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At least 19 recordsLinked to original sources
PubMedDate not supplied

Induction of lepromin positivity by a candidate anti-leprosy vaccine Mycobacterium w in lepromin negative healthy contacts of multibacillary leprosy patients.

In a hospital based study, 362 household contacts of multibacillary leprosy patients were screened for evidence of leprosy and 54 (14.9%) were found to be having leprosy. The remaining 308 apparently healthy contacts were lepromin tested and 109 (35.4%) were observed to be negative to Mitsuda lepromin. M.w vaccine was administered intradermally to 95 of these 109 lepromin negative contacts. Sixty eight of them could be retested for lepromin A reactivity. Fifty six (82.35%) manifested lepromin conversion. The twelve subjects who did not show lepromin conversion, received a second dose of the vaccine, and eleven subsequently became lepromin positive. The overall lepromin conversion rate was thus 98.5% (67 out of 68). Follow-up of these contacts upto a period of 30 months did not demonstrate reversion of lepromin positivity back to negativity status. No untoward effects of vaccination were observed except for local ulceration at the site of vaccine administration.

Adolescent↗
PubMed1983

Lepromin conversion in repeatedly lepromin negative BL/LL patients after immunization with autoclaved Mycobacterium w.

Thirty-two clinically, histopathologically confirmed cases of BL/LL leprosy were rendered bacteriologically negative by prolonged chemotherapy. All of them were negative to Mitsuda and Dharmendra lepromin at the start of study. They were immunized with a single intradermal injection of 5 X 10(7) autoclaved Mycobacterium w and were retested for lepromin reaction 4-6 weeks later. Twenty subjects gave at this time a positive reaction with both Dharmendra and Mitsuda lepromins. The histology of biopsies from converted cases showed mononuclear infiltration in all and granuloma formation in 12 of the 20 positive cases. The stability of the conversion of the patients' lepromin positivity was investigated 6-11 months after immunization with Mycobacterium w. Patients who were earlier converted to a positivity status remained positive in the skin test response to M. leprae. The leukocytes of these patients produced lymphokines on culture with lepromin, causing leukocyte migration inhibition. Patients who did not convert earlier continued to remain anergic to lepromin. These results suggest a conversion, stable for several months, to lepromin positivity caused by immunization with Mycobacterium w in about 60% of BL/LL leprosy patients.

Adult↗
PubMed1980

[Comparative study of the intradermal reaction performed with whole lepromin and ultrasonic-treated lepromin in normal subjects].

A comparative study on the Fernandez and on the Mitsuda reaction was made in 104 normal people employing whole and sonicated lepromin. Both types of lepromin can induce a good early reaction, and there was no significant difference in the results of the Fernandez reaction. The sonicated lepromin, though it contains all of the components of the original preparation, gives weaker late skin reactions. The results of the Mitsuda reaction were statistically significant.

Adolescent↗
PubMed2000

Induction of lepromin positivity and immunoprophylaxis in household contacts of multibacillary leprosy patients: a pilot study with a candidate vaccine, Mycobacterium w.

We screened 487 household contacts of multibacillary (MB) patients for evidence of disease and their lepromin status. From the 444 results available, 302 (68.02%) were lepromin positive and 142 (31.98%) were lepromin negative on initial testing. The initial lepromin status as assessed in the group of 54 contacts having disease at the outset showed 24 out of 46 (52.2%) to be lepromin positive and 22 of 46 (47.8%) to be lepromin negative. In the same group, among 24 lepromin positives, 22 (91.7%) had paucibacillary (PB) and 2 (8.3%) had multibacillary (MB) disease; among the lepromin negatives, 12 (54.5%) had PB and 10 (45.5%) had MB disease. Out of 72 initially lepromin-negative contacts administered Mycobacterium w vaccine and followed up, the cumulative percentages show that 53 (73.6%) converted to positivity after a single dose, 10 (87.5%) after a second dose and 67 (93.1%) after the third dose. The incidence of new cases with leprosy was 8 out of 231 (3.46%) among lepromin-positive contacts and 5 out of 93 (5.38%) among lepromin-negative contacts administered Mycobacterium w vaccine. Among 231 lepromin-positive contacts, the new cases occurred in those with a 1+ and 2+ lepromin response only, and no case occurred among 51 contacts with a 3+ lepromin response. The incidence among lepromin-positive contacts in this study (3.46%) was similar to the observations in two other studies: 3.2% by Dharmendra, et al. and 6.9% by Chaudhary, et al. However, the incidence among lepromin-negative contacts administered Mycobacterium w vaccine was significantly lower than that observed among lepromin-negative contacts not administered any vaccination in the other two studies (14.1% by Dharmendra, et al. and 29.0% by Chaudhary, et al.). To conclude, although a study of small sample size, the preliminary evaluation indicates that administration of Mycobacterium w vaccine seems to have the potential to reduce the incidence of leprosy among household contacts of leprosy patients. More explicit results about the vaccine will be available from the ongoing field trials in Kanpur Dehat in the near future.

Bacterial Vaccines↗
PubMedDate not supplied

Comparison of reactions to human and armadillo lepromins in leprosy.

To assess the usefulness of Mycobacterium leprae-infected armadillo tissue as a substitute for human lepromas for the manufacture of lepromin, we compared skin reactions to preparations from these two sources in 115 leprosy patients. The patient sample represented all the primary clinical forms of leprosy. Lepromin derived from the armadillo (lepromin-A) provoked the same pattern of responses as human derived lepromin (lepromin-H), i.e., lepromatous patients gave the weakest reactions. Lepromin-A reactions were consistently more intense than those to lepromin-H. We conclude that lepromin-A is a promising alternative to lepromin-H and may make the worldwide distribution of a standardized skin testing reagent feasible.

