Estudo sorológico da co-infecção de leishmania infantum e mycobacterium leprae em área de alta endemicidade / Sorological sutdy of coinfection leishmania infantum e mmycobacterium leprae in area of endemicity high

Introdução: A região Nordeste é responsável por 55% dos casos de hanseníase e por quase 50% dos casos de Leishmaniose visceral no Brasil. O Ceará, em especial a capital Fortaleza, é responsável por um grande número de casos novos dessas doenças. Este fato é reforçado pela correlação na distribuição de casos dessas patologias por municípios do estado do Ceará,onde de acordo com os dados da Secretaria de Saúde do Estado (2013), observa-se forte correlação epidemiológica entre os casos de hanseníase e do Leishmaniose visceral nos 184 municípios principalmente em Fortaleza. Objetivos: Nosso objetivo foi analisar a produção de anticorpos IgM anti-PGL1 em pacientes com Calazar sem tratamento. Material e métodos: 28 pacientes com confirmação clínico-laboratorial para Leishmaniose visceral acompanhados no Hospital São José de Doenças Infecciosas. Resultados: Quanto ao gênero, 21 foram do sexo masculino e 7 do sexo feminino, com mediana de idade de 20,5 anos (var. 3 a 76 anos), dos quais 15 pacientes não necessitaram internamento e 13 foram internados por um período médio de 28 dias (var. 5 a 28 dias). A média e desvio-padrão do índice de IgM anti-PGL1 foi de 1,91 + 0,69, sendo 78,6% considerados soropositivos. Conclusão: Não foi observada qualquer diferença entre gênero,idade, necessidade ou não de internamento, ou tempo de tratamento. A alta frequência de IgM anti-PGL1 positiva pode ser secundária à ativiação policlonal que ocorre na Leishmaniose visceral, dificultando a possibilidade de detecção da infecção pelo M. leprae por avaliação sorológica em região de alta endemicidade para Leishmaniose visceral.

Introduction: The Northeast region accounts for 55% of leprosy cases and nearly 50% of cases of visceral leishmaniasis in Brazil. Ceará, in particular the Fortaleza capital is responsible for a large number of new cases of these diseases. This fact is reinforced by the correlation in the distribution of cases of these diseases in the state of Ceará counties where according to the data of the State Health Departament (2013), we observed strong epidemiological correlation between cases of leprosy and visceral leishmaniasis in 184 counties mostly in Fortaleza. Objectives: Our objective was to analyze the production of anti-PGL1 IgM antibodies in patients with visceral leishmaniasis untreated. Materials and Methods: 28 patients with clinical and laboratory confirmation for visceral leishmaniasis followed at SãoJosé Hospital for Infectious Diseases. Results: As togender, 21 were males and 7 females, with a median age of 20,5 years (var 3-76 years.), Of which 15 patients did not require hospitalization and 13 were hospitalized for an average 28 days (var. 5 to 28 days). The mean and standard deviation of the anti-IgM PGL1 index was 1.91 ± 0.69, and 78.6% considered seropositive. Conclusion: It was not observed any difference between gender, age, necessity or not hospitalization, or time treatment. The high frequency of positive IgM anti-PGL1,can be secondary to polyclonal activation occurring in kala-azar, hindering the possibility of detection of M. leprae infection by serologic evaluation in high endemicity area for visceral leishmaniasis.

Correlation of zinc plasma and IgM anti-PGL-1 levels among close contact of leprosy.

Background: Previous study showed leprosy patients have low zinc status. Yet the status of zinc in close-contact, which indicated by IgM anti-PGL1 level, have not determined. The aim of the study was to determine the association of zinc plasma and IgM anti-PGL-1 levels among close contact of leprosy patients in Indonesia. Methods: This was an observational study. Subjects were 186 close-contact leprosy patients. Measurement of zinc plasma status used atomic absorption spectrophotometer while examination of IgM anti-PGL1 level used ELISA (Polyclonal rabbit anti human IgM/HRP/(Dako®). Results: The average level of IgM anti-PGL1 and zinc plasma were 804 unit/mL (± 439.4) and 16.6 μmol/L (± 3.5) consecutively. There was significant correlation between zinc plasma and IgM anti-PGL1 (r = - 0.230; p = 0.002). Conclusion: There is a significant correlation between zinc plasma and IgM anti-PGL1 in close contact of leprosy

Survey to identify Mycobacterium leprae-infected household contacts of patients from prevalent regions of leprosy in Colombia

Leprosy in Colombia is in the post-elimination phase; nevertheless, there are regions of this country where the incidence is still around 3-4/100,000. Early detection of leprosy patients is a priority for achieving control and elimination of leprosy; however, the clinical exam is not very sensitive and thus, the majority of patients are diagnosed only when they demonstrate lesions, and damage to the nerves and skin has already occurred. The goal of the present study was to identify Mycobacterium leprae infection and immune responses in household contacts (HHC) of leprosy patients from three prevalent regions of Colombia. Clinical examination, the Mitsuda test, evaluation of IgM anti-PGL-I in the serum, the bacillar index (BI), and polymerase chain reaction (PCR) from nasal swabs (NS) were performed for 402 HHC of 104 leprosy patients during a cross-sectional survey. Positive titers for IgM anti-PGL1 were found for 54 HHC, and PCR-positive NS for 22. The Mitsuda reaction was negative for 38 HHC, although three were positive for IgM anti-PGL-1 titers. The data document that leprosy transmission among HHC is still occurring in a non-endemic country.

The different levels of interferron gamma capacity production on several stages of leprosy.

Informations concerning imunological activity in subclinical leprosy is still lacking. Therefore, the objective of this study was to find out the prevalence of subclinical leprosy and interferon- (IFN-) production at several stages of leprosy. This observational study using a cross sectional approach was conducted in Semarang, Central Java, Indonesia. Twenty-six leprosy patients and 62 relatives who lived together with the leprosy patients were included in the study. The venous blood samples were taken from all (88) of the subjects. All of the venous blood samples were measured for IFN- levels by Elisa method. Sixty two blood samples from the relatives who lived together with the leprosy patients were measured for IgM anti PGL-1 to determine the subclinical stage of leprosy. Thus, there were three groups in this study: leprosy patients (LP), subclinical leprosy (SL) and sero-negative subjects (SN). Thirty three of the 62 relatives (53.2%) were in subclinical stage of leprosy, while 29 others were not (sero-negative). There was a significant difference (P= 0.001) in IFN- production capacity among the three groups (LP,SL and SN). Among the three groups, the LP group had the lowest, while SL group had the highest IFN- production capacity.