A preliminary investigation of the responsiveness or otherwise of patients and staff of a leprosy hospital to groups of shared or species specific antigens of mycobacteria

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Abstract
In an attempt to classify skin-test responsiveness of leprosy patients according to the groups of antigens, rather than the individual mycobacterial spp. to which they respond, patients and staff members at a leprosy hospital in Nepal were tested with Burulin (made from Mycobacterium ulcerans) and 3 specially mixed reagents. Ability to make a positive response to group I, common mycobacterial antigens, was almost absent to group II, antigens associated with slow growers, was markedly impaired in the patient groups. However, positive responses to group IV, species specific, antigens of slowly growing species were retained. Non-specific skin-test unresponsiveness due either to sequestration of the relevant cells outside the circulation or to circulating suppressor factors was present in 2 out of 27 staff members, 9 out of 24 TT[tuberculoid]/BT [borderline tuberculoid] patients and 10 out of 22 LL [lepromatous] patients. Evidence of a suppressor mechanism possibly triggered by group IV antigens of fast growers, and operative on positive responses to slow growers, was demonstrable in 3 out of 12 staff members, 8 out of 14 TT/BT patients, 7 out of 7 BL patients and 6 out of 12 LL patients. These observations may be related to susceptibility to the disease or may be consequences of it. However, the presence of the same or similar, suppressory phenomena among staff members argues against the latter.