Kampirapap K, Singtham N
Raj-Pracha-Samasai Institute, Nonthaburi, Thailand.
Southeast Asian J Trop Med Public Health. 1996 Dec;27(4):728-33.
Phenolic glycolipid - 1 (PGL-1) is a Mycobacterium leprae specific cell wall component. It is an immunodominant antigen and can induce a strong humoral immune response. IgM antibody levels against PGL-1 were measured in Thai leprosy patients between October 1992-April 1994 by a commercially available M. leprae particle agglutination test (MLPA). The percentage of seropositivity was much higher in newly untreated multibacillary (MB) patients (83.9%) than in paucibacillary (PB) patients (17.8%). Antibody levels in the MB group varied in the range 32-8,192, whereas they varied in the range 32-256 in the PB group. Patients being treated with multidrug therapy (MDT) were 68.3% and 19.4% seropositive in the MB and PB groups, respectively. Seropositivities in control serum specimens were 11.3% in active pulmonary tuberculosis patients, 2.6% in dermatologic patients and 4.4% in a healthy population. In conclusion, the anti-PGL-1 assay using MLPA appears to be a sensitive and specific diagnostic tool for the diagnosis of MB patients. Additionally, it may provide an alternative to the BI determination in monitoring MB patients under MDT, and also in the surveillance of such patients after MDT.
酚糖脂-1(PGL-1)是麻风分枝杆菌特有的细胞壁成分。它是一种免疫显性抗原,可诱导强烈的体液免疫反应。1992年10月至1994年4月期间,通过市售的麻风分枝杆菌颗粒凝集试验(MLPA)检测了泰国麻风病患者中抗PGL-1的IgM抗体水平。新确诊未治疗的多菌型(MB)患者的血清阳性率(83.9%)远高于少菌型(PB)患者(17.8%)。MB组的抗体水平在32至8192之间变化,而PB组的抗体水平在32至256之间变化。接受多药联合治疗(MDT)的患者中,MB组和PB组的血清阳性率分别为68.3%和19.4%。对照血清标本中,活动性肺结核患者的血清阳性率为11.3%,皮肤病患者为2.6%,健康人群为4.4%。总之,使用MLPA检测抗PGL-1似乎是诊断MB患者的一种敏感且特异的诊断工具。此外,它可能为监测接受MDT的MB患者以及MDT后此类患者的监测提供一种替代BI测定的方法。