Adolescent↗
PubMed1986

The lepromin test in rhesus monkeys.

The lepromin test was studied in rhesus monkeys. Six control monkeys which had not been inoculated with Mycobacterium leprae, six monkeys with experimentally induced leprosy, and nine monkeys which had been inoculated with M. leprae but had not developed leprosy were evaluated with 1X, 10X, and 15X lepromin A, with 1X and 10X lepromin M (mangabey monkey derived), with 1X and 25X purified inactivated M. leprae, and with an armadillo mock lepromin. We found that the lepromin test is useful in rhesus monkeys, but that a higher concentration of antigen than is used in humans is required to induce a response in monkeys. Control monkeys appear to be lepromin negative. Animals which have been inoculated and which develop lepromatous leprosy are also negative. Monkeys which are experimentally inoculated with M. leprae and do not develop leprosy become lepromin positive. Monkeys with indeterminate leprosy have reactions intermediate between lepromatous and resistant animals. No monkeys reacted to armadillo tissue. Our results indicate that 10X lepromin A is a useful preparation for the lepromin testing of rhesus monkeys.

Animals↗
PubMed1982

Tissue response to lepromin, an index of susceptibility of the armadillo to M. leprae infection--a preliminary report.

In this preliminary report the histopathological appearance of the lepromin reaction in armadillos was correlated with their response to infection with M. leprae. Three different types of lepromin response were described, namely the lepromatous, the borderline, and the tuberculoid lepromin reactions. It was found that 10 out of the 11 animals with a lepromatous lepromin reaction and the one animal with a borderline lepromin reaction developed disseminated disease. The two with a tuberculoid lepromin reaction and one of the 11 with a lepromatous lepromin reaction failed to develop leprosy. It is suggested that by using the lepromin response it is possible to assess, to a great extent, the susceptibility of armadillos to infection by M. laprae. The pros and cons of using the armadillo as an animal model for a vaccine trial are briefly discussed.

Animals↗
PubMed1997

Immunotherapy of lepromin-negative borderline leprosy patients with low-dose Convit vaccine as an adjunct to multidrug therapy; a six-year follow-up study in Calcutta.

The present report, which describes management of lepromin-negative borderline leprosy patients with low-dose Convit vaccine, is an extension of our earlier study on the treatment of lepromatous leprosy patients with low-dose Convit vaccine as an adjunct to multidrug therapy (MDT). The test Group I, consisting of 50 lepromin-negative, borderline leprosy patients, were given low-dose Convit vaccine plus MDT. The control group II consisted of 25 lepromin-negative, borderline leprosy patients given BCG vaccination plus MDT and 25 lepromin-negative, borderline leprosy patients given killed Mycobacterium leprae (human) vaccine plus MDT. The control group III consisted of 50 lepromin-positive, borderline leprosy patients not given any immunostimulation but given only MDT. Depending upon the lepromin unresponsiveness, the patients were given one to four inoculations of the various antileprosy vaccines and were followed up every 3 months for 2 years for clinical, bacteriological and immunological outcome. All patients belonging to the test and control groups showed clinical cure and bacteriological negativity within 2 years. However, immunologic potentiation, assessed by lepromin testing and the leukocyte migration inhibition test (LMIT), was better in the test patients receiving low-dose Convit vaccine plus MDT than in the control patients receiving BCG vaccine plus MDT or killed M. leprae vaccine plus MDT or MDT alone. But the capacity of clearance bacteria (CCB) test from the lepromin granuloma showed poor bacterial clearance in the test patients. However, there was no relapse during 6 years of follow up. Two mid-borderline (BB) patients had severe reversal reactions with lagophthalmos and wrist drop during immunotherapy despite being given low-dose Convit vaccine.

Adult↗
PubMed1999

Induction of lepromin positivity following immuno-chemotherapy with Mycobacterium w vaccine and multidrug therapy and its impact on bacteriological clearance in multibacillary leprosy: report on a hospital-based clinical trial with the candidate antileprosy vaccine.

A vaccine based on autoclaved Mycobacterium w was administered, in addition to standard multidrug therapy (MDT), to 157 bacteriologically positive, lepromin-negative, multibacillary (LL, BL and BB) leprosy patients. The vaccinees were supported by a well-matched control group of 147 patients with similar type of disease who received a placebo injection in addition to MDT. The MDT was given for a minimum period of 2 years and continued until skin-smear negativity, while the vaccine was given at 3-month intervals up to a maximum of 8 doses. The lepromin response evaluated in terms of percentage of subjects converting to positivity status, measurement in millimeters, and duration of lepromin positivity sustained, reflected a statistically significant better outcome in the vaccine group patients (especially LL and BL leprosy) in comparison to those in the placebo group. The data indicate that lepromin-positivity status seems to have an impact on accelerating the bacteriological clearance, as is evident by the statistically significant accelerated decline in the BI of those patients who converted to lepromin positivity as compared to those remaining lepromin negative throughout therapy and post-therapy follow up. To conclude, the addition of the Mycobacterium w vaccine to standard MDT induces a lepromin response of a statistically significant higher magnitude than that observed with MDT alone.

Bacterial Vaccines↗