Addition of <i>Mycobacterium indicus pranii</i>
 vaccine as an immunotherapeutic to standard chemotherapy in borderline leprosy: a double-blind study to assess clinical improvement (preliminary report)

Kamal, Raj; Pathak, Vinay Kumar; Kumari, Anjili; Natrajan, Mohan; Katoch, Kiran; Kar, Hemanta Kumar

doi:10.1111/bjd.14971

Cited by 19 publications

(11 citation statements)

References 5 publications

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“…A double blind phase III clinical trial conducted in the 1990s in which MIP was given to the household contacts of leprosy patients (involving about 30,000 people in an area which was endemic for both leprosy and TB) to prevent leprosy. However, the TB incidence was also found to be reduced significantly as compared with that of the placebo group after 13 years in retrospective analysis (19).…”

Section: Discussionmentioning

confidence: 99%

Mycobacterium indicus pranii Induced Memory T-Cells in Lung Airways Are Sentinels for Improved Protection Against M.tb Infection

et al. 2019

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The lungs are the most vulnerable site for air-borne infections. Immunologic compartmentalization of the lungs into airway lumen and interstitium has paved the way to determine the immune status of the site of pathogen entry, which is crucial for the outcome of any air-borne infections. Vaccination via the nasal route with Mycobacterium indicus pranii (MIP), a prospective candidate vaccine against tuberculosis (TB), has been reported to confer superior protection as compared to the subcutaneous (s.c.) route in small-animal models of TB. However, the immune mechanism remains only partly understood. Here, we showed that intranasal (i.n.) immunization of mice with MIP resulted in a significant recruitment of CD4+ and CD8+ T-cells expressing activation markers in the lung airway lumen. A strong memory T-cell response was observed in the lung airway lumen after i.n. MIP vaccination, compared with s.c. vaccination. The recruitment of these T-cells was regulated primarily by CXCR3–CXCL11 axis in “MIP i.n.” group. MIP-primed T-cells in the lung airway lumen effectively transferred protective immunity into naïve mice against Mycobacterium tuberculosis (M.tb) infection and helped reducing the pulmonary bacterial burden. These signatures of protective immune response were virtually absent or very low in unimmunized and subcutaneously immunized mice, respectively, before and after M.tb challenge. Our study provides mechanistic insights for MIP-elicited protective response against M.tb infection.

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Section: Discussionmentioning

confidence: 99%

Mycobacterium indicus pranii Induced Memory T-Cells in Lung Airways Are Sentinels for Improved Protection Against M.tb Infection

et al. 2019

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“…At the moment, besides BCG, two vaccines are considered potential candidates for leprosy prophylaxis: the Mw vaccine, developed in India, and LepVax, developed in the United States. [56][57][58][59][60] Because of the described positive protective efficacy of Mw, this cultivable, non-pathogenic mycobacterium was selected for further development. It has been sequenced and is now named Mycobacterium indicus pranii (MiP) to avoid confusion with M. tuberculosis-W. 61,62 MiP expedites bacterial clearance and shortens the recovery time in leprosy patients.…”

Section: Promising Vaccinesmentioning

confidence: 99%

<p>The State of Affairs in Post-Exposure Leprosy Prevention: A Descriptive Meta-Analysis on Immuno- and Chemo-Prophylaxis</p>

