Diagnóstico de lepra en niños mediante seguimiento serológico de anticuerpos contra el glicolípido fenólico I / Leprosy diagnosis in children by antibodies serologic follow up against the phenolic glycolipid I

Introducción: Los niños contactos de pacientes con lepra se consideran las personas con mayores posibilidades de desarrollar la enfermedad. Objetivo: Valorar la utilidad del seguimiento serológico de anticuerpos contra el glicolípido fenólico I para el diagnóstico de lepra en niños. Métodos: Investigación prospectiva. Se incluyeron todos los niños contactos de pacientes diagnosticados con lepra en las provincias de La Habana, Santiago de Cuba y Guantánamo entre enero 2013-junio 2015. Los menores se evaluaron clínicamente mediante examen dermatoneurológico y se determinó la presencia de anticuerpos contra el glicolípido fenólico I de Mycobacterium leprae para el estudio serológico. Los niños con serología positiva se siguieron, con estos dos métodos, cada seis meses durante dos años. La confirmación de un caso nuevo de lepra se realizó mediante baciloscopía y biología molecular. Resultados: Se estudiaron 151 niños, de ellos 44 (29,13 por ciento) resultaron positivos al glicolípido fenólico I. Se diagnosticaron durante el período 12 casos, de los cuales 11 tuvieron serología positiva. Presentaron sospecha clínica 10 niños de los estudiados, solo se confirmó un caso nuevo, el cual tuvo serología negativa. En ocho de los niños diagnosticados se detectó presencia de bacilos ácido alcohol resistente en la lámina de baciloscopía. En los restantes cuatro niños el diagnóstico se confirmó por la reacción en cadena de la polimerasa. Conclusiones: Los resultados de esta investigación denotan la utilidad del seguimiento serológico de anticuerpos contra el glicolípido fenólico I en el diagnóstico de lepra en niños, en apoyo a la vigilancia clínica(AU)

Introduction: Children having contact with leprosy patients are considered the contacts with greater possibilities of developing the disease. Objective: To assess the usefulness of antibodies´ serologic follow up against the phenolic glycolipid I (PGL-1) for the diagnosis of leprosy in children. Methods: Prospective study in which were included all children contacts of patients diagnosed with leprosy in Havana, Santiago de Cuba and Guantanamo provinces between January 2013 and June 2015. They were evaluated clinically by the dermato-neurological examination and the presence of antibodies against the PGL-1 of M. leprae was determined. Children with positive serology were followed up using these same two methods every six months for two years. The confirmation of a new case of leprosy was made by smear microscopy and molecular biology / PCR-Rlep. Results: A total of 151 children were studied. Of these, 44 children (29.13 percent) were positive for phenolic glycolipid I. A total of 12 children were diagnosed during this period, of which 11 had positive serology. Only 10 children of the studied ones presented clinical suspicion and of these only one new case was confirmed, which had negative serology. In eight of the diagnosed children, the presence of acid-fast bacilli was detected in the smear microscopy. In the remaining four children, the diagnosis was confirmed by the PCR result. Conclusion: The results of this investigation show the usefulness of the antibodies´ serologic follow up against the phenolic glycolipid I in the diagnosis of leprosy in children as a support to clinical surveillance(AU)

Evaluation of an Immunochromatography Assay Kit for the Detection of Antibodies to the Mycobacterium leprae-specific Phenolic Glycolipid-I Antigen / 나학회지

Among the many reported applications of the detection of antibodies to phenolic glycolipid-I (PGL-I) of Mycobacterium leprae, the use of seroprevalence as an indicator of the magnitude of the leprosy problem may turn out to be very useful in leprosy control programs. In order to facilitate the use of PGL-I based serology in leprosy control programs, however, a simple test system for the detection of antibodies to PGL-I has been required. For being searched the meaning of qualitative analysis for PGL-I antibodies, we examined enzyme-linked immunosorbent assay and immunochromatographic assay kit using PGL-I neoglycoconjugate antigens. The sensitivity was 91.7%, and the specificity was 78.1%.

Detection of Phenolic Glycolipid I of Mycobacterium leprae and Antibodies to the Antigen in Sera from Leprosy Patients and Their Contacts

Serum specimens from leprosy patients, their contacts and controls were examined for the presence of phenolic glycolipid I (PGL-I), a Mycobacterium leprae specific antigen, and antibodies to the antigen using enzyme-linked immunosorbent assays. Of 12 lepromatous patients with less than 2 years of therapy, 11(91.7%) were seropositive to PGL-l, thus indicating that new lepromatous cases can be identified by detecting anti-PGL-l antibodies. In contrast 88(56.4%) of 156 lepromatous patiens treated more than 2 years were positve. Moreover, only 69(40.8%) were seropositve among 169 lepromatous patients in the leprosy resettlement villages. The mean antibody level also declined significantly in proportion to the duration of chemotherapy. This may suggest the possibility of monitoring chemotherapy by detecting anti-PGL-l antibodies. The prevalence of anti-PGL-l antibodies among 200 controls from a high endemic area for leprosy was 5.5% and was significantly higher than that(1.5%) among 200 controls from a low endemic area. Of 103 household contacts in the resettlement villages, 10(9.7%) were seropositive, reflecting the frequent chance of exposure to M. leprae. However, PGL-l was not detected many in any of the sera from controls, contacts, and inactive lepromatous patients having the anti-PGL-l antibodies; on the other hand, 6(50%) of 12 lepromatous patients treated less than 2 years had detectable PGL-l in their sera. The results thus indicate that PGL-l detection may be more suitable for monitoring the effectiveness of chemotherapy and that it may be necessary to examine for the presence of PGL-l in sera from contacts and normal populations for confirming M. leprae infection.