title: Analysis of antibody and cytokine markers for leprosy nerve damage and reactions in the INFIR cohort in India.
abstract: BACKGROUND
  The ILEP Nerve Function Impairment in Reaction (INFIR) is a cohort study designed to identify predictors of reactions and nerve function impairment (NFI) in leprosy.
  
  
  OBJECTIVE
  Antibodies to mycobacteria, nerve components and serum cytokine were measured as potential markers for their possible association with reactions and NFI.
  
  
  METHODS
  303 newly diagnosed leprosy patients from two centres in North India were enrolled. Antibodies to PGL-1, LAM (IgG1 and IgG3), ceramide, S100 and TNFα levels were measured using ELISA techniques.
  
  
  RESULTS
  S-100, PGL IgG and IgM antibody levels were lowest in patients with BT leprosy and highest in patients with lepromatous leprosy. LAM IgG1 and LAM IgG3 antibody levels were highest in patients with BL leprosy. Ceramide antibody levels were not correlated with type of leprosy. Levels of all the antibodies tested and TNF α were lowest in patients with only skin reaction. PGL IgM antibody levels were elevated in patients with skin reactions and NFI. Old sensory NFI is associated with significant elevation of PGL IgG, LAM IgG and S100 antibody levels.
  
  
  CONCLUSIONS
  These results reveal that the antibody response to mycobacterial antigens, nerve antigens and cytokines are in a dynamic flux and could collectively contribute to NFI in leprosy. The association of multiple markers with old NFI may indicate the contribution of different pathological processes.
authors.affiliation: Stanley Brown Laboratories, The Leprosy Mission, Shahdara, New Delhi, India. rupenjadhav@yahoo.com
authors.forename: Rupendra
authors.initials: R
authors.lastname: Jadhav
authors.forename: Lavanya
authors.initials: L
authors.lastname: Suneetha
authors.forename: Ravindra
authors.initials: R
authors.lastname: Kamble
authors.forename: Vidyagouri
authors.initials: V
authors.lastname: Shinde
authors.forename: Karuna
authors.initials: K
authors.lastname: Devi
authors.forename: Meher Vani
authors.initials: MV
authors.lastname: Chaduvula
authors.forename: Renuka
authors.initials: R
authors.lastname: Raju
authors.forename: Sujai
authors.initials: S
authors.lastname: Suneetha
authors.forename: Peter G
authors.initials: PG
authors.lastname: Nicholls
authors.forename: Wim H
authors.initials: WH
authors.lastname: van Brakel
authors.forename: Diana N J
authors.initials: DN
authors.lastname: Lockwood
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood*; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007194:India; D007918:Leprosy / Q000150:complications* / Q000473:pathology*; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis*
chemical_list: D000907:Antibodies, Bacterial; D001323:Autoantibodies; D015415:Biomarkers; D016207:Cytokines; D007074:Immunoglobulin G