Ramanathan V D, Tyagi P, Ramanathan U, Katoch K, Sengupta U, Ramu G
Central JALMA Institute for Leprosy, Taj Ganj, Agra, India.
Int J Lepr Other Mycobact Dis. 1991 Mar;59(1):5-11.
It is held that immune complexes (IC) play a vital role in the pathogenesis of some of the reactions in leprosy. The complement system is known to solubilize and render IC innocuous. We have previously shown that patients undergoing lepra reactions had lowered complement-mediated IC solubilization (CMS). We, therefore, undertook a prospective study of untreated multibacillary leprosy patients and monitored their CMS levels sequentially while on therapy. In addition, the concentrations of the complement component C3d, immunoglobulins G, A and M, and circulating immune complexes (CIC) were also estimated. A total of 26 patients were included in the study and were investigated at 3-month intervals for 3 years. Thirteen of the 14 patients who did not develop reactions at all had normal CMS values, although all of them showed elevated CIC. From the inception of treatment, 10 of the 12 patients who developed lepra reactions had low CMS values which remained below normal levels even after evidence of complement activation disappeared and long after the subsidence of reaction. It is suggested that this defective CMS acts as a predisposing cause of lepra reactions.
人们认为免疫复合物（IC）在麻风病某些反应的发病机制中起重要作用。已知补体系统可溶解免疫复合物并使其无害。我们之前已表明，发生麻风反应的患者补体介导的免疫复合物溶解（CMS）能力降低。因此，我们对未经治疗的多菌型麻风病患者进行了一项前瞻性研究，并在治疗期间连续监测他们的CMS水平。此外，还对补体成分C3d、免疫球蛋白G、A和M以及循环免疫复合物（CIC）的浓度进行了评估。共有26名患者纳入该研究，并在3年的时间里每隔3个月进行一次调查。14名完全未发生反应的患者中有13名CMS值正常，尽管他们所有人的CIC均升高。从治疗开始，12名发生麻风反应的患者中有10名CMS值较低，即使在补体激活的证据消失后以及反应消退很久之后，这些值仍低于正常水平。有人认为这种有缺陷的CMS是麻风反应的诱发原因。
