Advances in the diagnosis and treatment of leprosy.
Leprosy is a chronic infectious disease caused by Mycobacterium leprae that mainly affects the skin and peripheral nerves. Over recent years, many important advances have been made in developing molecular diagnostics, in identifying highly effective drugs and designing multidrug regimens for treatment, and in unravelling the genomic structure and functions of the leprosy bacillus. Using the new information about specific sequences of M. leprae, several gene probes and gene amplification systems for confirming diagnosis and monitoring treatment have been developed. Among these, polymerase chain reaction (PCR)-based methods have been useful in confirming the diagnosis in paucibacillary leprosy (where few bacilli are present). RNA-targeting systems for monitoring the progress of treatment, in situ hybridisation techniques for analysing specimens with nonspecific histological features, and molecular methods for direct detection of rifampicin/dapsone resistance are other major technological advances with immense applied value. Several effective regimens for the treatment of leprosy have been developed, which include rifampicin, clofazimine and dapsone as core drugs. Although these regimens are generally satisfactory, limitations in terms of persisting activity and late reactions/relapses in paucibacillary leprosy, and persistence of dead and/or live organisms in multibacillary forms of the disease, have been observed.
Central JALMA Institute for Leprosy (Indian Council of Medical Research), PO Box 101, Taj Ganj, Agra 282 001, India. jalma@zyberway.com
Vishwa M
VM
Katoch
D000818:Animals; D019937:Diagnostic Techniques and Procedures / Q000639:trends*; D015195:Drug Design; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use*; D007918:Leprosy / Q000175:diagnosis* / Q000188:drug therapy*; D009166:Mycobacterium leprae / Q000187:drug effects / Q000302:isolation & purification
D007917:Leprostatic Agents