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Immunological unresponsiveness in leprosy.

B R Bloom, V Mehra

    Immunological Reviews
    |August 1, 1984
    PubMed
    Summary

    Leprosy patients exhibit immune unresponsiveness due to suppressor T cells (TS) that block interleukin-2 (IL-2) production. Immunotherapy with M. leprae and BCG vaccination restores cell-mediated immunity by overcoming this block.

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    Area of Science:

    • Immunology
    • Microbiology
    • Clinical Medicine

    Background:

    • Leprosy presents a spectrum of clinical and immunological responses, from tuberculoid to lepromatous forms.
    • Lepromatous leprosy is characterized by selective immunological unresponsiveness to Mycobacterium leprae antigens.
    • Tuberculoid leprosy patients exhibit strong cell-mediated immunity against M. leprae.

    Purpose of the Study:

    • To investigate the immunoregulatory mechanisms underlying leprosy, particularly the unresponsiveness in lepromatous patients.
    • To identify the role of suppressor T cells (TS) and their targets in M. leprae infection.
    • To evaluate the efficacy of immunotherapy in restoring cell-mediated immunity in leprosy.

    Main Methods:

    • In vitro experiments analyzing lymphocyte reactivity to M. leprae and BCG antigens.
    • Identification and characterization of suppressor T cells (T8 phenotype) and their role in antigen recognition.
    • Assessment of the effects of TS cell depletion and IL-2 addition on lymphocyte responsiveness.
    • Clinical evaluation of immunotherapy using M. leprae and BCG vaccination in lepromatous patients.

    Main Results:

    • Lepromatous patients show suppressor activity mediated by T8 cells, which recognize a unique phenolic glycolipid antigen of M. leprae.
    • Depletion of TS cells and addition of IL-2 partially restored in vitro lymphocyte responsiveness.
    • M. leprae and BCG vaccination restored cell-mediated immunity in most lepromatous patients.
    • Vaccination reduced in vitro suppressor activity and the number of activated T8 cells.

    Conclusions:

    • Leprosy involves stage-of-disease related suppressor cells that inhibit lymphokine production, including IL-2.
    • These suppressor cells block the responsiveness of T helper cells to mycobacterial antigens.
    • Successful immunotherapeutic vaccination can overcome this suppressive mechanism in lepromatous leprosy.

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