Schoenmakers

Mieras

Budiawan³

et al. 2020

RRTM

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Objective: Annually, over 200,000 people are diagnosed with leprosy, also called Hansen's disease. This number has been relatively stable over the past years. Progress has been made in the fields of chemoprophylaxis and immunoprophylaxis to prevent leprosy, with a primary focus on close contacts of patients. In this descriptive meta-analysis, we summarize the evidence and identify knowledge gaps regarding post-exposure prophylaxis against leprosy. Methods: A systematic literature search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was conducted by searching the medical scientific databases Cochrane, Embase, Pubmed/MEDLINE, Research Gate, Scopus and Web of Science on Jan. 22, 2020, using a combination of synonyms for index terms in four languages: "leprosy" and "population" or "contacts" and "prevention" or "prophylaxis." Subsequently, Infolep.org and Google Scholar were searched and the "snowball method" was used to retrieve other potentially relevant literature. The found articles were screened for eligibility using predetermined inclusion and exclusion criteria. Results: After deduplication, 1,515 articles were screened, and 125 articles were included in this descriptive meta-analysis. Immunoprophylaxis by bacillus Calmette-Guérin (BCG) vaccination is known to provide protection against leprosy. The protection it offers is higher in household contacts of leprosy patients compared with the general population and is seen to decline over time. Contact follow-up screening is important in the first period after BCG administration, as a substantial number of new leprosy patients presents three months postvaccination. Evidence for the benefit of re-vaccination is conflicting. The World Health Organization (WHO) included BCG in its Guidelines for the Diagnosis, Treatment and Prevention of Leprosy by stating that BCG at birth should be maintained in at least all leprosy high-burden regions. Literature shows that several vaccination interventions with other immunoprophylactic agents demonstrate similar or slightly less efficacy in leprosy risk reduction compared with BCG. However, most of these studies do not exclusively focus on post-exposure prophylaxis. Two vaccines are considered future candidates for leprosy prophylaxis: Mycobacterium indicus pranii (MiP) and LepVax. For chemoprophylaxis, trials were performed with dapsone/acedapsone, rifampicin, and ROM, a combination of rifampicin, ofloxacin, and minocycline. Single-dose rifampicin is favored as post-exposure prophylaxis, abbreviated as SDR-PEP. It demonstrated a protective effect of 57% in the first two years after administration to contacts of leprosy patients. It is inexpensive, and adverse events are rare. The risk of SDR-PEP inducing rifampicin resistance is considered negligible, but continuous monitoring in accordance with WHO policies should be encouraged. The integration of contact screening and SDR-PEP administration into different leprosy control programs was found to be feasible and well accep...

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“…The immunotherapeutic effect of MIP in patients affected with leprosy was also studied in a randomized double-blinded placebo-controlled trial conducted by Kamal, et al in 2017 (own study) shows faster bacillary clearance and clinical recovery [65]. Type 1 and 2 leprosy reactions occur early (initial 6 months) as compared with the control group due to immunomodulatory effects of the vaccine.…”

Section: Role Of Immunotherapy In the Treatment Of Leprosymentioning

confidence: 99%

Therapy of Leprosy- Present Strategies and Recent Trends with Immunotherapy

Divya¹,

Kc²,

Saxena³

2020

J Dermatol Res Ther

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Leprosy is a complex infectious diseases cause by Mycobacterium Leprae. As the nation is passing through the eradication phase of leprosy, reports are suggesting a change in epidemiology and symptomatology of the disease. Current therapeutic strategies like multidrug therapy (MDT) although effective in treating the majority of cases but not sufficient to eradicate still the new leprosy cases alone and with the complication of diseases like deformities, relapses, and recurrence of cases are occurring in the society. For eradication, there is a requirement of modification of current treatment strategies. The current management of patients affected with leprosy is insufficient to prevent nerve disabilities and control relapses, reactions, and recurrences. The need for newer anti-leprosy agents has been felt for a complete cure without complications and deformities. Various agents like fluoroquinolones (FQs), macrolides, and minocycline have also been tried in various combinations and duration. We reviewed the various issues related to treatment, drug resistance, and the possible steps of complete eradication of this stigmatized disease from the world. While alternative chemotherapy or supplemental immune therapies that would offer shorter or easier treatment regimens appear to be feasible, only a small number of trials are performed. More proactive strategies appear necessary in the drive for eradication. This article also reviews the addition of an immunotherapeutic strategy against leprosy.

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Addition of Mycobacterium indicus pranii vaccine as an immunotherapeutic to standard chemotherapy in borderline leprosy: a double-blind study to assess clinical improvement (preliminary report)

Abstract: Respond to this article

Cited by 19 publications

References 5 publications

Mycobacterium indicus pranii Induced Memory T-Cells in Lung Airways Are Sentinels for Improved Protection Against M.tb Infection

Mycobacterium indicus pranii Induced Memory T-Cells in Lung Airways Are Sentinels for Improved Protection Against M.tb Infection

<p>The State of Affairs in Post-Exposure Leprosy Prevention: A Descriptive Meta-Analysis on Immuno- and Chemo-Prophylaxis</p>

Therapy of Leprosy- Present Strategies and Recent Trends with Immunotherapy

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