Immunology and the Therapeutics of Leprosy

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In infections caused by facultative or obligate intracellular microorganisms, anergy (loss of allergic response) is generally recognized as an ominous signal of the host's dwindling capacity to limit multiplication of the pathogen. This phenomenon is perhaps no better illustrated than in leprosy, still a serious problem worldwide for more than 12 million people. Anergy is observed most consistently in persons with lepromatous leprosy who typically are infected by an enormous number of bacilli, up to 1012. These persons consistently fail to manifest delayed-type hypersensitivity to intradermal challenge with antigens of Mycobacterium leprae. In addition, many of those with lepromatous disease

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