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Specific IgG antibody responses may be used to monitor leprosy treatment efficacy and as recurrence prognostic markers

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Abstract

Although curable, leprosy requires better diagnostic and prognostic tools to accompany therapeutic strategies. We evaluated the serum samples of leprosy patients from Venezuela and Brazil for reactivity against the specific recombinant proteins, ML0405 and ML2331, and the LID-1 fusion protein that incorporates both of these antigens. Antigen-specific IgG was highest in lepromatous leprosy patients (LL) and decreased across the disease spectrum, such that only a small subset of true tuberculoid patients (TT) tested positive. The impact of multidrug therapy (MDT) on these antibody responses was also examined. Several years after treatment, the vast majority of Venezuelan patients did not possess circulating anti-LID-1, anti-ML0405, and anti-ML2331 IgG, and the seropositivity of the remaining cases could be attributed to irregular treatment. At discharge, the magnitude and proportion of positive responses of Brazilian patients against the proteins and phenolic glycolipid (PGL)-I were lower for most of the clinical forms. The monthly examination of IgG levels in LL patient sera after MDT initiation indicated that these responses are significantly reduced during treatment. Thus, responses against these antigens positively correlate with bacillary load, clinical forms, and operational classification at diagnosis. Our data indicate that these responses could be employed as an auxiliary tool for the assessment of treatment efficacy and disease relapse.

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Abbreviations

BB:

Borderline borderline

BI:

Bacterial index

BL:

Borderline lepromatous

BT:

Borderline tuberculoid

C:

Control

EC:

Endemic control

HHC:

Healthy household contact

LI:

Leprosy indeterminate

LID:

Leprosy Infectious Disease Research Institute (IDRI) diagnostic

LL:

Lepromatous leprosy

MB:

Multibacillary

MDT:

Multidrug therapy

NEC:

Non-endemic control

PB:

Paucibacillary

PGL:

Phenolic glycolipid

TT:

True tuberculoid

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Acknowledgments

This work was conducted with support from the American Leprosy Missions and the National Institutes of Health (1R43AI066613-01A1 and 2R44AI066613-02). The National Reference Center of Leprosy, Uberlândia, Brazil, was also supported by the Brazilian Ministry of Health, DECIT/MS, CNPq/MCT, CAPES/MEC, and FAPEMIG. The Infectious Disease Research Institute (IDRI) is a member of the IDEAL (Initiative for Diagnostic and Epidemiological Assays for Leprosy) Consortium.

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Authors and Affiliations

  1. Infectious Disease Research Institute, 1124 Columbia St., Suite 400, Seattle, WA, 98104, USA

    M. S. Duthie & S. G. Reed

  2. Protein Advances Inc., Seattle, WA, USA

    M. S. Duthie, M. N. Hay & D. Carter

  3. Biochemistry Laboratory, Instituto de Biomedicina, Universidad Central de Venezuela, Caracas, Venezuela

    E. M. Rada & J. Convit

  4. Instituto de Infectologia Emílio Ribas, Faculdade de Medicina da Fundação ABC, São Paulo, Brazil

    L. Ito & L. K. M. Oyafuso

  5. São Paulo Center for Dermatology (Centro de Dermatologia, Secretaria de Estado da Saude de São Paulo), São Paulo, Brazil

    M. I. P. Manini

  6. National Reference Center of Leprosy, Federal University of Uberlândia, Uberlândia, MG, Brazil

    I. M. B. Goulart, J. Lobato & L. R. Goulart

  7. Laboratory of Nanobiotechnology, Institute of Genetics and Biochemistry, Federal University of Uberlândia, Uberlândia, MG, Brazil

    L. R. Goulart

Authors
  1. M. S. Duthie
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  2. M. N. Hay
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  3. E. M. Rada
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  4. J. Convit
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  5. L. Ito
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  6. L. K. M. Oyafuso
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  7. M. I. P. Manini
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  8. I. M. B. Goulart
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  9. J. Lobato
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  10. L. R. Goulart
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  11. D. Carter
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  12. S. G. Reed
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Correspondence to M. S. Duthie.

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Duthie, M.S., Hay, M.N., Rada, E.M. 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 30, 1257–1265 (2011). https://doi.org/10.1007/s10096-011-1221-2

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  • DOI: https://doi.org/10.1007/s10096-011-1221-2

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