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T Warndorff van Diepen

Publications and source records attributed to T Warndorff van Diepen.

6 recordsLinked to original sources
PubMed1985

Relapse rate and incidence of dapsone resistance in lepromatous leprosy patients in Addis Ababa: risk factors and effect of short-term supplementary treatment.

A clinical trial was initiated at ALERT, Addis Ababa, Ethiopia, to study the effect of one-year supplementary treatment on the incidence of dapsone-resistant leprosy in lepromatous patients already on dapsone monotherapy. A total of 806 patients on dapsone therapy were assigned to one of four groups. The first group served as a control group, the second received a combination tablet of thiacetazone and INH (Thiazina) daily for 12 months, the third group received Thiazina daily for 12 months plus rifampin daily during months 1 and 7, and the fourth group received rifampin daily during months 1 and 7 but no Thiazina. Eighty-three percent of the patients were followed for five years after discontinuation of the supplementary treatment. The annual incidence of relapses and dapsone-resistant leprosy in the control group appeared to be 2.3% and 0.7%, respectively. The Thiazina treatment had no significant effect on either the overall relapse rate or the incidence of dapsone-resistant leprosy. The rifampin treatment, on the other hand, did significantly lower the relapse rate and only a single case of dapsone resistance was detected. A high incidence of relapse was found in young female patients. Nineteen of the 45 relapsed patients were bacteriologically negative at the start of the supplementary treatment and six had already been negative for over five years.

Adolescent↗
PubMed1985

In vivo responses to Mycobacterium leprae: antigen presentation, interleukin-2 production, and immune cell phenotypes in naturally occurring leprosy lesions.

To investigate the immune defect in lepromatous leprosy we studied immune cell phenotypes, lymphocyte activation states, and interleukin-2 (IL-2) production in naturally occurring leprosy skin lesions. Mouse hybridoma monoclonal antibodies reacting with the IL-2 receptor (anti-Tac), unbound IL-2 (DMS-1), antigen-presenting Langerhans' cells (OKT6) and the OKT4-Leu3 and OKT8 T-lymphocyte subpopulations were used with indirect horseradish peroxidase and alkaline phosphatase techniques on frozen biopsy sections. The percentage of Tac+ lymphocytes and the number of OKT6+ cells in the epidermis and dermal granuloma were significantly correlated in naturally occurring lesions (correlation coefficient 0.79) and were higher in tuberculoid than in lepromatous lesions. Leu3 antigen was expressed by 70-90% of Tac+ cells in tuberculoid lesions. Although the percentage of cells producing IL-2 was low in lesions of both lepromatous and tuberculoid patients, it was about 15 times greater in tuberculoid than in lepromatous lesions (0.032 +/- 0.037 tuberculoid vs 0.0019 +/- 0.023 lepromatous). There was an association between the number of OKT6+ cells and the percentage of IL-2-producing cells, but the association was weaker than that of OKT6+ cells and the percentage of IL-2 receptor-bearing cells (r = 0.2), implying that IL-2 production is not an intervening variable in the latter association. The absolute number of OKT4-Leu3+ lymphocytes was significantly different in different clinical leprosy groups and was positively correlated with host resistance (mean OKT4-Leu3+ cells/mm2 in 6 micron sections; 1412 +/- 288 tuberculoid, 400 +/- 93 borderline lepromatous, 200 +/- 100 polar lepromatous; r = 0.95). Absolute numbers of OKT8+ cells/mm2 in lesions were not significantly different. We conclude that there is a relative paucity of OKT4-Leu3+ cells as well as IL-2-producing cells at the local level in lepromatous leprosy lesions. Possible functional relationships between these findings and the failure of macrophage activation and destruction of Mycobacterium leprae in lepromatous leprosy are discussed.

Adolescent↗