S—100蛋白染色在T型麻风诊断中的应用

选择ＴＴ及ＢＴ型麻风３３例，用Ｓ－１００蛋白免疫组化（ＡＢＣ）法检测，有２８例可在肉芽肿内见到遭受不同程度破坏的神经，包括神经纤维肿胀，变形和断裂成碎片，阳性率为８５％；在作对照的４例结节病和２例皮肤结核中，Ｓ－１００蛋白阳性的神经均位于肉芽肿且结构完整。因此作者认为Ｓ－１００蛋白染色对诊断ＰＢ型麻风，特别是在ＨＥ和抗酸染色阴性时，有重要的诊断价值。     

M-Dot-ELISA检测麻风家内接触者血清中麻风杆菌特异性抗原

用改良酶联免疫斑点１５试验（简称 Ｍ－Ｄｏｔ－ＥＬＩＳＡ）对麻风家内接触者（ＨＣ）血清进行了麻风杆菌特异性酚酚糖脂Ｉ（ＰＧＬ－Ｉ）抗原检测。７５例ＨＣ均经麻风杆菌明胶微粒凝集试验（ＭＬＰＡ）和酶联免疫吸附试验（ＥＬＩＳＡ）证实为麻风杆菌特异性抗体阳性者。结果表明：①７５例ＨＣ中抗原阳性者１６例，阳性率为２１％。接触多菌型麻风（ＭＢ）者的抗原阳性率（２８％）明显高于接触少菌型麻风（ＰＢ）者（０％），两者之间有极显著性差异（ Ｐ ＜０．０１ ）。②抗体弱、强阳性组的抗原阳性率和抗原量之间亦有极显著差异（Ｐ＜０．０１）。③４０例正常人及１０例经ＭＬＰＡ和ＥＬＩＳＡ检测证实特异性抗体阳性的非麻风患者血清标本，抗原检测均阴性。     

S—100蛋白染色在麻风诊断中的应用

用Ｓ－１００蛋白免疫组化染色检测２３例少菌型麻风，有１８例在上皮样细胞肉芽肿内找到破坏的皮神经证实为麻风，而以病理抗酸染色法，只有１１例阳性证实麻风，两种方法差异显著（Ｐ＜０．０５）。以同样方法检测３７例多菌型麻风，有２２例在真皮肉芽肿内见皮神经肿胀，束膜增生，内有炎细胞浸润；还见到许菌胶颗粒，Ｓ－１００染色呈阳性，作对照的２５例非麻风病例，其真皮内的神经基本正常。作者认为Ｓ－１００蛋白免疫组化染     

麻风菌重组融合蛋白α-抗原的血清学活性

用麻风患者的血清（Ｌ３８份、Ｂ１９份、Ｔ３６份）比较了α１－ＥＬＩＳＡ、α２－－ＥＬＩＳＡ与ＰＧＬ－Ｉ－ＥＬＩＳＡ法，结果各型患者血清中的抗体滴度分别为：α１－抗原＞α２－抗原＞ＰＧＬ－Ｉ，尽管Ｌ型的血清中抗α１－抗原的滴度明显高于其它两种抗原，但其阳性率在三种方法之间统计学上没有差别，分别为９７％，９２％和９４％；Ｂ和Ｔ型血清α１－ＥＬＩＳＡ法的阳性率明显高于其它两种方法，分别为８４％、５８％、６８％和４７％、３８％、３０％，以α１－ＥＬＩＳＡ法的敏感性最高。提示α１－ＥＬＩＳＡ在麻风血清诊断中有很大潜力，值得进一步扩大样本进行评价     

艾滋病免疫重建炎性综合征并发麻风1例并文献复习

患者女,33岁。HIV-1抗体阳性7年。右上肢红斑和左上腹斑块4年。皮损组织病理示:表皮萎缩,部分侵蚀,真皮层见致密淋巴细胞包绕的上皮样细胞肉芽肿。皮肤组织液涂片抗酸染色查见抗酸阳性杆菌。诊断:艾滋病,界线类偏结核样型麻风。高效抗逆转录病毒治疗有反应,标准麻风联合化疗有效。     

