This study elicits the comparative evaluation of the Bacteriologic Index (BI) and Morphologic Index (MI) of the skin, lymph node, bone marrow, nerve and muscle tissues of 15 untreated leprosy patients. The findings of comparable or even higher BI's and MI's in lymph nodes than skin are of considerable interest, especially the presence of a significant percentage of viable bacilli during reaction states when MI of skin and nerve tissue was found to be negative. Evaluation of the BI's and MI's of lymph nodes has been suggested to be of utmost importance for follow-up studies of patients being treated with antileprosy drugs.

Adolescent↗

PubMedDate not supplied

Immunopathology of leprosy--current status.

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Animals↗

PubMedDate not supplied

An appraisal of enzyme linked immunosorbent assay (ELISA) and serum antibody competition test (SACT) in leprosy.

Seventy-eight untreated leprosy patients, 104 treated patients and 105 healthy contacts were tested using two serological tests, SACT (serum antibody competition test based on competitive inhibition of monoclonal antibody binding to the MY2a determinant of M. leprae) and ELISA (measurement of IgM antibodies to the neoglycoproteins D-BSA and ND-BSA representing the phenolic-glycolipid antigen of M. leprae). The controls included normal healthy individuals, patients with sputum positive pulmonary tuberculosis, and active cases of rheumatoid arthritis from the department of rheumatology. The specificity of SACT was found to be very high. ELISA was found to be positive in two patients with rheumatoid arthritis, one each for D-BSA and ND-BSA ELISA. Both tests had a high sensitivity in BL and lepromatous patients. The sensitivity to both tests was considerably lower in tuberculoid and BT patients i.e., below 40%. Therefore the diagnostic value of a negative test in suspected cases of leprosy was very low employing either of the two tests. A proportion of patients with paucibacillary tuberculoid and BT leprosy were positive after six months or longer after therapy. Similarly a large number of BL and lepromatous patients were positive after considerably longer periods of treatment. The use of either tests for determining the duration of therapy is therefore limited. SACT appears to be more sensitive than ELISA with ND-BSA in detecting subclinical infection. The cumulative positivity of the two tests may be used as a measure of the infectivity of the disease in the community and for evaluating disease control methods.

Antibodies, Bacterial↗

PubMedDate not supplied

The utility of animal models for selection of a candidate vaccine for leprosy.

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Animals↗

PubMedDate not supplied

Studies on lepromin and soluble antigens of M.leprae: their classification standardization and use.

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)

Antigens, Bacterial↗

PubMedDate not supplied

Demonstration of Mycobacterium leprae specific antigens in leprosy lesions using monoclonal antibodies.

Cryostat sections of dermal lesions from 13 untreated patients of leprosy were studied by indirect immunoperoxidase using monoclonal antibodies (MLO4 & MLO6), defining M. leprae specific antigens. The lymphocytes and macrophages in both the tuberculoid and lepromatous granulomas showed membranous staining with the above antibodies. M. leprae organisms in the lepromatous granulomas and the cells in the section of lymph nodes of patients with tuberculosis, or sections of normal skin or psoriatic lesions did not show any staining with these antibodies. These observations suggest that M. leprae specific antigens are present and expressed on the cells infiltrating the granulomas of leprosy lesions.

Antibodies, Monoclonal↗

PubMedDate not supplied

Follow up of BL/LL patients on a slightly modified WHO regimen of multidrug therapy.

56 lepromatous leprosy patients with an initial average BI of 4.45 were administered once a month 600 mg of Rifampicin, 100 mg of Clofazimine on alternate days and 100 mg of Dapsone daily. None of these patients became smear negative in 2 years, and the same regimen was continued further. Two patients have become negative in 3 years and treatment has been stopped in them. The study indicates that highly bacilliferous LL/BL patients are likely to need 3 years or more of MDT for achieving bacterial negativity.

Adolescent↗

PubMedDate not supplied

Studies on serum proteins in leprosy by polyacrylamide gel electrophoresis (page)--I.

Serum protein pattern was studied in the leprosy spectrum, their contacts and in normal individuals by employing polyacrylamide gel electrophoresis. Sera from 80% of untreated BL/LL, 70% of untreated TT/BT patients and 67% of contacts have shown dysproteinaemia either for 232 kD or for 175 kD or for both these proteins together. Tendency of these proteins to return to normal levels was observed after treatment. But both these proteins come back to normal levels only after subsidence of the disease.

Adolescent↗

PubMedDate not supplied

Dermatoglyphics in leprosy (II Metric analysis of palms).

A group of 100 leprosy patients consisting of 50 lepromatous (BL/LL) and 50 tuberculoid (BT/TT) were investigated for metric analysis of the patterns present on their palms. Hundred normal persons were also selected from the families of patients to serve as controls. BT/TT patients and controls did not show any significant difference in their palmar patterns. On the other hand, significant differences were observed in the patterns between BL/LL patients and controls.

Dermatoglyphics↗

PubMedDate not supplied

In situ characterization of cells in the dermal infiltrates of lepromin reaction using monoclonal antibodies.

A study was made on the in situ characteristics of dermal infiltrates in the early and late lepromin reaction with monoclonal antibodies defining T cell subsets, Langerhan cells and Ia like antigens. The early reaction (24 hrs) was elicited either with standard Dharmendra lepromin or leprosin-A and the late reaction (3-4 weeks) was elicited with standard Dharmendra lepromin. In all, 15 biopsies were studied. Most lymphocytes in the infiltrates of both the lepromin and leprosin reactions were positive for OKT 11, Leu 3a, OKT 8 and Ia like antigens indicating thereby the presence of activated T cells. A high proportion of OKT6 + cells were also noticed in the infiltrates of these reactions. In the late reaction, the lymphocytes in the granulomas were predominantly activated T lymphocytes expressing OKT 11, Leu 3a, OKT 8 and Ia like antigens. Leu 3a + cells were scattered diffusely amidst the epithelioid cells. In contrast, OKT 8 + cells were present mainly in the peripheral region of the granuloma. A small proportion of OKT6 + cells were also seen in these granulomas. Ia like antigens and T6 antigens were not discernible on the epithelioid cells. No difference in the number of OKT6 + epidermal langerhan cells was observed in the various types of reactions.

Antibodies, Monoclonal↗

PubMedDate not supplied

Studies on healthy contacts of leprosy patients--a preliminary report.

91 healthy contacts of leprosy patients were studied for subclinical infection and possibly the pre-clinical stage of the disease using a battery of tests. It was observed that the test based on competitive inhibition of monoclonal antibody binding to the MY2 a determinant of M. leprae identifies a preclinical stage of the disease.

Adolescent↗