01598nas a2200229   4500000000100000008004100001260001300042653001400055653002700069653001100096653002100107653001800128653001200146653001800158100001500176245004500191856007100236300001100307490000800318520102800326022001401354       1994                            d  c1994 Jun10aCytokines10aDisease Susceptibility10aHumans10aInterferon-gamma10aInterleukin-210aleprosy10aT-Lymphocytes1 aModlin R L00aTh1-Th2 paradigm: insights from leprosy.  uhttp://www.sciencedirect.com/science/article/pii/S0022202X94946140  a828-320 v1023 a<p>The mechanism by which T cells and cytokines regulate immune processes in skin can be investigated by studying patients with leprosy. The disease, caused by the obligate intracellular bacterium Mycobacterium leprae, forms a spectrum. At one pole, patients with tuberculoid leprosy are able to restrict the growth of the pathogen and their skin lesions are characterized by a predominance of CD4+ T cells and type 1 cytokines including interleukin 2 and interferon gamma. At the opposite pole, patients with lepromatous leprosy are unable to contain the infection and their skin lesions are characterized by a predominance of CD8+ T cells and type 2 cytokines including interleukins 4 and 10. A key determinant of the T-cell cytokine response may be interleukin 12, which selectively favors expansion of CD4+ T cells producing interferon gamma. By understanding the factors that regulate T-cell and cytokine responses in leprosy, it should be possible to devise specific immunologic interventions in diseases of skin.</p>  a0022-202X