BACKGROUND: Generalized immune activation occurs early in the course of many infectious disease. Laboratory investigations have shown that immune activation can be quantified by the measurement of soluble immune activation products in serum. Soluble CD25, CD8, and CD4 are major immune activation products. Soluble CD8 and CD4 are indices of CD8+ T cell and CD4+T cell activity, respectively. OBJECTIVE: We estimated the concentrations of these molecules in patients with leprosy. METHODS: The study population consisted of 31 patients with tuberculoid leprosy and 71 patients with lepromatous leprosy(32 cases of M. leprae negative patients and 39 cases of M. leprae positive patients). Serum samples and clinical and laboratory data were collected form each patient and control. The levels of serum soluble CD25, CD8, and CD4 were measured by sandwich enzyme immunoassay. RESULTS: The levels of serum soluble CD25 were significantly raised in leprosy patients as compared to control and did not vary signficantly between tuberculoid and lepromatous leprosy. The soluble CD8 levels in the serum of patients with leprosy did not differ from the levels of the control. The levels of serum soluble CD4 were significantly decreased in the patients with lepromatous leprosy, but not in the patients with tuberculoid leprosy. However, there was no significant correlation between CD25, CD8, and cD4 and bacterial indices in patients with lepromatous leprosy. CONCLUSIONs: There data suggest that non-specific immune activation occurs the spectrum in leprosy, while CD4+ T cell activity is significantly decreased in patients with lepromatous leprosy.
Communicable Diseases ; Humans ; Immunoenzyme Techniques ; Leprosy* ; Leprosy, Lepromatous ; Leprosy, Tuberculoid

INTRODUCTION: Along with the remarkable decrease in incidence of Hansen's disease, many physicians have little experience and are unfamiliar with the disease entity. Consequently physicians may make an error in or delay the correct diagnosis more frequently in these days. We feel that the physicians should constantly be interested in Hansen's disease, and be aware of the updated aspects as compared with the past. MATERIAL AND METHODS: We have analysed 13 new patients of Hansen's disease in Busan, Ulsan, and Kyungnam district during last 6 years (2002-2007). The clinical features of 13 new patients were compared with 370 cases reported 30 years ago, in our clinic. RESULTS: Among 13 patients, male was 4 and female was 9. Mean age was 63 years, and the mean duration until diagnosis was 15.6 months. Two patients had familial history of Hansen's disease. In the classification, lepromatous leprosy was 6, borderline lepromatous leproys was 4, mid-borderline leprosy was 1, borderline tuberculoid leprosy was 1, and tuberculoid leprosy was 1. Eight patients of 13 have experienced lepra reaction. Level of BI and PGL-I antibody corresponded with type of the disease. Among 13 patients, 9 patients (69.2%) were resident in Busan. CONCLUSION: There was an increase in female population, and mutibacillary forms of Hansen's disease were more common as compared with the past. Since majority of patients were resident in Busan and the duration until diagnosis was too long, the dermatologist, especially in Busan should be interested in and carry on clinical studies of Hansen's disease constantly.
Female ; Humans ; Incidence ; Leprosy ; Leprosy, Lepromatous ; Leprosy, Multibacillary ; Leprosy, Paucibacillary ; Leprosy, Tuberculoid ; Male

Recently, many reports suggest that the activation of Toll-like receptor 2 (TLR2) by microbial lipoproteins may initiate innate defense mechanism against infectious pathogens. Especially, TLR2 is critical in the immune response to mycobacterial infections and the mutations in the TLR2 have been shown to confer the susceptibility to severe infection with mycobacteria. A previous study reported that there is a mutation of TLR2 (TLR2-R677W) in lepromatous leprosy. In this study, thus, we performed the functional study on TLR2 by measurement of IL-12 production in serum and monocytes from leprosy patients with TLR2 mutation (R677W) to verify the relation between TLR2 and the susceptibility to leprosy. Tuberculoid leprosy patients showed higher serum levels of IL-12p70 compared with those of lepromatous leprosy. In contrast with the lepromatous leprosy patient with TLR2 mutation, especially, the group with wild-type TLR2 showed 2-fold increase levels of IL-12p70. Functional studies demonstrated that monocytes from patient with the TLR2 mutation, in comparison to the wild-type TLR2, is significantly less responsive to Mycobacterium leprae lysate. Our results reveal that TLR2 has a important role in the IL-12 production from monocytes and the susceptibility of lepromatous leprosy.
Humans ; Interleukin-12* ; Leprosy* ; Leprosy, Lepromatous ; Leprosy, Tuberculoid ; Lipoproteins ; Monocytes ; Mycobacterium leprae ; Toll-Like Receptor 2

