Leprosy Mailing List – April 30th, 2012
Ref.: In my opinion those
hypothetic concepts of upgrading and downgrading reaction only confuse
From: P AM Schreuder, Maastricht,
The Netherlands
Dear Salvatore,
I have problems with the
explanation of Prof. Bryceson [LML April 26th, 2012]:
<<
"Add more lymphocytes (as in upgrading) and the reaction, as measured
by titrated thymidine incorporation, increases. Add more antigen (as
in downgrading) and the reaction increases." >>
What we, however, see is
that most reactions happens the first six months after starting with MDT.
You would expect an enormous increase in antigen, while at the same time
the patient has a so-called "upgrading" reaction. In my opinion
those hypothetic concepts of upgrading and downgrading reaction only confuse.
Kind regards,
Pieter AM Schreuder
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