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Published on: July 19, 2007
Antigenic trigger for type 1 reaction in leprosy
Robert J Wilkinson1, Diana N J Lockwood
1Division of Medicine, Wellcome Trust Centre for Research Clinical Tropical Medicine, Imperial College London, 2nd Floor Wright Fleming Institute, Norfolk Place, London W2 1PG, UK. r.j.wilkinson@imperial.ac.uk
Abstract:
Type 1 (reversal or upgrading) reactions occur during or after chemotherapy in around 10% leprosy patients [Int J Lepr Other Mycobact Dis 61 (1993) 8-15]. The cause of this immunological upgrading is incompletely defined, although the approximately 2-fold increased risk of reaction in patients vaccinated with Mycobacterium w suggests that infection by mycobacteria other than Mycobacterium leprae may trigger this phenomenon [Vaccine 13 (1995) 1102-1110]. We report a case of borderline lepromatous leprosy in which we studied the antigenic specificity of peripheral blood mononuclear cells immediately before, and then during, a Type 1 reaction which provides more direct evidence in favor of this hypothesis.
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