Leprosy, an overview.

Leprosy is both a public health problem and a model for host-parasite relationship. There is much progress in many areas, and in most, hurdles are not only scientific but also social and financial. The following are goals to reach: 1) progress of growth of M. leprae in animals (to be able to breed armadillos in captivity or to substitute them with other animals); 2) to develop methods for in vitro culture of M. leprae; 3) to obtain antigens from M. leprae and characterize them immunologically; 4) to achieve techniques for objective diagnosis of infection with M. leprae and of leprosy (these techniques will most likely be serologic); 5) to develop methods to direct and manipulate immune response. This should include a better definition of immunologically active cells, their characterization by reliable methods, and an understanding of their functions. Immune control mechanisms and ways to channel them should also be understood; and 6) to have better methods of treatment including flexible adaptable schedules. It will be clear that "solving" the problem of leprosy requires "solving" the social problems in developing countries, as well as unraveling the mystery of the precise control of immune response. As I pointed out, the problems that we face are basically similar to those of autoimmune disorders and of cancer immunology. Research in autoimmune diseases or cancer might provide answers to questions posed by leprosy. It may also be that research in leprosy could supply answers to questions concerning cancer and autoimmunity.