Influence of hydrocortisone, cortisone and ACTH on the lepromin reaction.

Harris and Harris ( 8) studied the influence of general treatment with cortisone and ACTH on the tuberculin reaction in guinea-pigs and rabpits. They found that these hormones inhibit the local and general reactions to tuberculin but do not prevent the Arthus phenomenon. As soon as the treatment was stopped, the hypersensitivity reappeared within 4 days. Derbes and collaborators (4) found that cortisone and ACTH administered in large doses to guinea-pigs infected with virulent tubercle bacilli diminished but did not inhibit the skin reactions to tuberculin. The modifications of the histopathological changes consisted of a quantitative diminution of the inflammatory exudate, with no major modifications of the cytological structure. Sheldon and collaborators (12) found, in guinea-pigs with progressive tuberculosis submitted to treatment with cortisone and ACTH for 6 days, that the cutaneous reaction to tuberculin did not disappear, although it was less marked than in the control animals. Osgood and Favour (10) investigated the effect of the adrenocorticotropic hormone on the tuberculin reaction and the inflammatory reaction induced by turpentine. They found that the treatment inhibited the tuberculin hypersensitivity reactions in guineapigs sensitized with heat-killed tubercle bacilli, and also stopped the inflammation but not the necrosis provoked by oil of turpentine. Long and Favour ( 9) observed modifications of the reactions to tuberculin (PPD) and to the hemolytic streptococcus in a group of 34 patients ,given cortisone and ACTH treatment. These modifications depended upon the degree of sensitivity of the patients, the dosage of the hormone, and the duration of the treatment. With respect to the tuberculin reaction, it was found that there was a marked inhibitory effect on the necrosis, somewhat less effect on the infiltration, and least on the erythema. The treatment also acted on the general phenomena that usually accompany the reaction, but on the other hand it did not alter the reaction to histamin. Goldman and collaborators (7) hold that the tuberculin type of inflammation can be inhibited to a certain extent by means of local injection of Compound F.