Keywords
Diagnosis
Sorological tests
How to Cite
Abstract
Leprosy affects skin and peripheral nerves bringing several disabilities in absence of specific treatment. So that, effective diagnostic tools are required for early therapeutic interventions. Detection of antibodies against phenolic glycolipid I (PGL-I) is widely employed in the diagnosis and clinical classification while the leprosy IDRI diagnostic (LID-1) protein was designed to improve the diagnosis of paucibacillary patients. More recently, this synthetic antigen was conjugated with the natural octyl disaccharide (NDO) of PGL-I, originating the NDO-LID in order to increase its sensitivity. Here, we evaluate 16 studies, comparing the performance of these three antigens (PGL-I, LID-1 and NDO-LID) for leprosy diagnosis and evaluation of the household contacts. We verified among the different studies high variation regarding to population involved, sample size, clinical classification of patients and methodology used, making difficult the comparison. Among multibacillary patients, anti-PGL-I positivity ranged from 54.0 to 96.0%, while for LID-1 it was between 47.4 to 94.8% and for NDO-LID presented levels from 60 to 98.9%. In paucibacillary patients, responsiveness ranged from 6.4 to 52.9% when PGL-I was used, 4.0 to 60% against LID-1 and 16.0 to 63.6% if NDO-LID was employed. For household contacts, the response anti-PGL-I, LID-1 and NDO-LID was 13.2%, 21.7% and 22.9%, respectively. NDO-LID antigen showed higher sensitivity in most studies reflecting its potential as tool for leprosy diagnosis, mainly of MB patients, however, the recognition of this antigen by healthy household contact reinforces the value of the clinical evaluation to leprosy diagnosis.
References
World Health Organization. Global leprosy update, 2018: moving towards a leprosy free world. Wkly Epidemiol Rec [Internet]. 2019 [cited 2019 Sept 15];35/36(94):389–412. Available from: https://apps.who.int/iris/handle/10665/326776
White C, Franco-Paredes C. Leprosy in the 21st century. Clin Microbiol Rev. 2015;28(1):80–94. doi: 10.1128/CMR.00079-13
Ridley DS, Jopling WH. Classification of leprosy according to immunity. A five-group system. Int J Lepr Other Mycobact Dis[Internet]. 1966[cited 2019 sept 15];34(3):255–73. Available from: http://ila.ilsl.br/pdfs/v34n3a03.pdf
Fonseca ABL, Simon MV, Cazzaniga RA, Moura TR, Almeida RP, Duthie MS, et al. The influence of innate and adaptative immune responses on the differential clinical outcomes of leprosy. Infect Dis Poverty. 2017;6(1):5. doi: 10.1186/s40249-016-0229-3
Scollard DM, Adams LB, Gillis TP, Krahenbuhl JL, Truman RW, Williams DL. The continuing challenges of leprosy. Clin Microbiol Rev. 2006;19(2):338–81. doi: 10.1128/CMR.19.2.338-381.2006
WHO Expert Committee on Leprosy. World Health Organ Tech Rep Ser. 1998;874:1–43.
Sengupta U. Recent laboratory advances in diagnostics and monitoring response to treatment in leprosy. Indian Dermatol Online J. 2019;10(2):106–14. doi: 10.4103/idoj.IDOJ_260_18
Souza VNB, Iyer AM, Lammas DA, Naafs B, Das PK. Advances in leprosy immunology and the field application: A gap to bridge. Clin Dermatol.2016;34(1):82–95. doi: 10.1016/j.clindermatol.2015.10.013
Hunter SW, Brennan PJ. A novel phenolic glycolipid from Mycobacterium leprae possibly involved in immunogenicity and pathogenicity. J Bacteriol. 1981;147(3):728–35. doi: 10.1128/JB.147.3.728-735.1981
Cho SN, Yanagihara DL, Hunter SW, Gelber RH, Brennan PJ. Serological specificity of phenolic glycolipid I from Mycobacterium leprae and use in serodiagnosis of leprosy. Infect Immun. 1983;41(3):1077–83.
Jardim MR, Antunes SLG, Simons B, Wildenbeest JG, Nery JAC, Illarramendi X et al. Role of PGL-I antibody detection in the diagnosis of pure neural leprosy. Lepr Rev. 2005;76(3):232–40. doi: 10.47276/lr.76.3.232.
Spencer JS, Brennan PJ. The role of Mycobacterium leprae phenolic glycolipid I (PGL-I) in serodiagnosis and in the pathogenesis of leprosy. Lepr Rev. 2011;82(4):344–57. doi: 10.47276/lr.82.4.344.