SACT的建立及其与PGL—I—ELISA的比较研究

用抗麻风菌特异酚糖脂Ｉ（ＰＧＬ－Ｉ）单克隆抗体Ｂ８Ｆ１ＩＶ建立了间接血清抗体竞争试验（ｓｃｒｕｍ ａｎｔｉｂｏｄｙ ｃｏｍｐｅｔｉｔｉｏｎ ｔｅｓｔ，ＳＡＣＴ），其性为９９％特异性为９６．５％。以本法与标准化的Ｃ ＰＧＬ－抗原的间接酶联免疫吸附试验（ＰＧＬ－Ｉ－ＥＬＩＳＡ）作了比较。所用麻风血清为１００例（ＬＬ２０、ＢＩ２０，ＢＢ２０，ＢＴ２０），正常人血清为２８例，结果显示丙地在检测ＭＢ病人上无     

酶联免疫吸附试验检测麻风特异性抗PGL－1抗体

用麻风菌特异性酚糖脂－１（ＰＧＬ－１）抗原（ＮＴ－Ｐ－ＢＳＡ）作酶联免疫吸附试验（ＥＬＩＳＡ），分别检测麻风病人５０例（ＬＬ４０例。阳性１６例，占４０．０ｆ％；ＢＬ９例，阳性４例，占４４．４％；Ⅰ１例为阴性），总阳性２０例，占４０．０％。治愈老残病人１３３例阳性１９例，占１４．３％；家内接触者１０２例，阳性９例，占８．８％。并作了结核病人８７例及正常人群１７４例。结果表明ＮＴ－Ｐ－ＢＳＡ－ＥＬＩＳＡ法具有较高的敏感性和特异性，将有助于麻风的早期诊断、判愈、复发予测及亚临床感染和免疫流行病学等研究。     

酶联免疫吸附试验检测麻风特异性抗PGL－1抗体

用麻风菌特异性酚糖脂－１（ＰＧＬ－１）抗原（ＮＴ－Ｐ－ＢＳＡ）作酶联免疫吸附试验（ＥＬＩＳＡ），分别检测麻风病人５０例（ＬＬ４０例。阳性１６例，占４０．０ｆ％；ＢＬ９例，阳性４例，占４４．４％；Ⅰ１例为阴性），总阳性２０例，占４０．０％。治愈老残病人１３３例阳性１９例，占１４．３％；家内接触者１０２例，阳性９例，占８．８％。并作了结核病人８７例及正常人群１７４例。结果表明ＮＴ－Ｐ－ＢＳＡ－ＥＬＩＳＡ法具有较高的敏感性和特异性，将有助于麻风的早期诊断、判愈、复发予测及亚临床感染和免疫流行病学等研究。     

麻风菌重组融合蛋白α—抗原的血清学活性

用麻风２的血清（Ｌ３８份、Ｂ１９份、Ｔ３６份）比较了α１－ＥＬＩＳＡ、α２－－ＥＬＩＳＡ与ＰＧＬ－Ｉ－ＥＬＩＳＡ法，结果各型患者血清中的抗何不工分别为：α１－抗原〉α２－抗原〉ＰＧＬ－Ｉ，尽管ＬＧ 血清中α１－怕的滴度明显高于其它两种抗原，但其阳性率在三种方法之间统计学上没有差别，分别为９７％，９２％和９４％；Ｂ和Ｔ型血清α１－ＥＬＩＳＡ法的阳性率明显高于其它两种方法，分别为８４％、５８％、６８％     

麻风患者治疗前后血清麻风杆菌特异性抗原和抗体的变化

用免疫斑点试验改良法（Ｍ－Ｄｏｔ－ＥＬＩＳＡ）和酶联免疫吸附试验（ＥＬＩＳＡ）对１０例多菌型麻风患者治疗前后的９９份血清进行了ＰＧＬ－Ｉ抗原和抗体检测。结果表明治疗前后及治疗中各段时间的抗原下降速度远快于抗体，二者之间有非常显著性差异（Ｕ＝９．０５，＞２．５８，Ｐ＜０，０１）。抗原量的下降以治疗后第１个月最快（７９．１４％），治疗第３个月时已下降９９％以上，这提示抗原的检测可用于监测多菌型麻风的早期疗效，在发现耐药和抗麻风新药筛选方面亦有应用价值。     

