02558nas a2200385   4500000000100000008004100001260001300042653002600055653001400081653001900095653003000114653001100144653002100155653002100176653001200197653002500209653003000234653004400264653000900308100001300317700001400330700001600344700001400360700001400374700001100388700002600399700001800425700001300443245014100456300001100597490000800608050001400616520152800630022001402158       1994                            d  c1994 Oct10aAnti-Bacterial Agents10aCytokines10aDNA, Bacterial10aDrug Therapy, Combination10aHumans10aInterferon-gamma10aLangerhans Cells10aleprosy10aMycobacterium leprae10apolymerase chain reaction10aReceptors, Antigen, T-Cell, gamma-delta10aSkin1 aFlad H D1 aRichter E1 aSchlüter C1 aDuchrow M1 aArnoldi J1 aHahn M1 aGraf von Ballestrem W1 aAlvarenga A E1 aGerdes J00aMycobacterium leprae DNA content, cellular and cytokine patterns in skin lesions of leprosy patients undergoing multidrug therapy (MDT).  a388-940 v191  aFLAD 19943 a<p>Skin biopsies from untreated and MDT-treated patients were examined for infiltrating cells and cells producing the cytokines TNF-alpha, IFN-gamma, and IL-1 beta using immunohistochemistry. Biopsy specimens from untreated tuberculoid leprosy patients were characterized by the presence of cells producing TNF-alpha, IFN-gamma, and IL-1 beta and of subepidermal Langerhans cells. These cells were rarely found or completely absent in biopsies of untreated lepromatous leprosy patients, but tended to increase under MDT. In a short-term therapy trial for three months with brodimoprim, dapsone, and rifampicin, 12 patients were monitored 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. Immunophenotyping in these follow-up biopsies revealed that in the latter group IFN-gamma-positive cells and Langerhans cells were present and gamma delta T cell receptor-positive cells tended to decrease during therapy. In contrast, in patients whose mycobacterial DNA did not change during therapy, these phenotypical manifestations were not observed. We therefore, conclude that assessment of mycobacterial DNA in combination with phenotyping of infiltrating cells and determination of cytokine patterns may be useful tools in establishing criteria for the effectiveness and duration of MDT in patients with leprosy.</p>  a0171-2985