Oxygen metabolism in phagocytes of leprotic patients: enhanced endogenous superoxide dismutase activity and hydroxyl radical generation by clofazimine

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Abstract
The generation of active oxygens (O2-, H2O2, and OH.) and the superoxide dismutase (SOD) activity of polymorphonuclear leukocytes (PMN) and monocytes from 14 leprotic patients manifesting a bacillary index > 2.2 was examined. Patients with disease of > 4 yr in duration showed significantly enhanced SOD activity and a decrease in O2- and OH. production. The antileprotic agent, clofazimine, significantly increased the generation of OH. in a dose-dependent manner, with a subsequent decrease in H2O2, but had no effect on the SOD activity of the PMN and monocytes. In medium containing FeSO4 or Fe2+-EDTA, the drug elevated OH. production markedly further. Phagocytic SOD in PMN and monocytes of leprotic patients was both host and bacillus derived, because the presence of cyanide, to which human-derived cuprozinc SOD is susceptible, did not completely abrogate SOD activity. The difficulty in treating leprosy may be partly ascribable to decreased phagocytic OH. generation, which in leprosy patients is apparently due to the uptake of Hansen bacillus-derived SOD. Clofazimine may be effective in leprosy by chelating Fe2+, with the resultant potentiation of the catalyzing activity of Fe2+ in the Haber-Weiss reaction increasing OH. formation from H2O2.