Consequences of Smallpox Vaccination in Leprosy Patients

Abstract

This study illustrates the consequences of smallpox revaccination in 45 lepromatous, 28 tuberculoid, and 47 normal individuals. Results obtained with intradermal inoculations indicated that the patients with leprosy were associated with a relative anergy against the vaccinia virus, the anergy being minimal in the tuberculoid leprosy but marked in the cases with lepromatous leprosy. Major vaccinial reactions were observed more often in patients with lepromatous leprosy than in the controls or patients with tuberculoid leprosy. Furthermore in a patient with lepromatous leprosy, vaccinia necrosum also developed. The smallpox vaccination with live virus also appeared as a provocative factor for the precipitation of lepra reaction in the lepromatous leprosy cases. After 3 weeks of vaccination, the frequency of the specific humoral antibody response was the same in the tuberculoid patients and controls while it was higher in the cases with lepromatous leprosy. The prevaccination titer of total hemagglutination inhibition antibody was significantly higher in the lepromatous leprosy cases. However, the postvaccinial, humoral antibody response of the lepromatous patients was of the same magnitude as that observed in the normal individuals, and it was mainly due to a 2-mercaptoethanol-resistant antibody.

Breakdown Product of Factor B as an Index of Complement Activation in Lepromatous Leprosy and Its Relation with Bacillary Load

“…One obvious disadvantage of measuring the static profile of the complement components is that an increased rate of synthesis can mask hypercatabolism. Moreover, normal variation of the components, especially C3, is multifactorial [19], The normal levels of Clq, C3, C4, factor B and Ba have been established in this laboratory, and these data were compared with those in the lepromatous patients without or with ENL [4,15,18], More recently, direct quantitation of the breakdown products of C3 and properdin factor B have facilitated a dynamic estimation of the involvement of the complement system [2,5,9,12,13,19], Perrin et al [12,13] demonstrated elevated serum levels of C3d and Ba fragments in patients with systemic lupus erythematosus and membranoproliferative glomerulonephritis, Fn contrast, the serum levels of factor B and complemetit component C3 were near normal, suggesting the coexistence of increased synthesis of C3 and factor B and their hypercatabolism. Similar observations were made by Hunder et al during the study of complement cativation in synovial fluids [9].…”

Undernutrition and Immunity: Smallpox Vaccination in Chronically Starved, Undernourished Subjects and Its Immunologic Evaluation

“…The amounts used were 10 units of old tuberculin, 125 units of streptokinase-streptodornase (SK-SD), 50 /ig dinitrochlorobenzene, 2.5 million allogeneic blood lymphocytes, and 1 million heat-inactivated vaccinia virus particles. The methods have been described in detail elsewhere (13)(14)(15)(16)(17).…”

“…Normal controls and undernourished subjects were vaccinated by a multiple-puncture mtehod at two sites 2.5 cm apart on the left forearm with freeze-dried live vaccinia virus from the USSR (22). Each individual received a total of 4 X 10* plaque-forming units (PFU) (13,17) and was followed up for 3 weeks to observe the phasing of vaccinial lesions and any other complications. Time of vesiculation, pustulation, and maximum lesion and the size of maximum lesion were recorded.…”

“…One million heat-inactivated PFU in 0.1 ml buffered saline was injected intradermally 1 month after vaccination with live vaccine. Forty-eight hours later the size of induration was recorded, which was taken as a measure of specific cellular immunity to vaccinia virus (13,17). Inactivation of virus was done by heating the vaccine at 60°C for half an hour (21).…”

“…Infections precipitate acute nutri-been reported after smallpox vaccinations in tional disease in a chronically malnourished subjects with primary (10) and secondary impopulation. Conversely, malnutrition contrib-munologic deficiencies (17). Thus there is an utes to increased morbidity and mortality from increased risk of severe reactions from live infections, such as measles and tuberculosis.…”