Ridley M J, Oates C, Waters M F, Ridley D S
Br J Exp Pathol. 1985 Feb;66(1):109-22.
The levels and distribution of lysozyme-positive cells and exudate were studied in leprosy lesions through the spectrum, in untreated and treated patients, in relapse and in reactions. Altogether 124 skin biopsies were examined by the immunoperoxidase technique. Monocytes, neutrophil-polymorphs and mast cells were the most conspicuous cells seen. Lysozyme proved to be a useful means of indexing renewal of these cells in the lesions. Peak numbers of monocytes were seen in lesions of active lepromatous leprosy (LL) and of tuberculoid leprosy (TT), at poles of opposite immunological performance. In TT the stimulus for recruitment was delayed hypersensitivity (DH). A decline in DH from TT towards the middle of the spectrum, mid-borderline, was accompanied by a fall in monocyte level. Furthermore, reacting lesions due to enhanced DH also had increased numbers of monocytes. On the other hand reactions associated with immunological deterioration were similar to active lepromatous leprosy (LL) and monocyte influx was raised in response to the stimulus of free multiplication of bacilli in both cases. In TT delayed hypersensitivity acted also to promote the rapid transformation of monocytes to epithelioid and giant cells all of which were strongly positive for lysozyme. This was in contrast to much lower levels in histologically similar macrophage-epithelioid cells of BT granulomas. Lysozyme synthesis was not seen in macrophages after ingestion of M. leprae. Early foamy change was made conspicuous by lysozyme deposited in phagocytic vacuoles, but old foam cells in regressing lepromas were negative. Lysozyme bound to dead extracellular M. leprae but not to viable or intracellular organisms. Dead bacilli or immune complexes appeared to be the stimulus for neutrophil-polymorph recruitment, mainly in reactions.
通过光谱研究了未经治疗和已治疗的麻风病患者、复发患者及有反应患者的麻风病皮损中溶菌酶阳性细胞和渗出物的水平及分布情况。共采用免疫过氧化物酶技术检查了124份皮肤活检标本。单核细胞、中性多形核白细胞和肥大细胞是最明显可见的细胞。溶菌酶被证明是衡量皮损中这些细胞更新情况的有用手段。在具有相反免疫表现的两极，即活动期瘤型麻风（LL）和结核样型麻风（TT）的皮损中，单核细胞数量达到峰值。在TT中，募集单核细胞的刺激因素是迟发型超敏反应（DH）。从TT向光谱中间的中间界线型转变时，DH下降，同时单核细胞水平也随之下降。此外，由于DH增强而出现反应的皮损中，单核细胞数量也增加。另一方面，与免疫功能恶化相关的反应与活动期瘤型麻风（LL）相似，在这两种情况下，由于杆菌的自由增殖刺激，单核细胞流入量增加。在TT中，迟发型超敏反应还促使单核细胞迅速转化为上皮样细胞和巨细胞，所有这些细胞的溶菌酶均呈强阳性。这与组织学上相似的BT肉芽肿中的巨噬细胞 - 上皮样细胞中低得多的溶菌酶水平形成对比。巨噬细胞吞噬麻风杆菌后未观察到溶菌酶合成。吞噬泡中沉积的溶菌酶使早期泡沫样改变明显，但消退性麻风瘤中的陈旧泡沫细胞呈阴性。溶菌酶与死亡的细胞外麻风杆菌结合，但不与活的或细胞内的菌体结合。死杆菌或免疫复合物似乎是中性多形核白细胞募集的刺激因素，主要在反应中起作用。
