From the Department of Clinical and Toxicology Analysis, Faculty of Pharmacy, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
Faculty of Nursing and Pharmacy (ESENFAR), Universidade Federal de Alagoas, Maceio, Alagoas, Brazil.
Pediatr Infect Dis J. 2019 Sep;38(9):e193-e198. doi: 10.1097/INF.0000000000002337.
In 2015, the detection rate of leprosy in Santana do Ipanema municipality, Alagoas state, Brazil, was 39.3 cases per 100,000 inhabitants, and among young people below 15 years of age, it was 32.8 cases per 100,000 inhabitants.
A prospective study was carried out from 2015 to 2017, in Santana do Ipanema city, with 69 leprosy contacts in the age group of 4-15 years. Measurement of serum IgM, IgG, and IgA against phenolic glycolipid antigen-1 (PGL-1) was done by an indirect enzyme-linked immunosorbent assay.
A high frequency of positive anti-PGL-1 IgM was found in both paucibacillary and multibacillary contacts. Twenty-three participants presented suspected lesions and 45 did not. In both groups a high frequency of positive IgM was found. In regard to anti-PGL-1 IgG, it was found a strong association between its positivity and the presence of lesions (relative risk of 3.25). Eight new cases of leprosy were diagnosed, five of which were seropositive for anti-PGL-1. Again, a striking association was found between positive IgG and leprosy (relative risk of 8.5). No significant association was found between IgM isotype and disease, nor between IgA and disease.
The present study reinforces the importance of measuring the three anti-PGL-1 isotypes in follow-up studies of leprosy contacts. Moreover, positive anti-PGL-1 IgG is associated with a high associated risk of disease.
2015 年,巴西阿拉戈斯州桑塔纳伊帕内马市的麻风病检出率为每 10 万人 39.3 例,15 岁以下年轻人的检出率为每 10 万人 32.8 例。
2015 年至 2017 年在桑塔纳伊帕内马市进行了一项前瞻性研究,共纳入 69 名年龄在 4-15 岁的麻风病接触者。采用间接酶联免疫吸附试验检测血清 IgM、IgG 和 IgA 对酚糖脂抗原-1(PGL-1)的抗体。
无论是少菌型还是多菌型接触者,抗 PGL-1 IgM 阳性率均较高。23 名参与者出现疑似病变,45 名参与者未出现病变。两组的 IgM 阳性率均较高。至于抗 PGL-1 IgG,其阳性与病变的存在之间存在很强的相关性(相对风险为 3.25)。诊断出 8 例新的麻风病例,其中 5 例抗 PGL-1 呈阳性。同样,IgG 阳性与麻风病之间存在显著相关性(相对风险为 8.5)。未发现 IgM 同型与疾病之间存在显著相关性,也未发现 IgA 与疾病之间存在相关性。
本研究强调了在麻风病接触者随访研究中测量三种抗 PGL-1 同型抗体的重要性。此外,抗 PGL-1 IgG 阳性与疾病的高相关风险相关。