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PubMedDate not supplied

[Epidemiological immunological studies on leprosy in Okinawa. 6. Lepromin, lymphocyte transformation, FLA-ABS and leproagglutination tests in the in-and out-patients with leprosy and the relationships among these tests and personal or family history or clinical findings of the patients].

In- and out-patients with leprosy in Okinawa were surveyed by using the following immunological tests: cutaneous reaction to Mitsuda's lepromin (40 million bacilli/ml) (LPR), lymphocyte transformation test with Dharmendara's antigen (DL-LTT), that with phytohemagglutinin (PHA-LTT), fluorescent leprosy antibody absorption test (FLA-ABS) and Leproagglutination test with cardiolipin-lecithin antigen (LAT). A correlation between two tests and a relationship between the test and personal or family history or clinical finding of the patients were evaluated by non-parametric statistics. Spearman's rank correlation coefficient was significant between LPR and DL-LTT, while a reverse correlation was found between LPR and FLA-ABS, DL-LTT and FLA-ABS, and DL-LTT and LAT, respectively. High reactivity in PHA-LTT was found in almost all of patients, irrespective of type and stage of leprosy, suggesting general immune responsiveness of leprosy patients in Okinawa. The other tests showed a significant difference in the mean rank of reaction values according to clinical findings such as type and stage of leprosy, property of skin lesion, loss of eyebrow, and bacteriological test. The use of LPR and DL-LTT for the study of cell-mediated immunity in leprosy was therefore confirmed. FLA-ABS was found useful for early serodiagnosis, while LAT for the study of autoimmunity in leprosy. None of these immunological tests showed significant difference among the subgroups of patients classified by the following items: presence or absence of consanguineous patient with leprosy, living place, place of onset, presence or absence of neural symptoms such as the enlargement of peripheral nerve, claw hand and facial palsy, ocular and nasal involvement, ENL in lepromatous and borderline leprosy and conditions in the treatment. On the other hand, LPR showed higher reactivity in female than in male, in the patients at home than those discharged, and in the patients with drop foot than those without. Higher reactivity of DL-LTT was also found in male than in female and in the patients with plantar ulcer than those without. FLA-ABS reactivity was significantly higher in the discharged patients than the inpatients, in the period of 5 to 9 years after onset than that of 20 or more years, but the reactivity was lower in the patients with drop foot than those without. LAT reactivity was significantly higher in the 30-39 years old patients than 0-19 years old, and in the patients with physical work than those with mental.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed1983

Community awareness about leprosy and participation in National Leprosy Control Programme.

To evaluate the health education component of our National Leprosy Control Programme (NLCP), 955 adult community members and 225 adult leprosy patients were interviewed with a view to assess their awareness about leprosy and participation in NLCP. The early signs/symptoms of leprosy were poorly perceived by the community. Majority of the community (81%) and patients (75%) were unaware or held superstitious ideas about causation of leprosy. The spread of disease through close contact with patient(s) was better known to the community (65%) than the patients (45%); but the role of open cases in spread was stressed by more patients (17%) than community (5.5%). About 31% community and 23% patients had no idea about the ways to prevent leprosy spread. As against 89% patients, only 62% community believed in curability of leprosy with early and regular treatment; but 20% of the community members did not know where to refer patients for treatment. The causation and prevention of deformities were poorly perceived by 71% patients, and likewise 62% of the patients did not take precaution(s) to prevent the deformities. About 32% respondents were unaware of the efforts being made to control leprosy; and their (79-84% respondents) participation in NLCP was very vague. About 44% community members showed prejudice towards leprosy. The NLCP infra-structure and mass media could not educate community effectively. The implications of the findings are discussed in this paper.

Adult↗

PubMed1983

A clinical and immunological study of four babies of mothers with lepromatous leprosy, two of whom developed leprosy in infancy.

One hundred thirteen women and 27 healthy controls were studied throughout pregnancy, at delivery, and followed up with their babies during lactation. Thirty-eight of the mothers with lepromatous leprosy were found to have solid-staining bacilli in skin smears or biopsies, and hence were considered potentially highly infectious to their unborn children by hematogenous spread via the placenta. Two babies of mothers within this group were diagnosed as having leprosy on clinical and histological grounds. A third baby could well have had leprosy, but the case was not proven. The fourth baby did not have leprosy and, although it did have ringworm, was thus deemed to be a reasonable control. The leprosy skin lesions were first observed at a special followup clinic when the children were between the aged of 9 and 17 months. The demonstration of IgA and IgM anti-M. leprae antibodies in cord sera was taken as an indication of intrauterine immunologic stimulation, and hence transplacental transmission of M. leprae. The two babies with proven leprosy showed an early and significant increase in serum IgA and in particular serum IgM anti-M. leprae antibody activity. A third baby, suspected of having leprosy but in whom the diagnosis was not proven, showed a similar but less marked increase in serum IgA and IgM activity. The fourth baby showed no such rise in anti-M. leprae activity. A decrease in serum IgG anti-M. leprae antibody activity could be demonstrated in one of the babies with leprosy after healing of the leprosy lesions, but not in the second baby.

