Aktuelle Aspekte der Lepra-Therapie

Zusammenfassung

Die medikamentöse Therapie der Lepra hat in den letzten Jahrzehnten erhebliche Fortschritte gemacht. Vor dem Hintergrund der weltweiten Bemühungen um die Elimination der Erkrankung werden historische, gegenwärtige sowie neue und experimentelle Therapiestrategien erörtert und kritisch gewürdigt. Bedingungen für den künftigen Einsatz therapeutischer Regime sowie wesentliche Herausforderungen im Hinblick auf die medikamentöse Therapie der Lepra werden aufgezeigt.

Abstract

Drug therapy of leprosy has made great advances in the past decades. Regarding the worldwide efforts towards the elimination of the disease, historical, current and new, as well as experimental therapeutic strategies, are discussed and critically assessed. Conditions for the future application of therapeutic regimens, and essential challenges concerning the drug therapy of leprosy are elaborated.

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1 Exazerbationen des ansonsten hoch chronischen Krankheitsverlaufes der Lepra werden als Reaktionen bezeichnet. Man unterscheidet die Typ I-Reaktion, welche durch einen - oftmals therapieinduzierten - Anstieg der zellvermittelten Immunität verursacht wird, von der Typ II-Reaktion (Erythema nodosum leprosum [ENL]), die man als ein durch Präzipitation von Ag/Ak-Komplexen verursachtes Immunkomplex-Syndrom auffasst. Typ I-Reaktionen kommen bei BT, BB- und BL-, selten auch bei TT-Fällen vor, Typ II-Reaktionen sind in aller Regel auf LL-, gelegentlich auch BL-Fälle beschränkt.