Tadesse Azeb, Taye Engeda, Sandoval F, Shannon E J
Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
Lepr Rev. 2003 Sep;74(3):206-14.
The immune response in reversal reaction, (RR) and in erythema nodosum leprosum (ENL) is characterized in vitro by an enhancement in lymphocyte blast transformation against M. leprae. As thalidomide is an effective treatment for ENL, this study assessed the effect of this drug on these phenomena. Mononuclear cells from patients attending the clinic at ALERT and from healthy staff were cultured for 5 days with integral M. leprae (IMl), or a modified Dharmendra antigen (Dhar), or PPD from M. tuberculosis. In one set of cultures, thalidomide was added once at the initiation of the culture; in the other set thalidomide was added a second time (2x), 18 h prior to harvesting the cells. The mononuclear cells, in the absence of thalidomide, from healthy staff, borderline tuberculoid patients (BT) and BT patients in RR (BT/RR) incorporated [3H]-thymidine best when cultured with PPD > Dhar > M. leprae. The cells from patients with ENL did not respond well to the M. leprae antigens. Thalidomide (2x) enhanced proliferation to Dhar in the BTRR group (Wilcoxon signed rank test, P < 0.05). No significant changes occurred for the other groups. Comparing PPD-stimulated cells treated with thalidomide once to those treated with thalidomide twice, thalidomide (2x) suppressed incorporation of [H3]-thymidine by the PPD-stimulated (P < 0.05) as well as IMl-stimulated (P < 0.05) cells in the healthy staff group. In the Dhar-stimulated cells from the healthy staff thalidomide significantly suppressed TNF-alpha (P < 0.05). A mixed effect was seen within and between the other groups, but there was a trend for thalidomide to suppress TNF-alpha induced by the M. leprae, Dhar and PPD antigens.
逆转反应（RR）和结节性红斑麻风（ENL）中的免疫反应在体外的特征是针对麻风杆菌的淋巴细胞增殖转化增强。由于沙利度胺是治疗ENL的有效药物，本研究评估了该药物对这些现象的影响。将来自ALERT诊所的患者和健康工作人员的单核细胞与完整的麻风杆菌（IMl）、改良的达曼德拉抗原（Dhar）或结核分枝杆菌的PPD一起培养5天。在一组培养物中，在培养开始时一次性加入沙利度胺；在另一组中，在收获细胞前18小时第二次加入沙利度胺（2x）。在没有沙利度胺的情况下，健康工作人员、边缘结核样患者（BT）和处于RR的BT患者（BT/RR）的单核细胞在用PPD培养时掺入[3H] - 胸腺嘧啶核苷的效果最佳，其次是Dhar，麻风杆菌最差。ENL患者的细胞对麻风杆菌抗原反应不佳。沙利度胺（2x）增强了BTRR组对Dhar的增殖反应（Wilcoxon符号秩检验，P < 0.05）。其他组未发生显著变化。将一次性用沙利度胺处理的PPD刺激细胞与两次用沙利度胺处理的细胞进行比较，沙利度胺（2x）抑制了健康工作人员组中PPD刺激（P < 0.05）以及IMl刺激（P < 0.05）细胞对[H3] - 胸腺嘧啶核苷的掺入。在健康工作人员的Dhar刺激细胞中，沙利度胺显著抑制了TNF-α（P < 0.05）。在其他组内和组间观察到了混合效应，但沙利度胺有抑制由麻风杆菌、Dhar和PPD抗原诱导的TNF-α的趋势。
