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(American Journal of Pathology. 1999;154:1793-1804.)
© 1999 American Society for Investigative Pathology

Regular Articles

Immunohistological Analysis of In Situ Expression of Mycobacterial Antigens in Skin Lesions of Leprosy Patients Across the Histopathological Spectrum

Association of Mycobacterial Lipoarabinomannan (LAM) and Mycobacterium leprae Phenolic Glycolipid-I (PGL-I) with Leprosy Reactions

Claudia Verhagen*{dagger}, William Faber*, Paul Klatser{ddagger}, Anita Buffing*{dagger}, Ben Naafs§ and Pranab Das*{dagger}

From the Departments of Dermatology*
and Pathology,{dagger}
Academic Medical Center, University of Amsterdam, and the Department of Biomedical Research,{ddagger}
Royal Tropical Institute, Amsterdam, and the Department of Dermatology,§
University Hospital Leiden, Leiden, The Netherlands

The presence of mycobacterial antigens in leprosy skin lesions was studied by immunohistological methods using monoclonal antibodies (MAbs) to Mycobacterium leprae-specific phenolic glycolipid I (PGL-I) and to cross-reactive mycobacterial antigens of 36 kd, 65 kd, and lipoarabinomannan (LAM). The staining patterns with MAb to 36 kd and 65 kd were heterogeneous and were also seen in the lesions of other skin diseases. The in situ staining of PGL-I and LAM was seen only in leprosy. Both antigens were abundantly present in infiltrating macrophages in the lesions of untreated multibacillary (MB) patients, whereas only PGL-I was occasionally seen in scattered macrophages in untreated paucibacillary lesions. During treatment, clearance of PGL-I from granulomas in MB lesions occurred before that of LAM, although the former persisted in scattered macrophages in some treated patients. This persistence of PGL-I in the lesions paralleled high serum anti-PGL-I antibody titers but was not indicative for the presence of viable bacilli in the lesions. Interestingly, we also observed a differential expression pattern of PGL-I and LAM in the lesions of MB patients with reactions during the course of the disease as compared with those without reactions. In conclusion, the in situ expression pattern of PGL-I and LAM in MB patients may assist in early diagnosis of reactions versus relapse.




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M. Mempel, B. Flageul, F. Suarez, C. Ronet, L. Dubertret, P. Kourilsky, G. Gachelin, and P. Musette
Comparison of the T Cell Patterns in Leprous and Cutaneous Sarcoid Granulomas : Presence of V{alpha}24-Invariant Natural Killer T Cells in T-Cell-Reactive Leprosy Together with a Highly Biased T Cell Receptor V{alpha} Repertoire
Am. J. Pathol., August 1, 2000; 157(2): 509 - 523.
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