The Leprous Neuritis of The Lower Limbs:histopathological findings and its possible mechanism
スポンサーリンク
概要
- 論文の詳細を見る
Peripheral nerves of the lower limbs from the autopsied cases with so-called arrested leprosy (19 lepromatous leprosy and 16 tuberculoid one) were examined histopathologically. The results were as follows ;1. In the lepromatous type, the pattern and degree of the damage of nerve trunks, the reduction of myelinated fibers and the frequency of M. leprae were almost same in all the cases. The sural and peroneal nerves were more damaged than the posterior tibial and sciatic nerves. And in the same nerve trunk, the more distally the more heavily damaged.2. Active demyelinations with M. leprae between myelin lamellae, without foreign cells around Schwann cells were frequently observed in proximal sites in lepromatouscases. Teased fibers showed that it proceeded centripetally and was not the type of segmental demyelination. Many reserved naked large axons were also found without remyelination.3. Though the pattern and distribution of the nerve damages of the tuberculoid type were basically the same as those of the lepromatous type, their degrees were different between each cases. M, leprae/foamy cells were not observed.4. The densities of myelinated fibers were remarkably different between nerve fasci-cles and even in the same fascicles. They were thought to be due to the results of the leprous reactions and demyelinations. In addition, the finding resembled to Renaut's body was discussed.The possible mechanism of leprous neuritis was briefly discussed. In lepromatous leprosy, M. leprae mainly enter the nerve trunks through distally running dermal nerves and primarily demyelinate sensory fibers centripetally during patients' lives. Leprous reactions secondarily involve motor nerves together. During repetitive reactions at different levels, distal nerve trunks are more damaged under the anatomical rules of peripheral nerves. The proximal nerve damages in tuberculoid leprosy, without M. leprae are thought to be due to the active old day's leprous reactions, of which target M. leprae, had invaded there not via blood stream, but through dermal nerves originating directly from proximal nerves.As far as to the nerves in lower legs, the most possible portal of entry seems to be the areas of the course of sural and peroneal nerves. And the transmission of "the soils to man" seems to be more reasonable than that of "man to man ". The author recommend that the trial of taking shoes in the endemic areas, might be worth for preventing leprosy.
- 日本ハンセン病学会の論文
日本ハンセン病学会 | 論文
- NOによる細胞内感染防御の新しい展開
- ハンセン病多発国における神経障害の頻度と治療効果についてミャンマーにおける共同研究の結果から
- ハンセン病には不確定なことが多い
- ハンセン病とPCR
- ミャンマー、セガイン州カリイにおけるハンセン病のコントロール・プログラム