Narayanan R B, Girdhar A, Girdhar B K, Malaviya G N
Central JALMA Institute for Leprosy (ICMR), Agra, India.
Int Arch Allergy Appl Immunol. 1990;92(1):50-5. doi: 10.1159/000235223.
Immunohistological analysis of infiltrates of nerves in patients with neuritic leprosy was carried out using monoclonal antibodies defining T cell subsets, Langerhans cells, HLA DR antigens, and indirect immunofluorescence. In all, eight nerves were analyzed. 2 of the 8 nerves showed epithelioid cell granulomas surrounded by large numbers of lymphocytes. The predominant lymphocytes in these granulomas were activated T cells expressing CD3 and HLA DR antigens. The proportion of CD3+ and CD4+ cells was higher than that of CD8+ cells. The ratio of CD4+/CD8+ cells in these two biopsy specimens was 5.6 and 1.5, respectively. In these nerves CD4+ cells were diffusely scattered into epithelioid cell granulomas, while CD8+ cells were localized at the periphery of the granuloma. The remaining six nerves showed macrophages containing numerous bacilli, and a few lymphocytes and plasma cells diffusely distributed into the granuloma. In these nerves, only occasional lymphocytes expressing CD3 or CD4 or CD8 and HLA DR antigens were noticed. In two fo the biopsy specimens, a small proportion of CD8+ cells were visualized. Macrophages and Schwann cells were HLA DR+ in all nerves. CD1+ cells were not seen in the infiltrates of any of these nerves. A similar pattern and distribution of cells was noticed in the nerve granulomas of tuberculoid and lepromatous leprosy. These findings suggest that the mechanisms of nerve damage in the patients with neuritic leprosy could be either immunological or non-immunological, depending on the nature and characteristics of the infiltrates.
使用定义T细胞亚群、朗格汉斯细胞、HLA - DR抗原的单克隆抗体及间接免疫荧光法，对神经炎型麻风患者神经浸润进行免疫组织学分析。总共分析了8条神经。8条神经中有2条显示上皮样细胞肉芽肿，周围有大量淋巴细胞。这些肉芽肿中主要的淋巴细胞是表达CD3和HLA - DR抗原的活化T细胞。CD3 +和CD4 +细胞的比例高于CD8 +细胞。这两个活检标本中CD4 + / CD8 +细胞的比例分别为5.6和1.5。在这些神经中，CD4 +细胞弥漫性散布于上皮样细胞肉芽肿中，而CD8 +细胞则定位于肉芽肿周边。其余6条神经显示巨噬细胞含有大量杆菌，少量淋巴细胞和浆细胞弥漫性分布于肉芽肿中。在这些神经中，仅偶尔可见表达CD3或CD4或CD8以及HLA - DR抗原的淋巴细胞。在两个活检标本中，可见一小部分CD8 +细胞。所有神经中的巨噬细胞和施万细胞均为HLA - DR +。在这些神经的任何浸润物中均未见到CD1 +细胞。在结核样型和瘤型麻风的神经肉芽肿中也观察到类似的细胞模式和分布。这些发现表明，神经炎型麻风患者神经损伤的机制可能是免疫性的或非免疫性的，这取决于浸润物的性质和特征。
