Rafi A, Donoghue H D, Stanford J L
University College London Medical School, Department of Medical Microbiology, London, U.K.
Int J Lepr Other Mycobact Dis. 1995 Mar;63(1):42-7.
In this study of leprosy patients apparently cured by dapsone monotherapy, the polymerase chain reaction (PCR), one of the most reliable and sensitive DNA-based assays, was used for the specific detection of Mycobacterium leprae DNA. Sputum and slit-skin samples from 44 such patients at Baba Baghi Leprosy Sanatorium in Iran were examined. Primers for a 530-base-pair fragment of the gene encoding the 36-kDa antigen of M. leprae were used for the study. The PCR results were compared with microscopy for acid-fast bacilli. Of the 44 sputum samples, 2 were positive by PCR (4.5%) and of the 44 slit-skin swabs taken from the same patients, 10 were PCR positive (22.7%). Only one patient was PCR positive for both sputum and slit-skin specimens (2.3%). No positive results were found by acid-fast microscopy. In total, 11 of 44 (25%) patients in this study were found to be PCR positive for M. leprae, and it was thought probable that this indicated the presence of live organisms. Particularly interesting was the statistically significant association of positive results from slit-skin swabs with paucibacillary rather than multibacillary leprosy. It is suggested that whereas relapse or immunological reaction in paucibacillary disease may result from surviving organisms, in multibacillary leprosy this may be due to re-infection.
在这项对显然已通过氨苯砜单一疗法治愈的麻风病患者的研究中，聚合酶链反应（PCR）作为最可靠且灵敏的基于DNA的检测方法之一，被用于特异性检测麻风分枝杆菌DNA。对来自伊朗巴巴巴吉麻风病疗养院的44例此类患者的痰液和皮肤刮片样本进行了检查。研究使用了针对编码麻风分枝杆菌36 kDa抗原的基因的一个530碱基对片段的引物。将PCR结果与抗酸杆菌显微镜检查结果进行了比较。在44份痰液样本中，2份PCR呈阳性（4.5%），而在从同一患者采集的44份皮肤刮片样本中，10份PCR呈阳性（22.7%）。只有一名患者的痰液和皮肤刮片样本PCR均呈阳性（2.3%）。抗酸显微镜检查未发现阳性结果。在本研究的44例患者中，共有11例（25%）被发现麻风分枝杆菌PCR呈阳性，据认为这可能表明存在活的生物体。特别有趣的是，皮肤刮片样本的阳性结果与少菌型而非多菌型麻风病之间存在统计学上的显著关联。有人提出，少菌型疾病中的复发或免疫反应可能是由存活的生物体引起的，而在多菌型麻风病中，这可能是由于再次感染。
