Fine P E, Gruer P J, Maine N, Ponnighaus J M, Rees R J, Stanford J L
Department of Tropical Hygiene, London School of Hygiene and Tropical Medicine, England.
Clin Exp Immunol. 1989 Aug;77(2):226-9.
In order to test a published claim that the inclusion of Mycobacterium leprae antigens with a tuberculin skin test reagent can suppress delayed-type hypersensitivity (DTH) to tuberculin in both paucibacillary and multibacillary leprosy cases, 109 leprosy cases and 104 non-leprosy controls were skin-tested simultaneously with tuberculin with and without M. leprae soluble antigens. Tests were randomized between arms and carried out double-blind. There was a clear tendency for larger DTH responses with the combined tuberculin plus M. leprae antigen than with tuberculin alone in paucibacillary leprosy cases and in non-leprosy controls. No evidence for M. leprae antigen-mediated suppression of DTH was observed in any group. It is unclear whether the difference between the results reported here, which were obtained in Malawi, and those in the published literature which were obtained in India, is attributable to geographic differences in important biological variables or to differences in the experimental protocols. The need for methodological rigour in skin-test studies is stressed.
为了验证一项已发表的说法，即在结核菌素皮肤试验试剂中加入麻风分枝杆菌抗原可抑制少菌型和多菌型麻风病例对结核菌素的迟发型超敏反应（DTH），109例麻风病例和104名非麻风对照者同时接受了含和不含麻风分枝杆菌可溶性抗原的结核菌素皮肤试验。试验在不同组间随机进行，并采用双盲法。在少菌型麻风病例和非麻风对照者中，结核菌素加麻风分枝杆菌抗原联合使用时的DTH反应明显大于单独使用结核菌素时。在任何组中均未观察到麻风分枝杆菌抗原介导的DTH抑制证据。尚不清楚在马拉维获得的本研究结果与在印度获得的已发表文献结果之间的差异是由于重要生物学变量的地理差异还是实验方案的差异所致。强调了皮肤试验研究中方法严谨性的必要性。