Antibodies, Bacterial↗

PubMed1981

Fluorescent leprosy antibody absorption (FLA-ABS) test for early serodiagnosis of leprosy.

The conventional parameters for the diagnosis of leprosy i.e. clinical symptoms aided by smear and histological examinations, have certain limitations. With the conventional parameters, it is difficult to diagnose new cases in the early stage of leprosy. Recently Abe et al (1976) and Abe and Yoshino (1978) suggested that Florescent Leprosy Antibody Absorption (FLA-ABS) test developed by one of the authors (Abe) might be useful for early serodiagnosis of leprosy. Following this, the FLA-ABS test was standardised at the Central Jalma Institute for Leprosy, Agra to study the usefulness of the test in early serodiagnosis and detection of sub-clinical infections. In the present study sera were collected from 136 cases of different types of leprosy which includes 11 cases with lesions suspected to be leprosy, 58 healthy contacts and 19 healthy controls. Using FLA-ABS test, anti M. leprae antibodies were detected in all types of leprosy irrespective of the type and duration of the disease. The test has shown significantly high positive results in very early cases of leprosy with a duration of 3-6 months and having very small lesions measuring below 2 cms.

Fluorescent Antibody Technique↗

PubMed2000

Mast cells in leprosy and leprosy reaction.

BACKGROUND: Mast cells can be visualized in routine, acid-fast-staining, paraffin tissue section as metachromatic staining cells, and can be activated to release inflammatory mediators which play a role in the cell-mediated immune response. METHODS: Skin biopsy tissues were taken from the most active skin lesion of each leprosy patient at the time of diagnosis (nonreactional group) and at the time of reaction (reactional group) during the years 1994-1997 in the leprosy clinic at the Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand. Mast cells were identified by metachromatic staining (purple) in Fite's stain sections and reported as the average number of cells per high power field in three compartments: at the center and periphery of the granuloma and in the interstitium. The data were analyzed in three groups: nonreactional group, type I, and type II leprosy reactions. The mast cell count of each group and each compartment of the section, expressed as the mean +/- standard error, was compared. RESULTS: A total of 95 persons were included in the study, but 108 tissue sections were obtained due to nine cases having more than one section. Of these patients, 63 cases (66.32%) had no reaction, 19 cases (20%) had type I reaction, and 13 cases had type II reaction. There was no difference in age and sex among these groups. The mast cell count in the interstitium was higher than that within the granuloma, both at the center and at the periphery, in every type, and the count in this area reduced significantly in leprosy reactions, both type I and type II, compared with the nonreactional group. CONCLUSIONS: The change in the average mast cell number in nonreactional leprosy and leprosy reactions may indicate the important role of mast cells in dynamic changes in the cell-mediated immune response in leprosy and leprosy reactions.

Adult↗

PubMed1996

Electrophysiological evaluation of peripheral autonomic function in leprosy patients, leprosy contacts and controls.

Since there is immunocytochemical evidence that the initial damage in leprosy is directed at distal, small, unmyelinated nerve fibers, we investigated several electrophysiological methods for their potential value in detecting peripheral autonomic dysfunction in leprosy contacts and leprosy patients. Fingertip blood flow velocity and its control by vasomotor reflexes (VMR) with a laser Doppler flowmeter, fingertip skin temperature, and the sympathetic skin response (SSR) to exosomatic stimuli were studied in 89 leprosy patients, 36 leprosy contacts and 47 normal subjects. Whereas there were no significant differences between the groups in fingertip skin temperature and resting blood flow velocity measurements, there were significant differences in the prevalence of impaired fingertip VMR and absent SSR. The prevalence of absent SSR in leprosy patients was 60.9%, in contacts 13.8%, in controls 6.3%. The prevalence of abnormal VMR in leprosy patients was 61.2%, in contacts 34.7% and in controls 10.6%. VMR testing is a more sensitive test method for autonomic dysfunction compared with the SSR. The implication of impairment in vasomotor and sudomotor function in leprosy contacts needs yet to be determined. However, we propose this to be a response to exposure to Mycobacterium leprae, which represents either ongoing nerve damage or nonprogressive residual autonomic nerve damage. We suggest that VMR testing and SSR are valuable methods to evaluate early leprous neuropathy.

Adolescent↗

PubMedDate not supplied