Dharmendra antigen

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The Dharmendra antigen is a test widely used in India. The antigen is a suspension of de-fatted leprosy bacilli which has been extracted with chloroform-ether and killed, either by heat, or by other effective methods. This antigen was first reported by Dharmendra in 1941–42 and later standardized in 1979 by Sangupta et al. [1]

Antigen molecule capable of inducing an immune response (to produce an antibody) in the host organism

In immunology, antigens (Ag) are structures specifically bound by antibodies (Ab) or a cell surface version of Ab ~ B cell antigen receptor (BCR). The terms antigen originally described a structural molecule that binds specifically to an antibody only in the form of native antigen. It was expanded later to refer to any molecule or a linear molecular fragment after processing the native antigen that can be recognized by T-cell receptor (TCR). BCR and TCR are both highly variable antigen receptors diversified by somatic V(D)J recombination. Both T cells and B cells are cellular components of adaptive immunity. The Ag abbreviation stands for an antibody generator.

Leprosy chronic infection caused by the bacteria Mycobacterium lepræ and Mycobacterium lepromatosis

Leprosy, also known as Hansen's disease (HD), is a long-term infection by the bacteria Mycobacterium leprae or Mycobacterium lepromatosis. Initially, a person who is infected does not have symptoms and typically remains this way for 5 to 20 years. Symptoms that develop include granulomas of the nerves, respiratory tract, skin, and eyes. This may result in a lack of ability to feel pain, which can lead to the loss of parts of extremities due to repeated injuries or infection due to unnoticed wounds. Weakness and poor eyesight may also be present.

Dharmendra's Lepromin suspension consists of 10 mg of the dried and de-fatted, bacillary powder, dissolved in 100 ml carbol saline solution. It is a revised form of the original Lepromin test developed in 1919 by Kensuke Mitsuda. The Dharmendra test allows to differentiate tuberculoid leprosy from lepromatous leprosy.

The lepromin skin test is used to determine what type of leprosy a person has. It involves the injection of a standardized extract of the inactivated "leprosy bacillus" under the skin. It is not recommended as a primary mode of diagnosis.

Kensuke Mitsuda Japanese leprologist

Kensuke Mitsuda was a Japanese leprologist and director of the Tama Zenshoen Sanatorium (1914–1931) and the National Sanatorium Nagashima Aiseien (1931–1957). He had been at the frontier of leprosy policy of Japan. He was given the Order of Cultural Merits (1951) and Damien-Dutton Award (1961). He has been the cause of admiration from one side, and the target of criticism from the other.

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Mokutaro Kinoshita Japanese writer and dermatologist

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The Fernandez reaction is a reaction that occurs to signal a positive result in the lepromin skin test for leprosy. The reaction occurs in the skin at the site of injection if the body possesses antibodies to the Dharmendra antigen, one of the antigens found in Mycobacterium leprae, the bacteria that causes leprosy. The reaction occurs via a delayed-type hypersensitivity mechanism. This reaction occurs within 48 hours of injection of lepromin and is seen in only tuberculoid forms of leprosy. In contrast, the Mitsuda reaction( delayed granulomatous lesion) occurs 3-4 weeks after injection of lepromin and is only seen in patients with the tuberculoid form of leprosy. In terms of mechanism of action and appearance, the reaction is similar to the tuberculin reaction of a positive Mantoux test for tuberculosis.

The mononuclear spot test or monospot test, a form of the heterophile antibody test, is a rapid test for infectious mononucleosis due to Epstein–Barr virus (EBV). It is an improvement on the Paul–Bunnell test. The test is specific for heterophile antibodies produced by the human immune system in response to EBV infection. Commercially available test kits are 70–92% sensitive and 96–100% specific, with a lower sensitivity in the first two weeks after clinical symptoms begin.

A leprostatic agent is a drug that interferes with proliferation of the bacterium that causes leprosy.

Fumio Hayashi was a Japanese physician and leprologist. He worked in Tama Zenshoen Sanatorium, Nagashima Aiseien Sanatorium, Hoshizuka Keiaien Sanatorium and Ooshima Seishoen Sanatorium. He helped with Kensuke Mitsuda, and completed the first lepromin test or Mitsuda skin test.

References

  1. Mohanty J, Mohanty H C. Lepromin response with dharmendra antigen in patients with leprosy. Indian J Dermatol Venereol Leprol [serial online] 1997 [cited 2016 Jun 20];63:385-7. Available from: http://www.ijdvl.com/text.asp?1997/63/6/385/4627