Humans ; Leprosy, Tuberculoid ; diagnosis ; pathology ; Male ; Middle Aged ; Toes ; pathology

Leprosy has two polar types. The one tuberculoid leprosy (TL) is characterized by well preserved cellular immunity with a good prognosia and the other lepromatous leprosy(LL) shows no cellular immunity with a poor prognosis. The preaent study was designed to measure the activity of adenosine deaminase (ADA) in sera and erythrocytes of leprosy patients, as it's activities are known to be decreased in immune deficiency diseases. There were no significant differences in the erythrocyte ADA activities among normal subjects(9. 60+4. 43 units/1012 cells), TL patients (7. 12+2. 51 units/1012 cells) and LL patients(6. 96+0. 81 units/1012 cells), The ADA activities in sera of TL patients(20.15+2. 90 units/L) did not differ from those of normal subjects(20.44+ 2. 07 units/L), but the LL patients(17. 52+3. 30 units/L) showed a slightly lowered activity than those of normal subjects.
Adenosine Deaminase* ; Adenosine* ; Deficiency Diseases ; Erythrocytes* ; Humans ; Immunity, Cellular ; Leprosy* ; Leprosy, Tuberculoid ; Prognosis

To investigate leukocyte inhibitory factor(LlF) production and circulating immune complexes (CIC) in leprosy, peripheral blood mononuclear cells (PBMC) from 61 patients and sera from 6O patients were tested. The results indicate that there is a defect in LlF production in the lepromatous (LL) or borderline lepromatous (BL) types compared to the tubrculoid (TT) type (mean migration index=66.O +/- 16.O in LL 61.1 +/- 15.3 in BL, 51.9 +/- 11.2 in TT) (p < 0.05). The number of patients with positive CIC was higher among the LL patents (30%) than the TT patients (20%). There was also positive correlation between the bacterial index (Bl) and the CIC level (r=0.46, p < 0.05). The correlation between CIC and LIF in LL patients and the possibility (p=0.06) that the inuease m CIC may account for the decrease in LIF production in LL patients and vice versa are discussed.
Antigen-Antibody Complex/*analysis ; Human ; Leprosy/*immunology ; Leprosy, Lepromatous/immunology ; Leprosy, Tuberculoid/immunology ; Lymphokines/*analysis ; Support, Non-U.S. Gov't

Angiotensin-converting enzyme(ACE) is a ipeptidyl carboxypeptidase that is a membrane bound mainly on the luminal surface of pulmonary endothelial capillary cells. It functions to inactivate bradykinin, and also converts angiotensin 1 to angiotensin Activity of ACE was first identified in plasma by Skeggs and co-workers in ]956 In 1974 Lieberman discovered that elevated levels of serum ACE were associated with active sarcoidosis and that this assay would be usei to assist a diagnosis of sarcoidosis. The association of sarcoidosis and enhanced ACE activity was subsequently supported by data from other investigators. Increased serum ACE levels have also been observed in patients with nongranulomatous diseases and granulomatous diseases including leprosy. The author studied the serum ACE levels in leprosy patients(fourty-three with tuberculoid type and eighty-nine with lepromatous type) and twenty normal healthy controls by the spectrophotometric method described by Lieberman. Comparative studies of ACE levels in these two types of leprosy with normal healthy controls and relationship among the duration of treatment, age, and sex were also conducted. The results were summarized as follows: Ages of the selected patients were between 3Q to 77 years in tuberculoid leprosy (average 54 1), 23 to 75 years in lepromatous leprosy(average 53. 8) and 14 to 49 years in the control group(average 28 4) The duration of treatment in tuberculoid leprosy was between 1 and 39 years and average was 2p 7 years. Of lepromatous leprosy, duration of treatment was between 2 and 50 years and the average was 25. 4 years.
Angiotensins* ; Bradykinin ; Capillaries ; Diagnosis ; Humans ; Leprosy* ; Leprosy, Lepromatous ; Leprosy, Tuberculoid ; Membranes ; Peptidyl-Dipeptidase A* ; Phenobarbital ; Plasma ; Research Personnel ; Sarcoidosis

