Kurhade A M, Akulwar S L, Pathak A A, Thakar Y S, Dhanvijay A G
Department of Microbiology, Government Medical College, Nagpur.
Indian J Pathol Microbiol. 1996 Jul;39(3):197-201.
The cell mediated immunity (CMI) was studied in 50 healthy contacts of leprosy patients and 50 age & sex matched non-contact controls by lepromin test and leucocyte migration inhibition (LMI) test using phytohaemagglutinin (PHA) and lepromin and its association with other risk factors in contacts was assessed. The lepromin positivity correlated well with LMI results. There was no difference in CMI in I, II and III degree of contacts. Amongst direct contacts lepromin test was positive in 67 per cent as compared to 92 per cent in indirect contacts while in LMIT migration index (MI) was significantly increased (0.66 +/- 0.20) in direct contacts. MI was also significantly increased (0.73 +/- 0.20) contacts of less than two years duration which decreased to 0.51 +/- 0.18 in contacts of more than five years duration. Lepromin positivity also increased from 60 per cent to 100 per cent in these contacts. The specific CMI was significantly suppressed in contacts of LL patients (MI:0.74 +/- 0.21) and BL patients (MI: 0.61 +/- 0.01) as compared to healthy controls. B.C.G. vaccinated individuals showed better CMI response. The findings in the study showed specific unresponsiveness to lepromin in LMI in leprosy contacts of less than two years duration, direct contacts, contacts of lepromatous spectrum of index patients and contacts not vaccinated with B.C.G. emphasizing that CMI status is an important parameter in identifying the contact population at the greater risk of acquiring leprosy.
通过麻风菌素试验和使用植物血凝素（PHA）及麻风菌素的白细胞游走抑制（LMI）试验，对50例麻风患者的健康接触者和50例年龄及性别匹配的非接触对照者的细胞介导免疫（CMI）进行了研究，并评估了其与接触者其他危险因素的相关性。麻风菌素阳性与LMI结果密切相关。I、II和III度接触者的CMI无差异。在直接接触者中，麻风菌素试验阳性率为67%，而间接接触者为92%；在LMI试验中，直接接触者的游走指数（MI）显著升高（0.66±0.20）。接触时间少于两年的接触者MI也显著升高（0.73±0.20），而接触时间超过五年的接触者MI降至0.51±0.18。这些接触者中麻风菌素阳性率也从60%升至100%。与健康对照相比，LL患者接触者（MI：0.74±0.21）和BL患者接触者（MI：0.61±0.01）的特异性CMI显著受抑制。接种卡介苗的个体显示出更好的CMI反应。研究结果表明，接触时间少于两年的麻风接触者、直接接触者、指数患者瘤型谱接触者以及未接种卡介苗的接触者在LMI中对麻风菌素存在特异性无反应，强调CMI状态是识别感染麻风风险较高接触人群的重要参数。
