RESUMO
Over 100 patients with lepromatous leprosy were treated with rifampicin in a series of pilot, uncontrolled, and controlled trials in 1968-77. The rapid bactericidal effect of rifampicin on Mycobacterium leprae was confirmed. Clinical improvement became apparent sometimes as early as 14 days after the start of treatment. Nevertheless, a few persisting viable M leprae were detected as long as five years after the start of treatment with rifampicin either by itself or in combination with the bacteriostatic drug thiambutosine. Treatment with rifampicin and dapsone for six months reduced the number of persisting leprosy bacteria more than treatment with dapsone alone. Although rifampicin proved more effective than dapsone, it is unlikely that used by itself if can significantly shorten the length of treatment in lepromatous leprosy. Therefore initial intensive combined treatment with two or more bactericidal drugs (including rifampicin) warrants further investigation in both untreated leprosy and lepromatous leprosy resistant to dapsone.
Assuntos
Humanos , Animais , Camundongos , Combinação de Medicamentos , Dapsona/uso terapêutico , Ensaios Clínicos como Assunto , Feniltioureia/análogos & derivados , Feniltioureia/uso terapêutico , Hanseníase/tratamento farmacológico , Mycobacterium leprae , Rifampina/administração & dosagem , Rifampina/farmacologia , Rifampina/uso terapêuticoRESUMO
Mixed leucocyte cultures, from two normal donors, were set up in media containing human serum from one of the following sources: (a) a pool of normal group AB donors; (b) Chinese, Malay or Indian patients with untreated leprosy; (c) the same patients after effective anti-leprosy treatment; (d) control Chinese, Malay or Indian subjects. Transformation was estimated by measuring the incorporation of tritiated thymidine in the last 24 hr of a 7-day culture period. Transformation was impaired in sera from treated lepromatous patients, but was less impaired or not impaired at all in sera from treated lepromatous patients. The loss of depressive activity after treatment was more marked in Chinese and Indian than in Malay patients. Transformation was also impaired, though to a lesser extent, in sera from patients with untreated tuberculoid leprosy; it was still impaired in sera from treated tuberculoid patients. There was no evidence of specificity in impairment of mixed lymphocyte reactivity and lymphocytotoxic antibodies appeared to play no role. The incidences of hepatitis B antigen and antibody and of anti-nuclear factor were not notably high.
Assuntos
Masculino , Feminino , Humanos , Criança , Adulto , Pessoa de Meia-Idade , Idoso , Adolescente , Anticorpos Antinucleares , Antígenos da Hepatite B , Ativação Linfocitária , Dapsona/uso terapêutico , Especificidade de Anticorpos , Etnicidade , Hanseníase/imunologia , Hanseníase/tratamento farmacológico , Teste de Cultura Mista de LinfócitosRESUMO
Nerve damage in non-lepromatous leprosy and in "reversal" reactions is the result of an immune response to the presence of antigenic material derived from leprosy bacilli within nerves.