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麻风菌素及麻风杆菌可溶性抗原的研究:其分类、标准化及应用

Studies on lepromin and soluble antigens of M.leprae: their classification standardization and use.

作者信息

Sengupta U

机构信息

Central JALMA Institute for Leprosy, Taj Ganj, Agra.

出版信息

Indian J Lepr. 1991 Jul-Dec;63(3-4):457-65.

PMID:1804898
Abstract

Before the discovery of armadillo as a susceptible animal the source of M.leprae was limited and hence the use of lepromin was not common in the field. In recent times, the soluble antigens of armadillo-derived M.leprae have been used extensively in the field. Although the results of the study show that these antigens do not differentiate always a susceptible form from the resistant form, they are able to segregate the polar forms of leprosy. In a given field situation the criteria for diagnosis is so stressed that leprosy is overdiagnosed and within one year of follow up nearly half the number of cases are noted as not leprosy. Hence, in such situations lepromin reaction would be definitely a poor correlate with the type of leprosy. However, in hospital based studies the lepromin reaction has always been and would remain useful in confirming the classification (Sengupta et al 1984). Lepromins and M.leprae soluble antigens have gone through extensive standardization procedures. As these antigens contain mostly common mycobacterial antigens along with the M.leprae-specific antigens, these antigens are unable to specifically diagnose M.leprae infection. After purification of M.leprae from infected armadillo tissue, it was expected that the soluble antigen of M.leprae would probably be as useful as tuberculin. However, this was not found to be true in case of lepromin. Specificity for M.leprae has been noted in the epitopes (antigenic sites) on cross reacting molecules (12 kd, 18 kd, 28 kd, 35 kd, 36 kd) of mycobacteria (Ivanyi et al 1983; Watson 1989). These specific epitopes, if synthesized, could be of use as skin test antigens for determining M.leprae infection.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在犰狳被发现是易感动物之前,麻风分枝杆菌的来源有限,因此麻风菌素在该领域的使用并不普遍。近年来,源自犰狳的麻风分枝杆菌可溶性抗原在该领域得到了广泛应用。尽管研究结果表明,这些抗原并不总能区分易感型和抗性型,但它们能够区分麻风病的两极型。在特定的现场情况下,诊断标准被过度强调,以至于麻风病被过度诊断,在随访的一年内,近一半的病例被认定不是麻风病。因此,在这种情况下,麻风菌素反应肯定与麻风病类型的关联性很差。然而,在基于医院的研究中,麻风菌素反应一直并将继续有助于确认分类(森古普塔等人,1984年)。麻风菌素和麻风分枝杆菌可溶性抗原已经历了广泛的标准化程序。由于这些抗原大多包含常见的分枝杆菌抗原以及麻风分枝杆菌特异性抗原,这些抗原无法特异性诊断麻风分枝杆菌感染。从感染的犰狳组织中纯化出麻风分枝杆菌后,人们预计麻风分枝杆菌的可溶性抗原可能会像结核菌素一样有用。然而,在麻风菌素的情况下并非如此。在分枝杆菌的交叉反应分子(12kd、18kd、28kd、35kd、36kd)的表位(抗原位点)中已发现对麻风分枝杆菌的特异性(伊瓦尼等人,1983年;沃森,1989年)。如果合成这些特定表位,可用作皮肤试验抗原来确定麻风分枝杆菌感染。(摘要截选至250字)

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