Prednisolone의 경구투여가 결핵반응에 미치는 영향에 관한 실험적 연구

Abstract

[한글]

[영문]

Stoerk(1950) reported that the administration of cortisone or ACTH to guinea

pigs, vaccinated with BCG, will attenuate or block the tuberculin reaction. Derbes

et al(1950) and Cummings et al(1952) confirmed this.

Tuberculin skin reaction is the prototype of delayed hypersensitivity and contact

dermatitis, homograft rejection phenomena and autoimmune disease are a kind of

delayed type of hypersensitivity.

The present studies are undertaken in an attempt to identify the mechanism of

effects of prednisolone on tuberculin reaction.

Material and Method

Forty-five albino guinea pigs, each weighting 400 to 600 gm, were injected with

1cc(20mg/cc) of BCG intraperitoneally. After 3 weeks, a PPD skin test was done and

the animals which showed a positive reaction were for the experiment and divided

into the following three groups:

1) Control group 2) Predisolone treated group was subdivided into those having

doses of 1mg/kg and 4mg/kg.

Before administration of prednisolone, WBC, WBC differential count and antibody

titer to tuberculosis were checked and compared with the results after

administration of the drug. The prednisolone was administered per oral route,

daily, for 8 weeks. PPD skin test was done once every week and the size of

induration was read 48 hours after the test done.

When the tuberculin reaction was markedly suppressed with prednisolone, passive

transfer of tuberculin hypersensitivity with viable leukocytes was tried and a

histological examination was done with routine hematoxylin-Eosin staining

technique.

Result and Discussion

The Decreased tuberculin skin reaction occurred 1 week after administration and

the marked inhibition of tuberculin skin reaction occurred 5 weeks after

administration.

The group treated with prednisolone, dosage of 4mg/kg, was much more inhibited

than the group having doses of 1mg/kg for 4 weeks. From 5 weeks after

administration of prednisolone, there was no difference between the 2 groups.

The recovery from tuberculin skin reaction occurred within 48 hours after

discontinuing the administration of prednisolone.

When the tuberculin skin reaction was markedly suppressed, antibodies to

tuberculosis were not decreased accordingly and the leukocytes derived from the

guinea pigs could transfer immunity to normal guinea pigs, even though with

depressed skin reaction.

Lymphopenia and eosinopenia occurred after the prednisolone administration and

histologic examination of the skin tested showed a marked decrease of lymphocytes

in the area.

Regarding the mechanism of action on the tuberculin reaction, Germuth et al(1952)

stated that the same mechanism was involved in the suppression of nonspecific

inflammatory reactions. Leathy & Morgan(1952) reported that cytotoxic action of PPD

was inhibited by pretreatment of prednisolone. Wasserman(1967) also reported

prednisolone inhibited the synthosis of DNA and RNA, and suppressed the mitosis of

lymphocytes occurring after contact with antigen.

The mechanism of prednisolone in inhibiting tuberculin reaction is still unknown

and requires further study.