Leprosy Lepromatous cell

Cytokines, eg, interferons, interleukins, tumor necrosis factor (TNF), and certain growth factors, could have antitumor activity directiy, or may modulate cellular mechanisms of antitumor activity (2). Cytokines may be used to influence the proliferation and differentiation of T-ceUs, B-ceUs, macrophage—monocyte, myeloid, or other hematopoietic cells. Alternatively, the induction of interferon release may represent an important approach for synthetic—medicinal chemistry, to search for effective antiinflammatory and antifibrotic agents. Inducers of interferon release may also be useful for lepromatous leprosy and chronic granulomatous disease. The potential cytokine and cytokine-related therapeutic approaches to treatment of disease are summarized in Table 4. A combination of cytokines is a feasible modaUty for treatment of immunologically related diseases however, there are dangers inherent in such an approach, as shown by the induction of lethal disserninated intravascular coagulation in mice adrninistered TNF-a and IFN-y. 

The lepromatous form of leprosy is characterized by loss ofcutaneoussensibility. Hansen sbacillus(Mycobacterium leprae), which proliferates only in environments cooler than the core temperature maintained by most mammals, is capable of infecting Schwann cells in subcutaneous nerves because the basal lamina of these cells contains a-dystroglycan, to which this mycobacterium binds, and because subcutaneous nerves are often cooler than deeper tissues. Lepromatous neuropathy is a common cause of sensory mononeuropathy multiplex in the developing World [16,17]. 

One description of a clinical picture that results from tuberculoid leprosy is characterized by intact cell-mediated immunity, a positive lepromin skin reaction, granuloma formation, and a relative paucity of bacilli. At the other extreme, lepromatous leprosy is characterized by depressed cell-mediated immunity, numerous bacilli within the tissues, no granulomas, and a negative skin test for lepromin. Within these two extremes are the patients with an intermediate or borderline form of leprosy who show a variable lepromin reaction and few bacilli they may progress to either tuberculoid or lepromatous leprosy. 

Cellular immune response—The part of the immune system that destroys infected cells. Lepromatous leprosy—The most severe form of leprosy, characterized by numerous lesions and extensive nerve damage. 

Clarithromycin or azithromycin is recommended as first-line therapy for prophylaxis and treatment of disseminated infection caused by M. avium-intracellulare in AIDS patients and for treatment of pulmonary disease in non-HIV-infected patients. Azithromycin (1.2 g once weekly) or clarithromycin (500 mg twice daily) is recommended for primary prevention for AIDS patients with fewer than 50 CD cells per mm. Single-agent therapy should not be used for treatment of active disease or for secondary prevention in AIDS patients. Clarithromycin (500 mg twice daily) plus ethambutol (15 mg/kg once daily) with or without rifabutin is an effective combination regimen. Azithromycin (500 mg once daily) may be used instead of clarithromycin, but clarithromycin appears to be slightly more efficacious. Clarithromycin also has been used with minocychne for the treatment of Mycobacterium leprae in lepromatous leprosy. 

Flairy-cell and chronic lymphocytic leukemias non-Flodgkin s lymphoma chronic multiple sclerosis Pneumocystis carinii pneumonia associated with AIDS Lepromatous leprosy Treahng pain in cancer Hemophiha B Multiple sclerosis Hyahne membrane disease Mulhple sclerosis... 

In Vitro Production and Responsiveness. The production of IL-2 by peripheral blood mononuclear cells or lymphocytes in response to in vitro stimulation with mitogen or alloantigen was shown to be defective in patients with systemic lupus erythematosus,67-70 lepromatous leprosy,71 bone marrow transplantation,72 solid tumors, T cell immunodeficiency,7 76 rheumatoid arthritis.70 in some instances, a... 

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