Nelson K E, Speck S M, Suprasert S, Smith T
Int J Lepr Other Mycobact Dis. 1984 Jun;52(2):147-53.
A study was done of the response to PPD-tuberculin, candida and the tuberculin conversion rate after BCG vaccination among 302 healthy children in northern Thailand. The children were grouped according to whether their parent(s) or other household contact(s) had tuberculoid leprosy (74 children), lepromatous leprosy (47 children), or all family members were healthy (181 children). No significant differences were detected in the responses to candida or PPD-tuberculin on initial skin testing or in the history of a previous BCG vaccination in the three groups of children. However, among the children who were initially tuberculin negative, significantly decreased PPD conversion rates occurred in children from lepromatous families in comparison to those from tuberculoid families (p less than 0.01) or normal families (p less than 0.05). In the children from lepromatous families who were initially PPD and candida negative, 0 of 3 developed PPD-tuberculin conversions after BCG in comparison to 12 of 14 (85.7%) from normal families (p = 0.015). These data indicate that some children from lepromatous families were relatively unresponsive to stimulation with BCG and possibly other mycobacterial vaccines. The immunopathogenesis of this relative unresponsiveness should be further defined, since it might have important implications for the prevention of leprosy with a vaccine.
对泰国北部302名健康儿童进行了一项研究，观察他们对结核菌素纯蛋白衍生物（PPD）、念珠菌的反应以及卡介苗接种后的结核菌素转化率。这些儿童根据其父母或其他家庭接触者是否患有结核样麻风（74名儿童）、瘤型麻风（47名儿童）或所有家庭成员均健康（181名儿童）进行分组。在三组儿童中，初始皮肤试验对念珠菌或PPD的反应以及既往卡介苗接种史均未发现显著差异。然而，在初始结核菌素阴性的儿童中，瘤型麻风家庭的儿童与结核样麻风家庭的儿童相比（p<0.01）或正常家庭的儿童相比（p<0.05），PPD转化率显著降低。在初始PPD和念珠菌均为阴性的瘤型麻风家庭儿童中，3名儿童在接种卡介苗后均未发生PPD结核菌素转化，而正常家庭的14名儿童中有12名（85.7%）发生转化（p = 0.015）。这些数据表明，一些瘤型麻风家庭的儿童对卡介苗及可能的其他分枝杆菌疫苗刺激反应相对较弱。这种相对无反应性的免疫发病机制应进一步明确，因为这可能对麻风疫苗预防具有重要意义。
