EXPERIMENTAL LEPROSY & VACCINE STUDIES IN MONKEYS

我们继续对3组接种的卡介苗进行临床监测 卡介苗+2剂热致死麻风杆菌(HKML)]和一组 未接种(对照)恒河猴(RM)和煤烟黑尾猴 (SMM)确定接种疫苗/活疫苗的长期临床后果 麻风杆菌挑战赛。每组10个RM和7个SMM。这个 临床结果如下：1)单独接种卡介苗 70%保护RM；2)卡介苗+低剂量(LD)或高剂量(HD)HKML 保护红斑狼疮85%；3)接种卡介苗显著减缓了发病率 而麻风的进展程度在SMM，但未能显著 减少长期出现临床症状的动物总数 长期(仅靠卡介苗的长期保护很可能是 如果SMM/组的数量较多，则意义重大)；以及4) 卡介苗+LD或HD HKML疫苗接种加剧麻风易感性 SMM。因为我们已经观察到Rm趋向(约.80%)来开发 少杆菌(PB)型麻风和SMM的发展(约 80%)多菌(MB)，数据提示卡介苗+HKML 保护易患风湿病的动物 PB形式的麻风，但会加剧患有麻风病的动物的易感性 麻风病的先天遗传易感性。卡介苗似乎 PB端的保护非常有效，而MB端的保护效果较差 光谱。越南的一份报告与我们在#年的观察一致。 BCG+HKML仅在具有以下条件的地区提供保护 易患铅中毒的人比例很高。因为它不是很容易 预测哪些人易患PB与MB形式的 麻风，建议不要使用卡介苗+HKML治疗 为人类接种疫苗。另一方面，仅凭卡介苗一家似乎 对所有麻风类型都安全有效，尤其是 因此，在光谱的PB端。这些观察有助于解释 卡介苗保护率的极端变异性(从20%到80%) 在不同人群中接种麻风病疫苗( 不同比例的PB：MB麻风病)。我们的卡介苗结果 与这些关于人类的野外试验的报告是一致的 人口。

We continued to clinically monitor 3 groups of vaccinated [BCG or BCG + 2 doses of heat-killed M. leprae (HKML)] and one group of unvaccinated (control) rhesus monkeys (RM) and sooty mangabey monkeys (SMM) to determine long term clinical consequences of vaccination/live M. leprae challenge. There were 10 RM and 7 SMM per group. The clinical results were as follows 1) vaccination with BCG alone protected RM by 70%; 2) BCG + low dose (LD) or high dose (HD) HKML protected RM by 85%; 3) BCG vaccination significantly slowed the rate and the degree of leprosy progress in SMM, but failed to significantly diminish the total number of animals developing clinical symptoms long term (long-term protection by BCG alone would have probably been significant if there had been a larger number of SMM/group); and 4) BCG + LD or HD HKML vaccination exacerbated leprosy susceptibility in SMM. Since we have observed that RM tend (approx. 80%) to develop paucibacillary (PB) forms of leprosy and SMM develop (approx. 80%)multibacillary (MB) forms, the data suggest that BCG + HKML protect animals that have a predisposition towards susceptibility to PB forms of leprosy, but exacerbate susceptibility of animals with an innate predisposition towards MB forms of leprosy. BCG appears to protect very effectively at the PB end and less so at the MB end of the spectrum. A report from Vietnam agrees with our observations in that BCG + HKML only offered protection in geographic areas which had high percentages of PB-prone humans. Since it cannot be readily predicted which individuals are susceptible to PB vs. MB forms of leprosy, it is recommended that BCG + HKML not be utilized for vaccination of humans. BCG alone, on the other hand appears to be safe and effective over the entire range of leprosy types, especially so at the PB end of the spectrum. These observations help to explain the extreme variability (from 20-80%) in the protective rates of BCG vaccination against leprosy among various human populations (which vary in the proportions of PB:MB forms of leprosy). Our BCG results are in agreement with these reports of field trials among human populations.