02576nas a2200373   4500000000100000008004100001653001600042653000900058653002400067653001900091653002500110653001600135653000900151653000900160653002800169653001100197653001100208653002100219653002300240653002400263653001200287653001000299653001500309100001200324700001300336700001500349700001400364245008000378856005100458300001000509490000700519520166200526022001402188       2016                            d10aYoung Adult10aSkin10aRNA, Ribosomal, 16S10aRNA, Bacterial10aMycobacterium leprae10aMiddle Aged10aMice10aMale10aLeprosy, Multibacillary10aHumans10aFemale10aBiological Assay10aBacterial Proteins10aAntigens, Bacterial10aAnimals10aAdult10aAdolescent1 aSave MP1 aDighe AR1 aNatrajan M1 aShetty VP00aAssociation of viable Mycobacterium leprae with Type 1 reaction in leprosy.  uhttps://leprosyreview.org/article/87/1/07-8092  a78-920 v873 a<p><strong>UNLABELLED: </strong>The working hypothesis is that, viable Mycobacterium leprae (M. leprae) play a crucial role in the precipitation of Type 1 reaction (T1R) in leprosy.</p>

<p><strong>MATERIAL AND METHODS: </strong>A total of 165 new multibacillary patients were studied. To demonstrate presence of viable M. leprae in reactional lesion (T1R+), three tests were used concurrently viz. growth in the mouse foot pad (MFP), immunohistochemical detection of M. leprae secretory protein Ag85, and 16s rRNA--using in situ RT-PCR. Mirror biopsies and non reactional lesions served as controls (T1R-).</p>

<p><strong>FINDINGS: </strong>A significantly higher proportion of lesion biopsy homogenates obtained at onset, from T1R(+) cases have shown unequivocal growth in MFP, proving the presence of viable bacteria, as compared to T1R(-) (P &lt; 0.005). In contrast, few Mirror biopsies were positive in both T1R(+) and T1R(-). With respect to Ag85, while the overall positivity was higher in T1R(+) (74%), however the intensity of staining (Grade 2+) was disproportionately higher in T1R(+) BT-BB lesions 11/20 (55%). In the rebiopsies obtained during a repeat episode of T1R, Ag 85 as well as 16s rRNA, positivity (62% &amp; 100%) was higher in T1R(+). It is inferred therefore 'viable' bacteria are an essential component in T1R and difference in the quality of bacilli, not the quantity or the ratio of dead to viable play a role in the precipitation of T1R. In conclusion, the findings show that 'metabolically active' M. leprae is a component/prerequisite and the secretory protein Ag 85, might be the trigger for precipitation of T1R.</p>
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