Hd. Flad et al., MYCOBACTERIUM-LEPRAE DNA CONTENT, CELLULAR AND CYTOKINE PATTERNS IN SKIN-LESIONS OF LEPROSY PATIENTS UNDERGOING MULTIDRUG THERAPY (MDT), Immunobiology, 191(4-5), 1994, pp. 388-394
Skin biopsies from untreated and MDT-treated patients were examined fo
r infiltrating cells and cells producing the cytokines TNF-alpha, IFN-
gamma, and IL-1 beta using immunohistochemistry. Biopsy specimens item
untreated tuberculoid leprosy patients were characterized by the pres
ence of cells producing TNF-alpha, IFN-gamma, and IL-1 beta and of sub
epidermal Langerhans cells. These cells were rarely found or completel
y absent in biopsies of untreated lepromatous leprosy patients, but te
nded to increase under MDT. In a short-term therapy trial for three mo
nths with brodimoprim, dapsone, and rifampicin, 12 patients were monit
ored by follow-up biopsies. Semiquantitative PCR for mycobacterial DNA
revealed two groups of patients: one group in which mycobacterial DNA
in follow-up biopsies remained constant and a second group in which a
decrease of mycobacterial DNA during therapy was noted. Immunophenoty
ping in these follow-up biopsies revealed that in the latter group IFN
-gamma-positive cells and Langerhans cells were present and gamma delt
a T cell receptor-positive cells tended to decrease during therapy. In
contrast, in patients whose mycobacterial DNA did not change during t
herapy, these phenotypical manifestations were nor observed. We theref
ore, conclude that assessment of mycobacterial DNA in combination with
phenotyping of infiltrating cells and determination of cytokine patte
rns may be useful tools in establishing criteria for the effectiveness
and duration of MDT in patients with leprosy.