@article{9794,
  keywords = {Esterases, Gene Expression Regulation, Humans, Hypersensitivity, Delayed, Immunohistochemistry, Interferon-gamma, leprosy, Nucleic Acid Hybridization, RNA, Messenger, T-Lymphocytes, T-Lymphocytes, Helper-Inducer, T-Lymphocytes, Regulatory},
  author = {Cooper C L and Mueller C and Sinchaisri T A and Pirmez C and Chan J and Kaplan G and Young S M and Weissman I L and Bloom B R and Rea T H and Modlin R L},
  title = {Analysis of naturally occurring delayed-type hypersensitivity reactions in leprosy by in situ hybridization.},
  abstract = {<p>Analysis of tissue lesions of the major reactional states of leprosy was undertaken to study the immune mechanisms underlying regulation of cell-mediated immunity and delayed-type hypersensitivity (DTH) in man. In situ hybridization hybridization of reversal reaction biopsy specimens for INF-gamma mRNA expression revealed a 10-fold increase in specific mRNA-containing cells over that observed in unresponsive lepromatous patients. Expression of huHF serine esterase, a marker for T cytotoxic cells, were fourfold increased in reversal reaction and tuberculoid lesions above that detected in unresponsive lepromatous individuals. Immunohistology of reversal reactions confirmed a selective increase of Th and T cytotoxic cells in the cellular immune response. Of interest, the microanatomic location of these serine esterase mRNA-containing cells was identical to the distribution of CD4+ cells. Analysis of erythema nodosum leprosum (ENL) lesions revealed differences in the underlying immune processes in comparison with reversal reaction lesions. Although phenotypic Th cells predominated in ENL lesions, IFN-gamma and serine esterase gene expression were markedly reduced. We suggest that reversal reactions represent a hyperimmune DTH response characterized by a selective increase of CD4+ IFN-gamma producing cells and T cytotoxic cells, which result in the clearing of bacilli and concomitant tissue damage. In contrast, ENL reactions may be viewed as a transient diminution of Ts cells and activity leading to a partial and transient augmentation in cell-mediated immunity, perhaps sufficient to result in antibody and immune complex formation, but insufficient to clear bacilli from lesions.</p>},
  year = {1989},
  journal = {The Journal of experimental medicine},
  volume = {169},
  pages = {1565-81},
  month = {1989 May 01},
  issn = {0022-1007},
  doi = {10.1084/jem.169.5.1565},
  language = {eng},
}