BACKGROUND: On previous reports, the incidence of hepatitis C in Korean leprous patients is too high (55.6~69%). We investigated the percentage of the leprous patients with hepatitis C, genotypes, and risk factors in National Sorokdo Hospital. METHODS: Out of total 714 leprous patients in National Sorokdo Hospital, 147 selected risky patients (with abnormal AST/ALT, plateletleprosy, 29 (5.57% out of 503) were patients with lepromatous leprosy and 16 (11.94% out of 134) were those with tuberculoid leprosy. Genotypic result for 41 patients was 1b in 16 (39.02%), 2a in 20 (48.78%), other type in 3 (7.32%) and mixed in 2 (4.88%). Only 2 of the patients (4.40%) had experienced blood transfusion before 1990, 20 (44.40%) had taken an operation or tattooing, 3 (6.67%) were given intravenous drugs, 2 (4.44%) were family members as married couple, and as much as 20 (44.40%) had no previously known possible risk factors. CONCLUSIONS: Major genotype of hepatitis C in leprous patients was 2a and it is different from that of other Korean population without leprosy (p-value= 0.0027). The percentage of patients with hepatitis C was not related to the subclass of the leprosy. Further studies for the non-blood transmission of hepatitis C virus in them and its controls are needed.
Blood Transfusion ; Female ; Genotype* ; Hepacivirus ; Hepatitis C* ; Hepatitis* ; Humans ; Incidence ; Leprosy ; Leprosy, Lepromatous ; Leprosy, Tuberculoid ; Male ; Risk Factors* ; Tattooing

Immunohistochemical staining was performed in 20 skin granulomas of 16 patients with leprosy using antisera against lysozyme and S-100 protein. In lepromatous leprosy, lysozyme positive cells and S-100 protein positive cells were rarely found in the dermis. However, the histoid leprosy specimen had large numbers of lysozyrne positive cells and S-100 protein positive cells in granuloma. In borderline group, lysozyme positive cells and S-l00 protein positive cells were found in the dermis. S-100 protein positive cells were diffusely distributed throughuut the granuloma in borderline lepromatous leprosy, while they were often found in lymphocytic mantle in borderline tuberculoid leprosy. In tuberculoid leprosy, lysozymal staining was encouritered in epitheloid cells and giant cells, but S-100 protein positive cells were predominantly found encircling granuloma. In the epidermis, great numbers of S-l00 protein positive cells were found in tuberculoid leprosy than in lepromatous leprosy.
Dermis ; Epidermis ; Giant Cells ; Granuloma ; Humans ; Immune Sera ; Leprosy* ; Leprosy, Lepromatous ; Leprosy, Multibacillary ; Leprosy, Paucibacillary ; Leprosy, Tuberculoid ; Muramidase* ; S100 Proteins ; Skin

Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae. The prevalence and number of new cases have recently markedly decreased in Korea, and the possibility of leprosy can therefore be clinically overlooked. However, leprosy is still endemic in various regions of the world. A 30 year-old male immigrant from Indonesia presented with an erythematous plaque without sensory loss on his face six months after immigration. The skin lesion was diagnosed as tuberculoid leprosy based on clinico-pathology.
Emigrants and Immigrants* ; Emigration and Immigration ; Granulomatous Disease, Chronic ; Humans ; Indonesia ; Korea ; Leprosy ; Leprosy, Tuberculoid* ; Male* ; Mycobacterium leprae ; Prevalence ; Skin