IN LEPROSY THE PRESENCE OF MYCOBACTERIA IN THE NERVE IS AN ESSENTIAL FACTOR IN THE CYCLE AND SPECTRUM OF MYCOBACTERIUM-LEPRAE INFECTION

A total of 220 untreated leprosy patients who underwent parallel skin and nerve biopsies arc included in this study, which is intended to ev aluate the extent of previously reported differences in bacillary load between skin and nerve lesions in leprosy and to describe the respons e of peripheral blood lymphocytes to Mycobacterium leprae antigens in such patients. In 161 patients out of the 220, the skin and nerve biop sies were diagnostic for leprosy. When patients were grouped according their skin and nerve lesions, the 3 groups observed were (1) paucibac illary skin and nerve lesions; (2) multibacillary skin and nerve lesio ns, and (3) paucibacillary skin and multibacillary nerve lesions. Ther e was no observation of a group of patients with multibacillary skin a nd paucibacillary nerve lesions. In all patients with multibacillary n erve lesions, regardless of the type of skin lesions, a low response o f peripheral blood lymphocytes to M. leprae was consistently noted. Th ese results suggest that the bacillary load in the nerve is certainly one of the factors determining the immunological spectrum observed in leprosy.