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一项关于转移因子治疗瘤型麻风病的安慰剂对照临床试验。

A placebo controlled clinical trial of transfer factor in lepromatous leprosy.

作者信息

Faber W R, Leiker D L, Nengerman I M, Schellekens P T

出版信息

Clin Exp Immunol. 1979 Jan;35(1):45-52.

Abstract

The effects of repeated injections of transfer factor over a period of 20 weeks were investigated in fourteen bacteriologically positive patients at the lepromatous side of the leprosy spectrum. All patients showed negative (0 mm induration) skin tests to M. leprae antigens (i.e. leprolin and lepromin). Of these patients, seven were treated with transfer factor with a total of 9 units (1 unit being equivalent to 5 x 10(8) lymphocytes) and seven with a placebo. Maintenance treatment with clofazimine was continued. Transfer factor was prepared from the lymphocytes of donors who showed positive skin tests to M. leprae antigens (i.e. leprolin greater than or equal to 12 mm induration, average 15.5 mm or lepromin greater than or equal to 8 mm induration, average 13.6 mm), as well as a positive lymphocyte transformation in vitro to M. leprae (the average transformation being higher than the average transformation of lymphocytes of tuberculoid leprosy patients). No differences were found between the two groups as regards the clinical course of the disease, the histopathological and bacteriological evaluation of skin biopsies, changes in skin test reactivity to various antigens (i.e. lepromin, leprolin, PPD, Mumps, C. albicans, Tr. rubrum and Varidase), as well as the lymphocyte transformation in vitro to various mitogens (i.e. PHA, PWM, Con A) and antigens (i.e. M. leprae, leprolin, PPD, BCG, Mumps, C. albicans, Trichophyton and Varidase). No evidence was found to suggest that transfer factor is a valuable adjuvant in the treatment of lepromatous leprosy patients or that it increases cell-mediated immune reactivity towards M. leprae.

摘要

对麻风病光谱中瘤型麻风病一侧的14例细菌学阳性患者,研究了连续20周重复注射转移因子的效果。所有患者对麻风杆菌抗原(即麻风菌素和麻风结节菌素)的皮肤试验均呈阴性(硬结0毫米)。这些患者中,7例接受了总量为9单位(1单位相当于5×10⁸淋巴细胞)的转移因子治疗,7例接受了安慰剂治疗。继续用氯法齐明进行维持治疗。转移因子由对麻风杆菌抗原皮肤试验呈阳性(即麻风菌素硬结大于或等于12毫米,平均15.5毫米或麻风结节菌素硬结大于或等于8毫米,平均13.6毫米),以及体外对麻风杆菌淋巴细胞转化呈阳性(平均转化率高于结核样型麻风病患者淋巴细胞的平均转化率)的供体淋巴细胞制备。两组在疾病临床进程、皮肤活检的组织病理学和细菌学评估、对各种抗原(即麻风结节菌素、麻风菌素、结核菌素纯蛋白衍生物、腮腺炎、白色念珠菌、红色毛癣菌和杆菌肽酶)皮肤试验反应性的变化,以及体外对各种促有丝分裂原(即植物血凝素、美洲商陆有丝分裂原、刀豆蛋白A)和抗原(即麻风杆菌、麻风菌素、结核菌素纯蛋白衍生物、卡介苗、腮腺炎、白色念珠菌、毛癣菌和杆菌肽酶)的淋巴细胞转化方面均未发现差异。没有证据表明转移因子是治疗瘤型麻风病患者的有效佐剂,也没有证据表明它能增强对麻风杆菌的细胞介导免疫反应性。

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