SLE患者皮质类固醇治疗前后血清IL－2和TNF－α水平的比较

ＳＬＥ患者皮质类固醇治疗前后血清ＩＬ－２和ＴＮＦ－α水平的比较刘国英①瞿国伟②ＳＬＥ是一种以免疫调节异常为特征的自身免疫性疾病，而免疫调节主要是通过多种细胞因子相互作用实现的。因此，研究ＳＬＥ病人细胞因子变化将有助于阐明该病的发病机理，我们检测了１４...     

Comparative evaluation of enzyme immunoassays based on synthetic glycoconjugates and phenolic glycolipid-I for immunodiagnosis of leprosy

Enzyme immunoassays (EIAs) based on synthetic glycoconjugates containing the terminal monosaccharide (M-BGG) or disaccharide (ND-BSA) residue of the trisaccharide component of phenolic glycolipid-I (PGL-I), for immunodiagnosis of leprosy are described. The results of the assays were compared with that of the EIA using PGL-I. All the three assays were highly specific for leprosy. The per cent positivity of active lepromatous leprosy (LL) patients with M-BGG was 78.05 in comparison to 85.36 with ND-BSA and 82.11 with PGL-I. Similarly, the positivity of tuberculoid (TT) leprosy patients in M-BGG assay was lower than that in EIAs using ND-BSA or PGL-I. However, the difference in the positivity of individual category of leprosy patients in the three EIAs was not statistically significant. The correlation between absorbance values of leprosy sera in EIAs based on M-BGG and PGL-I, as well as that in assays using ND-BSA and PGL-I was statistically significant.     

A dot enzyme immunoassay for detection of IgM antibodies against phenolic glycolipid-I in sera from leprosy patients

A visual dipstick dot enzyme immunoassay (EIA) for diagnosis of leprosy is described. The assay is based on detection of IgM antibodies against phenolic glycolipid (PGL-I) in sera from leprosy patients. The antigen (PGL-I or synthetic disaccharide of PGL-I) was dotted on a nitrocellulose pad stuck on a plastic strip (dipstick). Sera were used at a dilution of 1:200. Peroxidase coupled mouse anti-human IgM monoclonal antibodies were used as the conjugate. A positive test gave a blue dot against a white background. The test was highly specific for leprosy, and was quite sensitive for detection of bacilliferous (BL/LL) leprosy. The antigen dotted and preblocked dipsticks stored at room temperature upto 4 months of observation period, were unable in the assay.     

Evaluation of Phenolic Glycolipid-I (PGL-I) Antibody as a Multidrug Therapy (MDT) Monitor

Since phenolic glycolipid-I (PGL-I) is an unequivocal marker for Mycobacterium leprae, this antigen has been a good candidate for the serodiagnosis and monitoring of the effectiveness of leprosy chemotherapy. The present study, a continuation of an earlier report, was undertaken to estimate PGL-I antibody titers in 40 leprosy patients 3 and 6 months after starting MDT. All the leprosy groups showed significant declines in anti PGL-I reactivity after 6 months. There was a good correlation between bacteriological indices (BI) and anti PGL-I antibody levels. Thus, PGL-I based serology may be useful in monitoring the response to multidrug therapy.     

