以灭活麻风菌加卡介苗诱导对麻风菌抗原的迟发型超敏反应的初步研究

Preliminary Study of Delayed Hypersensitivity to Leprosy Antigen Induced by Killed Leprosy Bacilli plus BCG

为30例多菌型麻风病人皮内注射HKML+BCG菌苗后均出现局部反应,包括红斑、硬结和溃疡,不过能为病人所接受。反复注射后局部反应无加剧倾向;全身性反应(主要是虹睫炎和主诉指、趾麻木)只在第五次注射后常见(43％),但能减低菌苗注射的可接受性。反复菌苗注射似能引发虹膜炎,而主诉麻木与注射之间的联系尚不能肯定;没有发现Ⅰ型和Ⅱ型麻风反应。反复注射后大部分病人的SMLA阳转,但前一次阳性者在下一次注射后也有又转阴性的,并不稳定。第七次菌苗注射后SMLA-Ⅰ(Rees)抗原的阳性率45％,SMLA-Ⅱ(Convit抗原)为35％。第八次注射后66.7％病人麻风菌素晚期反应阳转。但能否持久尚需随访证明。SMLA-Ⅰ和SMLA-Ⅱ反应有相关,但仅为中等水平;反复注射后SMLA-Ⅰ的阳转率高于SMLA-Ⅱ;麻风菌素试验的早期及晚期反应与SMLA反应不相关。本组中皮肤查菌阴性的癌型患者,于接种前抗PGL-Ⅰ抗体水平呈弱阳性,反复菌苗接种未能对此产生影响。

After intracutaneous injection of a (heat-killed) vaccine of leprosy bacilli plus BCG in 30 cases of MB leprosy, localized skin reactions including redness, induration and ulceration were found without influence on its usefulness. Repeated injection did not strengthen the reactions. Only after the fifth injection general reaction was found in 43％, which included iritis and complaints of numbness in the fingers and toes, which might decrease its usefulness. Repeated injection seems be able to induce iritis, but the association between the injection and finger or toe numbness is still uncertain. The injection did not induce Ⅰ or Ⅱ type lepra reaction, but it make SMLA positive in most cases. The reduced SMLA positivity is instable. After the seventh injection, the positive rate of SMLA-Ⅰ(Rees antigen) wa 45％ and that of SMLA-Ⅱ (Convit antigen) 35％. After the eighth injection Mitsuda reaction became positive in 66.7％ of the cases, but it still needs following-up whether the positivity will be sustained or not. SMLA-Ⅰ and MLA-Ⅱ reactious are correlative but their degree is only medium.The positive rate of SMLA-Ⅱ after re- peated injection is higher thn that of SMLA-Ⅰ. There was no correlation between Fernandez or Mitsuda reaction and SMLA reaction.The repeated injection did not influence the level of PGL-1 in MB cases with weak positivity of PGL-1 and negative skin Smears.