{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T05:58:47Z","timestamp":1779256727166,"version":"3.51.4"},"reference-count":0,"publisher":"Rockefeller University Press","issue":"5","content-domain":{"domain":["rupress.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1989,5,1]]},"abstract":"<jats:p>Analysis of tissue lesions of the major reactional states of leprosy was undertaken to study the immune mechanisms underlying regulation of cell-mediated immunity and delayed-type hypersensitivity (DTH) in man. In situ hybridization hybridization of reversal reaction biopsy specimens for INF-gamma mRNA expression revealed a 10-fold increase in specific mRNA-containing cells over that observed in unresponsive lepromatous patients. Expression of huHF serine esterase, a marker for T cytotoxic cells, were fourfold increased in reversal reaction and tuberculoid lesions above that detected in unresponsive lepromatous individuals. Immunohistology of reversal reactions confirmed a selective increase of Th and T cytotoxic cells in the cellular immune response. Of interest, the microanatomic location of these serine esterase mRNA-containing cells was identical to the distribution of CD4+ cells. Analysis of erythema nodosum leprosum (ENL) lesions revealed differences in the underlying immune processes in comparison with reversal reaction lesions. Although phenotypic Th cells predominated in ENL lesions, IFN-gamma and serine esterase gene expression were markedly reduced. We suggest that reversal reactions represent a hyperimmune DTH response characterized by a selective increase of CD4+ IFN-gamma producing cells and T cytotoxic cells, which result in the clearing of bacilli and concomitant tissue damage. In contrast, ENL reactions may be viewed as a transient diminution of Ts cells and activity leading to a partial and transient augmentation in cell-mediated immunity, perhaps sufficient to result in antibody and immune complex formation, but insufficient to clear bacilli from lesions.<\/jats:p>","DOI":"10.1084\/jem.169.5.1565","type":"journal-article","created":{"date-parts":[[2004,6,24]],"date-time":"2004-06-24T07:56:10Z","timestamp":1088063770000},"page":"1565-1581","update-policy":"https:\/\/doi.org\/10.1084\/jem.crossmarkpolicy","source":"Crossref","is-referenced-by-count":70,"title":["Analysis of naturally occurring delayed-type hypersensitivity reactions in leprosy by in situ hybridization."],"prefix":"10.1084","volume":"169","author":[{"given":"C L","family":"Cooper","sequence":"first","affiliation":[{"name":"Department of Pathology, University of Southern California, School of Medicine, Los Angeles 90033."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Southern California, School of Medicine, Los Angeles 90033."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T A","family":"Sinchaisri","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Southern California, School of Medicine, Los Angeles 90033."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Pirmez","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Southern California, School of Medicine, Los Angeles 90033."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Southern California, School of Medicine, Los Angeles 90033."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Southern California, School of Medicine, Los Angeles 90033."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S M","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Southern California, School of Medicine, Los Angeles 90033."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I L","family":"Weissman","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Southern California, School of Medicine, Los Angeles 90033."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B R","family":"Bloom","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Southern California, School of Medicine, Los Angeles 90033."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T H","family":"Rea","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Southern California, School of Medicine, Los Angeles 90033."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"291","published-online":{"date-parts":[[1989,5,1]]},"container-title":["The Journal of experimental medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/rupress.org\/jem\/article-pdf\/169\/5\/1565\/1669789\/1565.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/rupress.org\/jem\/article-pdf\/169\/5\/1565\/1669789\/1565.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,25]],"date-time":"2023-07-25T01:32:00Z","timestamp":1690248720000},"score":1,"resource":{"primary":{"URL":"https:\/\/rupress.org\/jem\/article\/169\/5\/1565\/57316\/Analysis-of-naturally-occurring-delayed-type"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1989,5,1]]},"references-count":0,"journal-issue":{"issue":"5","published-print":{"date-parts":[[1989,5,1]]}},"URL":"https:\/\/doi.org\/10.1084\/jem.169.5.1565","relation":{},"ISSN":["0022-1007","1540-9538"],"issn-type":[{"value":"0022-1007","type":"print"},{"value":"1540-9538","type":"electronic"}],"subject":[],"published":{"date-parts":[[1989,5,1]]}}}