Asunto(s)
Clofazimina/administración & dosificación , Clofazimina/uso terapéutico , Dapsona/administración & dosificación , Dapsona/uso terapéutico , Leprostáticos/administración & dosificación , Leprostáticos/efectos adversos , Leprostáticos/uso terapéutico , Lepra Dimorfa/tratamiento farmacológico , Lepra Tuberculoide/tratamiento farmacológico , Lepra Lepromatosa/tratamiento farmacológico , Lepra/tratamiento farmacológico , Hipersensibilidad a las Drogas/etiología , Quimioterapia Combinada/uso terapéutico , Rifampin/administración & dosificación , Rifampin/efectos adversos , Rifampin/inmunología , Rifampin/uso terapéutico , Sulfonamidas/administración & dosificación , Sulfonamidas/uso terapéutico , Trombocitopenia/inmunología , Trombocitopenia/inducido químicamenteRESUMEN
T cell subsets and T cell functions were explored in 31 leprosy patients with the following methods: determination of the percentages of the different T cell subpopulations defined by monoclonal antibodies directed at total T cells, helper T cells and suppressor/cytotoxic T cells; measurement of the in vitro proliferative responses to mitogens; study of the concanavalin A-induced suppressive activity, assessed on MLC; measurement of delayed-type hypersensitivity by skin testing. The confrontation between immunological lepromatous patients without type-2 reaction (erythema nodosum leprosum), (2) lepromatous patients without ENL (erythema nodosum leprosum), (2) lepromatous patients was recent ENL and (3) tuberculoid patients. Unexpectedly, groups 1 and 3, although differing strongly in their clinical status and their sensitivity to lepromin (absent in group 1 and strong in group 3), showed a similar immunological profile with a normal percentage of T cells and a normal distribution of T cells among the major T cell subset contrasting with a moderate decrease of proliferative responses to mitogens and impaired delayed-type hypersensitivity reactions. Concanavalin A-induced suppressive activity was type-2 reaction) strongly differed from both other groups, showing striking abnormalities other groups, showing striking abnormalities of the repartition of the T cell subsets, with increased percentages of helper T cells and decreased percentages of suppressor T cells, and elevated proliferative responses to mitogens. Concanavalin A-induced suppressive activity was reduced in most patients of this group. It is suggested that this imbalance between T cell subsets contributes to the occurrence of ENL reactions in lepromatous patients.