らい性結節性紅斑の研究

Abstract

Latex agglutination tests were made on leprosy sera using cardiolipin, sphingo- myelin, nucleoprotein, human gamma-globulin and thyroglobulin as antigens res- pectively. The tests were made on 24 lepromatous cases with erythema nodosum leprosum (ENL), 46 lepromatous cases without clinical evidence of ENL and 12 tuberculoid cases. In the cases with ENL, there were marked positive agglutination reactions of high antibody titers. These serum antibodies in cases of ENL could be detected in 100 per cent against cardiolipin, in 75 per cent against sphingomyelin, in 54 per cent against thyroglobulin and in 42 per cent against human gamma-globulin. However the antibody against nucleoprotein was found only in 4 per cent. In lepro- matous leprosy cases without ENL, positive results were observed in 46 per cent against cardiolipin, in 35 per cent against sphingomyelin and in l l per cent against human gamma-globulin. The antibody titers were of lower levels in lepromatous leprosy cases without. ENL than in those with ENL. In tuberculoid leprosy cases, the antibody against cardiolipin was found only in 10 per cent, and the antibody against sphingomyelin was found in 30 per cent. The titers of these antibodies were very low. The nucleoprotein and thyroglobulin antibodies have never been found either in lepro- matous cases without ENL or in tuberculoid cases.Those antibodies in serum from lepromatous leprosy cases, especially from those with ENL were heat-labile. On heating at 63°C for 10 min. latex agglutination became non-visible. These antibodies were found to he sensitive to the treatment with mercaptoethanol as indicated by the complete loss of latex agglutinating activity. In addition, it was found that the circulating antibodies is present in a rM-immuno- globulin. Repeated examination revealed the gradual decline of the antibody titers in ENL cases which are at convalescent stage. From the results, it is suggested that the clinical occurrences of arthritis, arthralgia, vasculitis, peripheral neuritis and/or neuralgia in addition to the skin eruptions in ENL of at the later stage of lepromatous leprosy is due to the antigen-antibody reac- tions against cardiolipin, sphingomyelin, human gamma-globulin or nucleoprotein.