Reece ST, Ireton G, Mohamath R, Guderian J, Goto W, Gelber R et al. ML0405 and ML2331 Are antigens of Mycobacterium leprae with potential for diagnosis of leprosy. Clin Vaccine Immunol. 2006;13(3):333–40. doi:10.1128/CVI.13.3.333-340.2006
Duthie MS, Goto W, Ireton GC, Reece ST, Cardoso LP, Martelli CM et al. Use of protein antigens for early serological diagnosis of leprosy. Clin Vaccine Immunol. 2007;14(11):1400–8. doi: 10.1128/CVI.00299-07
Duthie MS, Ireton GC, Kanaujia G V., Goto W, Liang H, Bhatia A et al. Selection of antigens and development of prototype tests for point-of-care leprosy diagnosis. Clin Vaccine Immunol. 2008;15(10):1590–7. doi: 10.1128/CVI.00168-08
Duthie MS, Balagon MF, Maghanoy A, Orcullo FM, Cang M, Dias RF et al. Rapid quantitative serological test for detection of infection with Mycobacterium leprae, the causative agent of leprosy. J Clin Microbiol. 2014;52(2):613–9. doi: 10.1128/JCM.02085-13
Cardoso LPV, Dias RF, Freitas AA, Hungria EM, Oliveira RM, Collovati M et al. Development of a quantitative rapid diagnostic test for multibacillary leprosy using smart phone technology. BMC Infect Dis. 2013;13(1):497. doi:10.1186/1471-2334-13-497
Fabri ACOC, Carvalho APM, Araujo S, Goulart LR, de Mattos AMM, Teixeira HC et al. Antigen-specific assessment of the immunological status of various groups in a leprosy endemic region. BMC Infect Dis. 2015;15(1):218. doi: 10.1186/s12879-015-0962-4
Duthie MS, Hay MN, Rada EM, Convit J, Ito L, Oyafuso LKM et al. Specific IgG antibody responses may be used to monitor leprosy treatment efficacy and as recurrence prognostic markers. Eur J Clin Microbiol Infect Dis. 2011;30(10):1257–65. doi: 10.1007/s10096-011-1221-2
Duthie MS, Raychaudhuri R, Tutterrow YL, Misquith A, Bowman J, Casey A et al. A rapid ELISA for the diagnosis of MB leprosy based on complementary detection of antibodies against a novel protein-glycolipid conjugate. Diagn Microbiol Infect Dis. 2014;79(2):233–9. doi: 10.1016/j.diagmicrobio.2014.02.006
Wen Y, You YG, Yuan LC, Yuan YH, Zhang Y, Duthie MS et al. Evaluation of novel tools to facilitate the detection and characterization of leprosy patients in China. Biomed Res Int. 2014; 2014:371828. doi: 10.1155/2014/371828
Freitas AA, Oliveira RM, Hungria EM, Cardoso LPV, Sousa ALOM, Costa MB et al. Alterations to antigen-specific immune responses before and after multidrug therapy of leprosy. Diagn Microbiol Infect Dis. 2015;83(2):154–61. doi: 10.1016/j.diagmicrobio.2015.06.021
Mizoguti DF, Hungria EM, Freitas AA, Oliveira RM, Cardoso LPV, Costa MB et al. Multibacillary leprosy patients with high and persistent serum antibodies to leprosy IDRI diagnostic-1/LID-1: Higher susceptibility to develop type 2 reactions. Mem Inst Oswaldo Cruz. 2015;110(7):914–20. doi: 10.1590/0074-02760150198
Freitas AA, Hungria EM, Costa MB, Sousa ALOM, Castilho MLO, Gonçalves HS et al. Application of Mycobacterium leprae-specific cellular and serological tests for the differential diagnosis of leprosy from confounding dermatoses. Diagn Microbiol Infect Dis. 2016;86(2):163–8. doi: 10.1016/j.diagmicrobio.2016.07.024
Frade MAC, Paula NA, Gomes CM, Vernal S, Bernardes Filho F, Lugão HB et al. Unexpectedly high leprosy seroprevalence detected using a random surveillance strategy in midwestern Brazil: A comparison of ELISA and a rapid diagnostic test. PLoS Negl Trop Dis. 2017;11(2):e0005375. doi: 10.1371/journal.pntd.0005375
Carvalho APM, Coelho A da CO, Correa-Oliveira R, Lana FCF. Specific antigen serologic tests in leprosy: Implications for epidemiological surveillance of leprosy cases and household contacts. Mem Inst Oswaldo Cruz. 2017;112(9):609–16. doi: 10.1590/0074-02760160505
