在边缘性麻风患者中出现1型反应的危险因素
P W Roche1, W J Theuvenet, W J Britton
1Mycobacterial Research Laboratory, Anandaban Leprosy Hospital, Kathmandu, Nepal.
Lancet (London, England)
|September 14, 1991
概括
麻风中的1型反应是神经损伤的主要原因,由IgM抗基脂-1 (PGL-1) 抗体预测. 早期监测这些抗体的患者可以预防残疾.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 皮肤病学 皮肤病学
背景情况:
- 1型反应是麻风患者神经损伤和残疾的重要原因.
- 确定1型反应的预测标记对于及时干预和预防长期并发症至关重要.
研究的目的:
- 确定临床和实验室标志物,预测麻风患者的1型反应风险增加.
- 调查特定菌根细菌抗体的血清阳性与1型反应的发展之间的关联.
主要方法:
- 136名尼泊尔边缘性麻风患者的队列在多药疗法的前两年被监测到1型反应.
- 血清样本被分析为抗体基脂-1 (PGL-1),利波亚比诺南,和35kDa的蛋白质从Mycobacterium leprae.
- 在一小部分患者中进行了勒普林的测试.
主要成果:
- 31%的患者出现了1型反应. 对IgM抗PGL-1抗体的血清阳性与随后的1型反应显著相关 (p < 0.001).
- 患有1型反应的患者的IgM抗PGL-1抗体度显著更高.
- 抗PGL-1 IgM 血清阳性是1型反应的独立风险因素,即使考虑到麻风类,皮肤涂抹阳性和其他抗体. 结合积极的勒普林反应性,它在78%的病例中预测了反应.
结论:
- 抗 IgM 抗 PGL-1 抗体血清阳性是麻风患者1型反应的强有力的预测因子.
- 患有IgM抗PGL-1抗体和乐胺活性阳性的患者需要在治疗期间进行仔细监测.
- 这些患者的早期检测和抗炎治疗可以最大限度地减少神经损伤和残疾.
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