Van Voorhis W C, Kaplan G, Sarno E N, Horwitz M A, Steinman R M, Levis W R, Nogueira N, Hair L S, Gattass C R, Arrick B A, Cohn Z A
N Engl J Med. 1982 Dec 23;307(26):1593-7. doi: 10.1056/NEJM198212233072601.
We report on the characteristics of cells in the cutaneous lesions and blood of 21 patients with lepromatous, tuberculoid, and intermediate forms of leprosy. A large proportion of the infiltrates in lepromatous lesions consist of macrophages heavily parasitized with Mycobacterium leprae. The T cells in the lesions are devoid of OKT4/Leu 3a-positive ("helper") cells and consist almost exclusively of OKT8/Leu 2a-positive ("suppressor") populations. In contrast, the tuberculoid infiltrates contain well-organized epithelioid and giant-cell granulomas and only remnants of bacilli, and the predominant T cell is from the OKT4/Leu 3a-positive subset. In both tuberculoid and lepromatous infiltrates, T cells and macrophages expressed HLA-DR antigen. No marked alteration in the distribution of blood T-cell phenotypes was noted. We conclude that there is a marked difference between T-cell subsets in lepromatous and tuberculoid infiltrates, which may influence the microbicidal activity of macrophages in the lesions.
我们报告了21例瘤型、结核样型及中间型麻风患者皮肤损害处及血液中的细胞特征。瘤型损害中的大量浸润细胞由被麻风杆菌严重寄生的巨噬细胞组成。损害处的T细胞缺乏OKT4/Leu 3a阳性（“辅助性”）细胞，几乎完全由OKT8/Leu 2a阳性（“抑制性”）群体组成。相比之下，结核样浸润含有组织良好的上皮样细胞和巨细胞肉芽肿，仅残留少量杆菌，且主要的T细胞来自OKT4/Leu 3a阳性亚群。在结核样和瘤型浸润中，T细胞和巨噬细胞均表达HLA-DR抗原。血液T细胞表型分布未发现明显改变。我们得出结论，瘤型和结核样浸润中的T细胞亚群存在显著差异，这可能会影响损害处巨噬细胞的杀菌活性。
