In-vitro lymphoproliferative response to Mycobacterium leprae of HLA-D-identical siblings of lepromatous leprosy patients.

Lymphoproliferative responses to Mycobacterium leprae and P.P.D. were measured in 23 lepromatous and borderline lepromatous leprosy patients and in 27 of their normal siblings. At the same time siblings HLA-D-identical with the patients were identified by the absence of a mixed-lymphocyte reaction. The 7 siblings who were HLA-identical to lepromatous patients responded as well to M. leprae as did the 20 HLA-non-identical normal siblings. In contrast, 22 of the 23 lepromatous patients failed to respond to M. leprae but responded normally to P.P.D. The specific unresponsiveness of lepromatous patients thus does not result from an HLA-linked genetic defect and the defective cell-mediated immune response to M. leprae seems to be acquired, not inherited. Lepromatous patients may be high responders to antigens shared by M. leprae and other microorganisms in whom a strong antibody response has blocked the induction of an M. leprae-specific-cell-mediated immune response.