The role of Mycobacterium leprae phenolic glycolipid I (PGL-I) in serodiagnosis and in the pathogenesis of leprosy

PGL-I (phenolic glycolipid I) emerged in the early 1980s on the one hand as part of intensive efforts to define the typing antigens of a host of Mycobacterium spp. and also from characterisation of the lipids of skin biopsies from highly bacillary positive lepromatous leprosy patients. PGL-I, despite its extreme lipophilicity due to its inherent phthiocerol dimycocerosyl component, is highly antigenic evoking high titre IgM antibodies in lepromatous leprosy patients, attributable largely to the unique 3,6-di-O-methyl-beta-D-glucosyl entity at the non-reducing terminus of its trisaccharide. PGL-I itself or in the form of semisynthetic neoglycoproteins containing the synthetic terminal disaccharide or the whole trisaccharide chemically conjugated to such as bovine or human serum albumin, has found its greatest utility in the serological diagnosis, confirmation and management of lepromatous leprosy. PGL-I has also been implicated in the tropism of M. leprae for Schwann cells, through specific binding to laminin, and to play an important role in downregulation of the inflammatory immune response and inhibition of dendritic cell maturation and activation, thereby facilitating the persistence of M. leprae/leprosy.     

Antibody-based enzyme-linked immunosorbent assay for determination of anti-PGL-I specific circulating immune complex in leprosy patients

A serological study was performed in 122 individuals: 75 leprosy patients and 47 healthy controls. The ELISA test was performed for IgG and IgM using the glycolipid PGL-I antigen from Mycobacterium leprae. Circulating immune complexes (CIC) were isolated by PEG 6000 precipitation method and after dissociation with an acid solution, the IgG and IgM specific against PGL-I were tested with the ELISA test. The multibacillary patients had high levels of antibodies, compared with paucibacillary patients and controls. The antibodies isolated from the CIC presented a similar spectrum spectral distribution as the serology. A positive correlation between the levels of free and CIC bound antibodies was observed. In contrast with tuberculosis patients, specific antibodies present in CIC were not responsible for false-negative results found in some multibacillary patients' serology, since no or very low levels of specific antibodies were found in PEG precipitated serum of these patients. No relation was observed with specific antibody levels detected in CIC during leprosy reactions.     

Immunohistochemical detection of PGL-1, LAM, 30 kD and 65 kD antigens in leprosy infected paraffin preserved skin and nerve sections

A panel of lipid, carbohydrate and protein antibodies were optimized for use in detecting M. leprae antigens in paraffin embedded material. Skin and nerve biopsies from 13 patients across the leprosy spectrum were studied. All antibodies detected antigen in tissues with a BI > 1. Phenolic-glycolipid was not detected in bacteriologically negative tissue but lipoarabinomanan (LAM) and protein antigens were detected. Staining with LAM was strongest and gave least background. The transfer of this immunohistochemical technique to paraffin embedded material will allow examination of tissue with better morphology and from clinics without access to tissue freezing facilities.     

Comparison of PCR mediated amplification of DNA and the classical methods for detection of Mycobacterium leprae in different types of clinical samples in leprosy patients and contacts

Traditional staining and microscopic examination techniques for the detection of Mycobacterium leprae, DNA amplification by polymerase chain reaction (PCR) of a 531-bp fragment of the M. leprae specific gene encoding the 36-kDa antigen, and serodiagnosis with M. leprae specific antigens (PGL-1 and D-BSA) were compared on different clinical specimens (serum samples, slit-skin smears, biopsies and swabs) from 60 leprosy patients attending the Sanatorium of Fontilles. Patients were divided into groups; (i) 20 multibacillary patients (MB) with positive bacteriological index (BI) by conventional methods and on WHO multidrug therapy (MDT); (ii) 30 MB patients with negative BI and completed minimum 2 years treatment MDT; (iii) 10 paucibacillary (PB) patients who had completed 6 months MDT at least 8 years ago. Control groups included four non-leprosy patients for PCR methods and 40 health control patients and 10 tuberculosis patients for serological methods. In the multibacillary BI positive group, there was a good correlation between all methods. All tests were negative in the paucibacillary group, although only a few patients were tested and all had been treated many years ago. One must be cautious concerning the diagnostic potential of these techniques in this type of leprosy. We also studied different combinations of leprosy diagnosis methods to determine the potential risk in a leprosy contact individuals group. The prevalence of antibodies to M. leprae antigens in serum was measured, together with the presence of M. leprae DNA in the nose and lepromin status in a group of 43 contacts of leprosy patients (12 household and 31 occupational) to evaluate the maintenance of infection reservoirs and transmission of the disease. Only two individuals were found to form a potential high risk group.