02231nas a2200373   4500000000100000008004100001260001600042653001500058653001000073653002400083653003800107653001100145653001100156653002100167653003200188653001200220653000900232653001600241653002500257653001700282653002800299653001100327653001500338100001700353700001300370700001400383700001500397245007400412300001100486490000800497050002000505520131800525022001401843       1995                            d  c1995 Dec 2710aAdolescent10aAdult10aAntigens, Bacterial10aEnzyme-Linked Immunosorbent Assay10aFemale10aHumans10aImmunoglobulin A10aImmunoglobulin A, Secretory10aleprosy10aMale10aMiddle Aged10aMycobacterium leprae10aNasal Mucosa10aNasal Provocation Tests10aSaliva10aTuberculin1 aRamaprasad P1 aCree I A1 aOluwole M1 aSamson P D00aDevelopment of a mucosal challenge test for leprosy using leprosin A.  a239-460 v188  aRAMAPRASAD 19953 a<p>There is little information about the mucosal immune response in leprosy. We have developed a nasal provocation test with leprosin A which will be used to investigate mucosal immunity to Mycobacterium leprae. Initial studies were performed with increasing doses of leprosin A (1.0 pg/ml-10 micrograms/ml) to determine the optimal safe dose of leprosin A. Anti-M. leprae IgA antibody and normal IgA concentrations were measured in the saliva of leprosy contacts and controls before and after instillation of leprosin A. Nasal leprosin A was well tolerated up to a concentration of 10 micrograms/ml without side effects. None of the six subjects who had not been exposed to leprosy had salivary IgA against whole M. leprae, whereas IgA was detected from 64 h to 140 h following instillation of leprosin A in all of the leprosy hospital workers and in 15 out of 18 healthy household contacts tested. There was no correlation between serum and salivary anti-M. leprae IgA levels before and after testing. Salivary IgA anti-lipoarabinomannan responses were seen in 12 out of 20 household contacts. Normal salivary IgA concentrations varied from 8 to 240 mg/l. The leprosin A nasal provocation test appears to be a safe method for the investigation of the role of mucosal immunity in the pathogenesis of leprosy.</p>  a0022-1759