FUNDAMENTOS: A hanseníase, causada pelo Mycobacterium leprae, manifesta-se por forma clínica denominada paucibacilar, benigna, Mitsuda-positiva, imunocompetente, e por outra forma, denominada multibacilar, grave, Mitsuda-negativa, imunodeficiente. Doentes multibacilares, eliminadores de bacilos, são considerados os mantenedores da endemia hansênica. OBJETIVOS: Os autores testaram cultura de micobactérias, obtida em laboratório, em pacientes Mitsuda-negativos, em busca de possível viragem imunológica. MÉTODOS:Com a cultura de micobactérias, foi preparado antígeno mitsudina-símile, que foi testado em 28 hansenianos Mitsuda-negativos, os quais, após avaliação desse teste, foram submetidos a novo teste de Mitsuda. Outros 28 Mitsuda-negativos receberam a inoculação de placebo e, posteriormente, foram avaliados por meio de novo teste de Mitsuda. RESULTADOS: Nos pacientes inoculados com a mitsudina experimental houve respostas favoráveis: em 25 deles reações macroscópicas positivas, em quatro das quais, com granuloma tuberculóide. Avaliados por meio de novo teste de Mitsuda, quatro deles responderam com típicas reações Mitsuda-positivas, com granuloma tuberculóide. Nos pacientes testados com placebo, as respostas foram negativas; a um novo teste de Mitsuda, houve uma resposta positiva. CONCLUSÕES: Em hansenianos Mitsuda-negativos, testados com mitsudina experimental, foram constatadas 14,29% de respostas favoráveis, com reações de Mitsuda-símiles provocadas por essa mitsudina; testados os pacientes, novamente, com o antígeno de Mitsuda, foram constatadas 14,81% de respostas favoráveis, com reações positivas.

BACKGROUND: Leprosy, a disease caused by Mycobacterium leprae, manifests itself into two clinical forms: the paucibacillary form is benign, Mitsuda positive and immunocompetent; the multibacillary form is severe, Mitsuda negative and immunodeficient. Multibacillary affected individuals, who release bacilli, are postulated to maintain endemic leprosy. OBJECTIVES: The authors used cultivated mycobacteria to test Mitsuda negative patients, with the objective to induce immune conversion. METHODS:A Mitsuda-like antigen was prepared from cultivated mycobacteria and tested in 28 Mitsuda negative leprosy patients. All patients were evaluated and then submitted to a new Mitsuda test. A control group of 28 Mitsuda negative leprosy individuals were inoculated with placebo and later evaluated by a second Mitsuda test. RESULTS: Patients inoculated with the experimental Mitsuda antigen had favorable responses: 25 presented positive macroscopic reactions and four were tuberculoid granuloma. When submitted to a second Mitsuda test, four individuals presented typical positive Mitsuda reactions, with tuberculoid granuloma. Among the control group inoculated with placebo, the responses were negative, and there was one positive response observed for the second Mitsuda test. CONCLUSIONS: In Mitsuda negative leprosy patients tested with an experimental Mitsuda antigen, we observed 14.29% of favorable responses, with Mitsuda-like reactions induced by the experimental Mitsuda antigen. When tested again with the Mitsuda antigen, we observed 14.81% of favorable responses with positive reactions.

Em 20 portadores de Lepra, internados na Colônia de São Roque, Paraná, 13 dos quais eram da forma lepromatosa e os 7 restantes da forma nervosa pura ou tuberculoide, o autor estudou a reação intradérmica de antigenos bacilares (Leprolinas Souza-Araujo 1, 1a, 3, 5, 5a), comparativamente com as reações produzidas, ao mesmo tempo, com antígeno lepromatoso (Emulsão de lepromas, lepromina). Observou o seguinte: 1.° - Que a lepromina, comportou-se como habitualmente, isto é, negativa nos lepromatosos e ositiva nos nervosos e tuberculoides e sempre mais intensa ao fim da quarta semana. 2.° - Que as leprolinas provocam reações, que o autor não conclui serem positivas ou negativas no sentido imunológico da expressão em virtude de estar estudando-as neste sentido, nos leprotomatosos e tuberculoides, mas, sempre mais intensas entre a 1.ª e 2.ª semanas, diminuindo de intensidade na 3.ª e desaparecendo ou quase desaparecendo ao fim da quarta semana: nódulos, nódulos-eritema, ulcerações. 3.° - Que nestas reações houve destruição de tecidos, pois a presença tardia de cicatrizes, mesmo quando não houve ulceração, mostra êste fato. 4.° - Que as inoculações das lepromina, não trouxeram nenhum inconveniente a saúde dos paciente; embora um deles tenha apresentado nos primeiros dias leve reação geral; outro, intensa fusão de suas lesões nodulars de lepra e, dois outros, a chamada Reação leprótica.

The Author has studied the intradermal reaction on 20 cases of leprosy (13 L and 7 N) by antigens from cultures of acid-fast bacilli, obtained by SOUZA-ARAUJO in the Instituto Oswaldo Cruz ("SOUZA-ARAUJO's leprolins 1, 1a, 3, 5, 5a") and by the lepromin. The experiments were carried out in the "Hospital Colonial São Roque", at the State of Paraná, Brazil. He has observed: 1. That lepromin has produced the same classical results: positive in the nervous cases and negative in lepromatous ones. 2. That SOUZA-ARAUJO's leprolins" and lepromin, were done at th same time, without great malaise to the patients. In two lepers have developped the lepra reaction during the experiments; oe, a little fever, another with fusion of the lepromatous lesions in his skin.

The AA. carried out experiments in the leprosarium São Roque, State of Paraná, South Brazil, to verify if the cattle tick Boophilus microplus could be experimentally infected in lepers, which was true. The AA. Tried also to be ascertained if Boophilus microplus and Amblyomma cajennense could change of hosts during their feedings which was true, both ticks continue feeding, the last species for many days, after being transferred from one to another leper. The junior A. describes in full their experiments and also a dermatites caused by tick bites. The senior A. brought to Rio de Janeiro most of the infected ticks for examination, which revealed a very high positivity. He smeared the sediments of lots of both species of ticks in Loewenstein medium and after a variable periode of incubation at 37° C. he obtained four new samples of cultures of acid-fast organisms, two from Amblyomma cajennense and two from Boophilus microplus. These cultures are being studied and will be inoculated into laboratory animals. The senior A. inoculated new batches of white rats with sediments of many ticks infected in lepers. Various hypotheses of both previous notes upon the subject now are verified facts. The A. is accumulating facts to draw the conclusions in the future. He also suggested the leprosy workers in the interior of the country to cooperate with him in such important studies, specially in the habitat of lepers in the rural zones of various States.