinctus species, which had systemic infection 15 months after being inoculated subcutaneously and intravenously. Bacilli were found in large quantities in various organs like the skin, lymph nodes, liver, kidneys and spleen. No bacilli were found in the myocardium, pancreas, thyroid and testicles. The authors are of the opinion that this is the first armadillo of the D. novemcinctus species to present experimental systemic infection with M. leprae in South America. Another armadillo, which has been inoculated with a suspension of 1.2 X 10(8) bacilli by the intracardiac route already showed nodules with bacilli on the abdominal wall 10 months after being inoculated. They believe that the results already obtained indicate that soon they will be able to provide material for institutions in Brazil as well as other countries that are interested in the study of M. leprae and in the preparation of the Mitsuda antigen which is so vital to the control of Hansen's disease.