AÇÃO DO PROMIN SôBRE O MYCOBACTERJUM DE STEFANSKY. ESTUDOS MORFOLÓGICOS

Abstract

This work has heen executed with the primary intention of not1cmg, in strict parallelism to facts also observed in other Micobacteria. alterations which are produced in Mycobacterium Stcfanskyi by the use of the new anti-leprotic drugs and draw conclusions regarding the treatment rhythm. Mycobacterium Stefanskyi, as many othcr pathologenic Mycobacteria, has a vast cyclogeny, it being possible that certain forms of thc microorganism are more susceptible to drugs than others, and that necessity of prolonging the treatment for such a long time be also due to the existence of resisting forms. As already known, sulfas react only on newly-formed germs. Perhaps sulfonas have a similar reaction. Experiments were performed on three groups o f rats: the first acted as control; the second was treated with Promin and the third was given Promin and a series of injections of a carotenoid suspension intercalated, which had the effect of rendering acido-resistant bacilli active in t'itro and in vivo.Some of the animais died before the expected time. The majority however 11ere killed 6 months after treatment and observation.The results obtained were as follows:1) In the group o f control, excepting 2 cases, formation o f lepromata was seen, with no tendency to ulcerate. Bacilli were mostly smooth, short or granulous. 2) In those rats, treated with Promin. ali cases presented lepromata, hut most. frankly receeding. There was in the beginning of the treatment. some excitation of germ and lesions. Then a relative silence predominated. Bacilloscopy did not yield the same results as found in the control group:there predominated long bacilli; we found also some granulous bacilli. Jragmented and even globi. The interesting fact to observe is that we have an morphology. which is called "resistance forms" by the bacteriologists. The bacillus, stained by the Ziehl-Neelsen prescnts one or two dark granulations.3) ln the third group ( rats treated with Promin and carotenoids) lepromata were frankly receeding and in two cases, were completely absent. Bacillosco py: Homogenous, long bacilli, bacilli with dark granulations and bacilli of the type of final tuberculoid reaction, well described by J. M. M. Fernandez.In those cases, where lepromata were not found, there were acido-resistant corpusclPs, lesser in size than a red cell.These corpuscles have been described by Hoffmann, Souza Araujo, and the author himself, who, using Lleras Acosta's technique has found them, in some cases of tuberculoid leprosy. Presence of resistance forros in the germs, explains for the time of treatment required and explains also Faget's idea - to whom belongs the longest experience in leprous promintherapy - of establishing periods of rest' and a certain rhythmicity in treatment, thus allowing a chance of evolution to the resistanc·e forros. Maybe such was not Faget's original intention but his clinicai ohservation showed that the patients benefitted a good deal more, when allowed to enjoy some days of rest, during the treatrnent. Having in mind the necessity of promoting Lhe acceleration of cyclogenic phases of the germ, we decided to intercalate, in the treatment with Promin, series of injections of a carotenoid solution.CONCLUSIONS: 1 - Administration of Promin to rats, inoculated with M. Stefanskyi modifies the morphology of the germ, yielding long forros and also many bacilli with one or two dark granulations (Ziehl-Neelsen) considered to be resistance forros. 2 - One may infer that Promin IS more active in the "young" stage of the bacillus. 3 - The presence of dark granulations or resistance forros, justifies the long duration of thc treatment and also periods of rest, which allow the granulations to mature. 4 - With lhe intercalations of carotenoid injections, which have amongst others, the effect of forcing thc evolution of the germ, we obtained more degraded forros of germs, as the onc which is seen in the final stage of tuberculoid reaction and acido-resistant corpuscles. 5 - The manifestations of clinicai improvement were more accentuated the latter group of animal experiments.