Significant epidermal changes were observed in lesions of leprosy patients undergoing type 1 (reversal) and type 2 (erythema nodosum leprosum, ENL) reactions. Using indirect immunofluorescence and frozen sections stained with the appropriate monoclonal antibodies, an increase in epidermal cell layers, the presence of Ia on keratinocytes, an increase in Langerhans' cell numbers, and scattered T cells within the epidermis were seen in both types of reactions. Although borderline tuberculoid patients with type 1 reactions showed the consistent presence of Ia on all keratinocytes, lepromatous patients undergoing ENL reactions showed only a patchy distribution. Taken together, these studies indicate that local T-cell activation leading to the production of terminal lymphokine, such as interferon-gamma, with subsequent induction of Ia on epidermal cells may be an important event in reactional leprosy states. It is of interest that the hitherto considered "anergic" lepromatous patients should recover temporary T-cell reactivity during the natural course of the disease.
BT - International journal of leprosy and other mycobacterial diseases : official organ of the International Leprosy Association C1 - http://www.ncbi.nlm.nih.gov/pubmed/2458421?dopt=Abstract DA - 1988 Sep IS - 3 J2 - Int. J. Lepr. Other Mycobact. Dis. LA - eng N2 -Significant epidermal changes were observed in lesions of leprosy patients undergoing type 1 (reversal) and type 2 (erythema nodosum leprosum, ENL) reactions. Using indirect immunofluorescence and frozen sections stained with the appropriate monoclonal antibodies, an increase in epidermal cell layers, the presence of Ia on keratinocytes, an increase in Langerhans' cell numbers, and scattered T cells within the epidermis were seen in both types of reactions. Although borderline tuberculoid patients with type 1 reactions showed the consistent presence of Ia on all keratinocytes, lepromatous patients undergoing ENL reactions showed only a patchy distribution. Taken together, these studies indicate that local T-cell activation leading to the production of terminal lymphokine, such as interferon-gamma, with subsequent induction of Ia on epidermal cells may be an important event in reactional leprosy states. It is of interest that the hitherto considered "anergic" lepromatous patients should recover temporary T-cell reactivity during the natural course of the disease.
PY - 1988 SP - 401 EP - 7 T2 - International journal of leprosy and other mycobacterial diseases : official organ of the International Leprosy Association TI - Epidermal changes in reactional leprosy: keratinocyte Ia expression as an indicator of cell-mediated immune responses. VL - 56 SN - 0148-916X ER -