Learning from lesions: patterns of tissue inflammation in leprosy.

RL Modlin, J Melancon-Kaplan… - Proceedings of the …, 1988 - National Acad Sciences
RL Modlin, J Melancon-Kaplan, SM Young, C Pirmez, H Kino, J Convit, TH Rea, BR Bloom
Proceedings of the National Academy of Sciences, 1988National Acad Sciences
The clinical forms of leprosy constitute a spectrum that correlates closely with the degree of
cell-mediated immunity. Patients with tuberculoid leprosy develop strong cell-mediated
responses and have only a few, localized lesions, whereas patients with multibacillary
lepromatous leprosy are specifically unresponsive to antigens of Myobacterium leprae. T
cells of the CD4+ subset predominate in tuberculoid lesions, whereas CD8+ cells
predominate in lepromatous lesions. Monoclonal antibodies that distinguish subpopulations …
The clinical forms of leprosy constitute a spectrum that correlates closely with the degree of cell-mediated immunity. Patients with tuberculoid leprosy develop strong cell-mediated responses and have only a few, localized lesions, whereas patients with multibacillary lepromatous leprosy are specifically unresponsive to antigens of Myobacterium leprae. T cells of the CD4+ subset predominate in tuberculoid lesions, whereas CD8+ cells predominate in lepromatous lesions. Monoclonal antibodies that distinguish subpopulations of CD4+ and CD8+ cells were used to analyze the distribution of T cells infiltrating lesions across the disease spectrum. In lepromatous lesions, T cells of T-suppressor phenotype (9.3-) were the predominant CD8+ cells and suppressor/inducer cells (2H4+, Leu-8+) represented half of the CD4+ subset. In tuberculoid lesions, helper T cells (CD4+4B4+) outnumbered suppressor/inducer T cells by 14:1, compared with a ratio of 1.2:1 in peripheral blood. Analysis of the precursor frequency of antigen-reactive T cells permitted us to estimate that there was a 100-fold enrichment of T cells able to proliferate in response to M. leprae antigens in tuberculoid lesions (2/100), when compared with blood from the same patients. The methods used here to characterize the T-lymphocyte subsets and frequency of antigen-reactive T cells in leprosy may be useful in analyzing immunological reactions occurring in lesions of other inflammatory and autoimmune diseases.
National Acad Sciences