Anders E M, McAdam K P, Anders R F
Clin Exp Immunol. 1977 Jan;27(1):111-7.
Cell-mediated immunity in lepromatous leprosy patients with and without amyloidosis has been studied. Amyloidosis occurred mostly in patients with a history of recurrent erythema nodosum leprosum (ENL) reactions. For this reason, two control groups of leprosy patients were included, one having a history of recurrent ENL and the other little or no ENL. The lack of responsiveness to lepromin in vivo and in vitro, characteristic of lepromatous leprosy, was not altered by the presence of amyloidosis or a history of ENL. No significant difference between the patient groups was observed in the response to PPD in vitro, but skin reactivity to PPD was significantly lower in the patients with amyloidosis than in those without amyloidosis. In contrast, the PHA responses of patients with amyloidosis were significantly higher than those of control patients without a history of ENL, but not significantly different from those of control patients with a history of recurrent ENL. Lepromatous leprosy patients who develop amyloidosis thus appear to belong to a group, susceptible to repeated attacks of ENL, whose PHA responses are higher than those of other lepromatous leprosy patients. The lower skin reactivity to PPD observed in the amyloid group may reflect a general impairment in delayed cutaneous hypersensitivity.
对有或没有淀粉样变性的瘤型麻风患者的细胞介导免疫进行了研究。淀粉样变性大多发生在有反复结节性红斑型麻风（ENL）反应病史的患者中。因此，纳入了两组麻风患者作为对照组，一组有反复ENL病史，另一组很少或没有ENL病史。瘤型麻风的特征是体内和体外对麻风菌素无反应性，这种情况不会因淀粉样变性或ENL病史而改变。在体外对PPD的反应中，患者组之间未观察到显著差异，但有淀粉样变性的患者对PPD的皮肤反应性明显低于无淀粉样变性的患者。相比之下，有淀粉样变性的患者对PHA的反应明显高于无ENL病史的对照患者，但与有反复ENL病史的对照患者无显著差异。因此，发生淀粉样变性的瘤型麻风患者似乎属于一组易反复发生ENL的人群，其PHA反应高于其他瘤型麻风患者。在淀粉样变性组中观察到的对PPD较低的皮肤反应性可能反映了迟发性皮肤超敏反应的普遍受损。
