title: An attempt to improve pure neural leprosy diagnosis using immunohistochemistry tests in peripheral nerve biopsy specimens.
abstract: The diagnosis of pure neural leprosy (PNL) is based on clinical and laboratory data, including the histopathology of nerve biopsy specimens and detection of Mycobacterium leprae DNA by polymerase chain reaction (PCR). Given that histopathologic examination and PCR methods may not be sufficient to confirm the diagnosis, immunolabeling of lipoarabinomanan (LAM) and/or phenolic glycolipid 1 (PGL-1) M. leprae wall components was utilized in the present investigation in an attempt to detect any vestigial presence of M. leprae in acid-fast bacilli (AFB) nerve samples. Twenty-three PNL nerve samples (6 AFB and 17 AFBPCR) were cryosectioned and subjected to LAM and PGL-1 immunohistochemical staining by immunoperoxidase. Five nonleprosy nerve samples were used as controls. The 6 AFB samples showed LAM/PGL-1 immunoreactivity. Among the 17 AFB samples, 8 revealed LAM and/or PGL-1 immunoreactivity. In 17 AFBPCR patients, just 7 yielded LAM and/or PGL-1 nerve results. In the PNL cases, the detection of immunolabeled LAM and PGL-1 in the nerve samples would have contributed to an enhanced diagnostic efficiency in the absence of molecular diagnostic facilities.
authors.affiliation: *Leprosy Laboratory ‡Cellular Microbiology Laboratory, Oswaldo Cruz Institute †Division of Pathology, National Institute of Cancer, Rio de Janeiro, RJ, Brazil.
authors.forename: Mildred
authors.initials: M
authors.lastname: Ferreira Medeiros
authors.forename: Márcia Rodrigues
authors.initials: MR
authors.lastname: Jardim
authors.forename: Robson Teixeira
authors.initials: RT
authors.lastname: Vital
authors.forename: José Augusto da Costa
authors.initials: JA
authors.lastname: Nery
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Sales
authors.forename: Milton Ozorio
authors.initials: MO
authors.lastname: de Moraes
authors.forename: Leila Maria
authors.initials: LM
authors.lastname: Chimelli
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Vidal Pessolani
authors.forename: Helen
authors.initials: H
authors.lastname: Ferreira
authors.forename: Euzenir Nunes
authors.initials: EN
authors.lastname: Sarno
authors.forename: Sérgio Luiz Gomes
authors.initials: SL
authors.lastname: Antunes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000378:metabolism*; D001706:Biopsy; D004269:DNA, Bacterial / Q000032:analysis*; D005260:Female; D006017:Glycolipids / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D015441:Leprosy, Tuberculoid / Q000175:diagnosis*; D008070:Lipopolysaccharides / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000235:genetics*; D010525:Peripheral Nerves / Q000276:immunology / Q000378:metabolism*; D058996:Quality Improvement; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial; D004269:DNA, Bacterial; D006017:Glycolipids; D008070:Lipopolysaccharides; C050016:lipoarabinomannan; C045169:phenolic glycolipid I, Mycobacterium leprae