title: From genome-based in silico predictions to ex vivo verification of leprosy diagnosis.
abstract: The detection of hundreds of thousands of new cases of leprosy every year suggests that transmission of Mycobacterium leprae infection still continues. Unfortunately, tools for identification of asymptomatic disease and/or early-stage M. leprae infection (likely sources of transmission) are lacking. The recent identification of M. leprae-unique genes has allowed the analysis of human T-cell responses to novel M. leprae antigens. Antigens with the most-promising diagnostic potential were tested for their ability to induce cytokine secretion by using peripheral blood mononuclear cells from leprosy patients and controls in five different areas where leprosy is endemic; 246 individuals from Brazil, Nepal, Bangladesh, Pakistan, and Ethiopia were analyzed for gamma interferon responses to five recombinant proteins (ML1989, ML1990, ML2283, ML2346, and ML2567) and 22 synthetic peptides. Of these, the M. leprae-unique protein ML1989 was the most frequently recognized and ML2283 the most specific for M. leprae infection/exposure, as only a limited number of tuberculosis patients responded to this antigen. However, all proteins were recognized by a significant number of controls in areas of endemicity. T-cell responses correlated with in vitro response to M. leprae, suggesting that healthy controls in areas where leprosy is endemic are exposed to M. leprae. Importantly, 50% of the healthy household contacts and 59% of the controls in areas of endemicity had no detectable immunoglobulin M antibodies to M. leprae-specific PGL-I but responded in T-cell assays to >or=1 M. leprae protein. T-cell responses specific for leprosy patients and healthy household contacts were observed for ML2283- and ML0126-derived peptides, indicating that M. leprae peptides hold potential as diagnostic tools. Future work should concentrate on the development of a sensitive and field-friendly assay and identification of additional peptides and proteins that can induce M. leprae-specific T-cell responses.
authors.affiliation: Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands. a.geluk@lumc.nl
authors.forename: Annemieke
authors.initials: A
authors.lastname: Geluk
authors.forename: John S
authors.initials: JS
authors.lastname: Spencer
authors.forename: Kidist
authors.initials: K
authors.lastname: Bobosha
authors.forename: Maria C V
authors.initials: MC
authors.lastname: Pessolani
authors.forename: Geraldo M B
authors.initials: GM
authors.lastname: Pereira
authors.forename: Sayera
authors.initials: S
authors.lastname: Banu
authors.forename: Nadine
authors.initials: N
authors.lastname: Honoré
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Reece
authors.forename: Murdo
authors.initials: M
authors.lastname: MacDonald
authors.forename: Bishwa Raj
authors.initials: BR
authors.lastname: Sapkota
authors.forename: Chaman
authors.initials: C
authors.lastname: Ranjit
authors.forename: Kees L M C
authors.initials: KL
authors.lastname: Franken
authors.forename: Martha
authors.initials: M
authors.lastname: Zewdie
authors.forename: Abraham
authors.initials: A
authors.lastname: Aseffa
authors.forename: Rabia
authors.initials: R
authors.lastname: Hussain
authors.forename: Mariane M
authors.initials: MM
authors.lastname: Stefani
authors.forename: Sang-Nae
authors.initials: SN
authors.lastname: Cho
authors.forename: Linda
authors.initials: L
authors.lastname: Oskam
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Brennan
authors.forename: Hazel M
authors.initials: HM
authors.lastname: Dockrell
mesh_terms: D000328:Adult; D000942:Antigens, Bacterial; D001459:Bangladesh; D001938:Brazil; D005002:Ethiopia; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000096:biosynthesis*; D007918:Leprosy / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000276:immunology*; D009390:Nepal; D010154:Pakistan; D011994:Recombinant Proteins; D012680:Sensitivity and Specificity; D013601:T-Lymphocytes / Q000276:immunology*; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial; D011994:Recombinant Proteins; D007371:Interferon-gamma