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A gelatin particle agglutination test (MLPA) for the detection of anti-phenolic glycolipid-1 (PGL-1) antibodies was compared with the slit skin smear method in the diagnosis of leprosy. MLPA and BI tests showed a good agreement rate of 88.1% and MLPA and ELISA tests showed an excellent agreement rate 96.2%. This MLPA test is simple and reliable, it will be very convenient for the medical practitioners, it would be of great benefit for leprosy patient as well because this test would look like a routine blood examination compared with slit skin smear method which is widely known diagnostic tool for leprosy.

An investigation on the demonstration of PGL-I and LAM-B antigens in thirty-four paraffin embedded skin biopsies taken from leprosy patients who covered the whole spectrum of the disease and in four control specimens was carried out. Neither the PGL-I antigen nor the LAM-B antigen was demonstrated in the normal skin specimens that were used as negative control; and only the LAM-B antigen appeared in the tuberculosis specimens in which the PGL-I antigen was negative. The PGL-I antigen was demonstrated on thirty-three leprosy samples except one TT sample and the LAM-B antigen, on all samples by immunochemical staining technique. The antigens were identified as intracytoplasmic bacillary staining, in solitary, granular as well as debris patterns; and as soluble antigenic staining, in vacuolar or amorphous pattern. In LL and BL cases, the antigens were detected predominantly from macrophages and peripheral nerves in all five staining patterns; in BB cases, from macrophages mostly in the granular as well as debris patterns, from the nerves in the vacuolar pattern; while in TT and the majority of BT cases, they were mainly from nerve remnants inside the granuloma in the vacuolar or amorphous staining pattern. In addition, it is interesting to note that the immunochemical staining was able to differentiate the foamy change from the hydropic degeneration. We also found that the antigens distributed in arrector pili muscles and the walls of muscular vessels were obviously related to the unmyelinated nerve fibers innervating the smooth muscle cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Lepromin reaction was studied with immunoperoxidase techniques using monoclonal antibodies. The skin reactions were induced by injecting Mitsuda antigen into healthy adults without a family history of leprosy. Both early (48 hours) and late (3 weeks and 2 months) reactions were examined. In the late reaction, focal collections of epithelioid cells had formed, and not only T- but also B-lymphocytes were observed around the granuloma. CD1a+ cells were also confirmed to have increased in the late reaction.

Four cases with leprosy were treated with immunotherapy by means of injection of transfer factor (TF). In the first case, BI reached the level of 1 in 1975, which thereafter continued for three years despite of continuation of chemotherapy. And this case was treated with the transfusion of leucocytes. The immunotherapy by means of injection of TF started nine weeks after the termination of transfusion of leucocytes. Also in the next case, the number of leprosy bacilli decreased to a small number by chemotherapy, but could not reach the negetivity despite of continuation of chemotherapy. In the other two cases, the injection of TF started at the stadium in which the number of leprosy bacilli decreased to middle grade by chemotherapy. The type of eprosy was BL in three cases, and LL/BL in a case.TF was extracted from the leucocytes of normal healthy adults. One vial of TF was injected once or twice weekly, or two vials of TF were injected once weekly. The total number of times of injection of TF is 25 in the first case, and 31 in the 2 nd case. And the total amount of TF is 38 vials in the first case, and 45 vials in the 2 nd case. In the other 2 cases, the number of times was 16 and 13 respectively, and the total amount was 16 vials and 13 vials respectively.The reversal reaction did not occur in every cases. The tendency of decrease of number of leprosy bacilli was somewhat observed in the first 2 cases, but not observed in the other 2 cases. In a case of first two cases, the number of T-cell increased a little.The function of lymphocytes did not change by the injection of TF. The lepromin reaction of first two cases was examined. In a case, the marked but temporarily positive Fernandez reaction occurred, and the Mitsuda reaction changed from negative to doubtful reation. But despite of the injection of TF made many times, clearly positive Mitsuda reaction did not occur. The amount of immunoglobulin and complement did notchange.Judging from the data obtained from this study, big hope cannot be placed on TF.

The trisaccharide segment of the phenolic glycolipid I of Mycobacterium leprae was synthesized effectively in the form of p-(2-methoxycarbonylethyl)phenyl glycoside by the condensation of p-(2-methoxycarbonylethyl)phenyl 4-O-benzyl-3-O-methyl-α-L-rhamnopyranoside and 2, 3-di-O-methyl-4-O-(2, 4-di-O-acetyl-3, 6-di-O-methyl-β-D-glucopyranosyl)-α-L-rhamnopyranosyl chloride in the presence of silver triflate and 1, 1, 3, 3-tetra-N-methylurea, and subsequent selective deprotection. This was then coupled to BSA by the acyl azide method, giving NT-P-BSA. The NT-P-BSA showed very high reactivity and specificity to leprosy sera. The trisaccharide-BSA conjugate with a β-linked rhamnosylrhamnose unit (βT-P-BSA) was also synthesized.

