Significance of lepromin test: a reappraisal
Desikan, K.V. (1980) Significance of lepromin test: a reappraisal. Indian Journal of Tuberculosis, 27 (2). pp. 73-80.
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The Lepromin test was first described by Mitsuda in 1919. The preparation of the antigen has since been modified by different workers and the test has been extensively applied for clinico-immunological assessments. Two types of antigens are in use—Mitsuda and Dharmendra lepromins which are described. Dhamendra lepromin is being studied in depth at the Central JALMA Institute for Leprosy, Agra, ll has been standardized carefully and the standard lepromin has been found to give consistent results. The response of the skin test in leprosy patients helps in determining the position of a case in the wide immunological spectrum of the disease. Observation on healthy contacts showed that lepromin positivity increased with age, most of the close contacts becoming positive to the test after 30 years of age. Lepromin positively is also associated with a higher immunity and better protection against leprosy particularly against development of lepromatous leprosy. A close correlation has been found between tuberculin and lepromin positivity indicating a cross immunity between the two disease. This has naturally resulted in efforts to produce immunity against leprosy by B.C.G. vaccination. The conversion of lepromin negativity to positivity by B.C.G. has led to extensive investigations to find out the protective value of B.C.G. Results have been equivocal as they have been found to be highly divergent in 3 large scale trials conducted in Uganda, New Guinea and Burma. While B.C.G. vaccination gave effective protection against leprosy in Uganda, the W.H.O. trials in Burma showed B.C.G. vaccination to be ineffective. It was therefore hypothesized that other factors might influence the protective efficacy of B.C.G. The data available on this work indicate that M. vacate and M. non-chromogeoicum stimulate the action of B.C.G. while M. mariamin has an opposite effect of depressing it.
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