Silva EA, Rosa PS, Belone AFF, Coelho NMB, Ura S, Tomimori J. Serodiagnosis of leprosy and follow-up of household contacts using a commercial rapid test containing ND-O/LID-1 antigens. Lepr Rev. 2017;88(2):174–83.doi: 10.47276/lr.88.2.174
Muñoz M, Beltrán-Alzate JC, Duthie MS, Serrano-Coll H, Cardona-Castro N. Comparison of enzyme-linked immunosorbent assay using either natural octyl disaccharide-leprosy IDRI diagnostic or phenolic glycolipid-I antigens for the detection of leprosy patients in Colombia. Am J Trop Med Hyg. 2018;98(1):274-277. doi: 10.4269/ajtmh.17-0500
Hungria EM, Bührer-Sékula S, Oliveira RM, Aderaldo LC, Pontes MAA, Cruz R et al. Mycobacterium leprae-specific antibodies in multibacillary leprosy patients decrease during and after treatment with either the regular 12 doses multidrug therapy (MDT) or the uniform 6 doses MDT. Front Immunol. 2018; 9:915. doi: 10.3389/fimmu.2018.00915
Leturiondo AL, Noronha AB, Do Nascimento MOO, Ferreira CDO, Rodrigues FDC, Moraes MO et al. Performance of serological tests PGL1 and NDO-LID in the diagnosis of leprosy in a reference center in Brazil. BMC Infect Dis. 2019;19(1):22. doi: 10.1186/s12879-018-3653-0
Nicchio MVC, Araujo S, Martins LC, Pinheiro A V., Pereira DC, Borges A et al. Spatial and temporal epidemiology of Mycobacterium leprae infection among leprosy patients and household contacts of an endemic region in Southeast Brazil. Acta Trop. 2016;163:38–45. doi: 10.1016/j.actatropica.2016.07.019
Smith CS, Aerts A, Saunderson P, Kawuma J, Kita E, Virmond M. Multidrug therapy for leprosy: a game changer on the path to elimination. Lancet Infect Dis. 2017;17(9):e293-e297. doi: 10.1016/S1473-3099(17)30418-814
Devides AC, Rosa PS, de Faria Fernandes Belone A, Coelho NMB, Ura S, Silva EA. Can anti–PGL-1 and anti–NDO-LID-1 antibody titers be used to predict the risk of reactions in leprosy patients? Diagn Microbiol Infect Dis. 2018; 91(3): 260–5. doi: 10.1016/j.diagmicrobio.2018.03.002
Roche PW, Britton WJ, Failbus SS, Williams D, Pradhan HM, Theuvenet WJ. Operational value of serological measurements in multibacillary leprosy patients: clinical and bacteriological correlates of antibody responses. Int J Lepr Other Mycobact Dis [Internet]. 1990 [cited 2019 Sept. 18];58(3):480–90. Available from: http://ila.ilsl.br/pdfs/v58n3a05.pdf
Halder A, Mundle M, Bhadra UK, Saha B. Role of paucibacillary leprosy in the transmission of disease. Indian J Lepr. 2001;73(1):11–5.
Morgado de Abreu MAM, Roselino AM, Enokihara M, Nonogaki S, Prestes-Carneiro LE, Weckx LLM et al. Mycobacterium leprae is identified in the oral mucosa from paucibacillary and multibacillary leprosy patients. Clin Microbiol Infect. 2014;20(1):59–64. doi: 10.1111/1469-0691.12190
Solomon S, Kurian N, Ramadas P, Rao PS. Incidence of nerve damage in leprosy patients treated with MDT. Int J Lepr Other Mycobact Dis [Internet]. 1998[cited 2019 Sept 19];66(4):451–6. Available from: http://ila.ilsl.br/pdfs/v66n4a02.pdf
Serrano-Coll H, Salazar-Peláez L, Acevedo-Saenz L, Cardona-Castro N. Mycobacterium leprae-induced nerve damage: direct and indirect mechanisms. Pathog Dis. 20181;76(6): 10.1093/femspd/fty062. doi: 10.1093/femspd/fty062
Cunha MHCM, Silvestre MPSA, Silva AR, Rosário DDS, Xavier MB. Fatores de risco em contatos intradomiciliares de pacientes com hanseníase utilizando variáveis clínicas, sociodemográficas e laboratoriais. Rev Pan-Amaz Saúde. 2017;8(2):21–8. doi: 10.5123/s2176-62232017000200003
Marçal PHF, Fraga LA de O, de Mattos AMM, Menegati L, Coelho A da CO, Pinheiro RO et al. Utility of immunoglobulin isotypes against LID-1 and NDO-LID for, particularly IgG1, confirming the diagnosis of multibacillary leprosy. Mem Inst Oswaldo Cruz. 2018;113(5): e170467. doi: 10.1590/0074-02760170467
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2019 Giovana M. Bovolini, Eliane A. Silva, Vânia Nieto Brito de Souza
Downloads