A female case 56 years old had the variously sized erythemata on her face, neck, buttock, and extremities. They were from coin-sized to twice the size of palm. Some patches had the apparently normal area in their inner part. In addition to those erythemata, the papules which were from marking-pin-head-sized to lens-sized, well-defined, hemispherically raised, and hard were scattered on the back of both hands, fingers, lower arms, legs, and neck.The macroscopical findings that the skin lesions were multiple, some eruptions were small in size, and some patches had the punched-out appearance suggested us the borderline nature of skin lesions. But the skin biopsy revealed the typical tuberculoid features. The bacteriological examination of skin lesions were negative, and the Mitsuda-test was positive. The small dosis of CIBA 1906 was given to her every day, except for the 1 st week when CIBA 1906 was given 5 days a week. About 5 weeks after the start of chemotherapy, the remarkable desquamation appeared on the patches of legs. And about 4 weeks later, two ulcers came out on the patches of the right leg. Thereafter, the ulcers expanded gradually, and new other ulcers appeared on both legs. About 3 months after the start of chemotherapy, the drug was changed from CIBA 1906 to DDS. But the ulcers did not improve. By the suspicion of skin tuberculosis, INH and PAS were administered, but they had no effect. The biopsy of a nerve which was enlarged revealed the tuberculoid change in the nerve. This result decided that she had the leprosy. Besides, the skin reaction against PPD was not positive, and the cultivation of tubercle bacilli from a eruption was negative. And also the comparative study of macroscopical and microscopical findings of skin eruptions denied the combination of skin tuberculosis. The mycotic dermatitis, syphilis, and the ulcer caused by Mycobacterium ulcerans were denied, too. Thus, it was fixed that they were the ulcers which came out on the leprous tuberculoid patches. About 6 months after the appearance of ulcers, they were cured.The literatures on the lazarine leprosy were reviewed in this paper. This case is similar to neither Mexican type of lazarine leprosy nor Cuban type, and similar to the cases reported by Ryrie, and Ota and Sato.The term "lazarine leprosy" should not be used hereafter, because many confusions arose concerning the interpretation of "lazarine leprosy". The terms "Lucio's leprosy" and "Pacha's leprosy" should be used. The former means the spotted leprosy with ulcers in diffuse lepromatous case reported first by Lucio, and the latter expresses the monosymptomatic case having destructive ulcer reported first by Pacha.

295 lepromatous and 74 tuberculoid leprosy patients were typed for HLA-A, -B and -C and compared to 110 healthy controls. It was found that frequency of HLA-B7 was significantly high and that of Bw54 was significantly low in lepromatous leprosy. HLA-DR and MT types were investigated in 84 lepromatous and 28 tuberculoid patients and compared to 55 controls. Both lepromatous and tuberculoid patients showed a marked increase in DR2 frequency. The relative risk is 8.7 and 5.9. Lepromatous leprosy showed an increase in frequency of MT1 and decreases in those of DRw9 and MT3 too.

The disaccharide, 2,3-di-O-methyl-4-O-(3,6-di-O-methyl-β-d-glucopyranosyl)-l-rhamno-pyranose, the distal segment of phenolic glycolipid I, that is a specific antigen from Mycobacterium leprae, and some related disaccharides were synthesised as the glycosides of methyl 3-(p-hydroxyphenyl)propionate. The methyl 3-(p-hydroxyphenyl)propionate was coupled with 2,3,4-tri-O-acetyl-l-rhamnosyl bromide, deacetylated, acetonated, coupled with 2,4,6-tri-O-acetyl-3-O-methyl-d-glucosyl bromide, and converted into a variety of p-(2-methoxycarbonylethyl)phenyl 4-O-(3,6-di-O-methyl-d-glucopyranosyl)-containing disaccharides that are amenable to ready conjugation with protein carriers, thereby providing neo-glycoconjugates for the specific serodiagnosis of leprosy.

A constitutive saturated and monounsaturated fatty acid pattern of Mycobacterium leprae, isolated from the liver of a nine-banded armadillo with experimental leprosy, was analyzed gaschromatographically and compared with that of cultured M. lepraemurium, M. avium, M. bovis, strain BCG and M. smegmatis. In comparing the fatty acid pattern thus obtained and the known structure of mycolic acids in these mycobacteria, an experiential rule that each species of mycobacteria has a relatively high content of normal (straight-chained) saturated fatty acid having two more carbons than those of the alpha-branch in this species' mycolic acids, coincided well for all mycobacteria tested. In particular, M. leprae was found to contain a relatively high content of behenic acid (n-C22:0) and the carbon-number of the alpha-branch in this species' mycolic acids is 20 as we previously reported. These data suggested the possibility of simple detection of M. leprae by gaschromatography, and results sustaining this possibility were obtained.