Stefani M M, Martelli C M, Morais-Neto O L, Martelli P, Costa M B, de Andrade A L
Department of Immunology, University Hospital, Federal University of Goias, Goiania, Brazil.
Int J Lepr Other Mycobact Dis. 1998 Sep;66(3):356-64.
The anti-phenolic glycolipid-I (PGL-I) assay as currently applied for leprosy is conceived as an early marker of asymptomatic infection, early disease diagnosis and cure monitoring. Its use as a prognostic marker of reaction is still a matter of controversy. We conducted a case-control study to investigate whether IgM and IgG anti-PGL-I antibodies could discriminate patients at increased risk of developing reactions. Eligible cases were untreated leprosy patients at the onset of type 1 and type 2 reactions recruited from among 600 concurrent, newly detected, untreated leprosy patients attending an outpatient clinic in central Brazil. For the patients with reaction, approximately the same number of leprosy cases without reaction matched as to bacterial index (BI), age and gender were randomly selected. Individuals without clinical leprosy were evaluated as healthy controls. Sera from type 1 reaction (N = 43) and type 2 reaction (N = 26) patients were tested by an ELISA using PGL-I synthetic disaccharide-BSA antigen and 1:300 sera dilution (cut-off point > or = 0.2 OD). Antibody profiles were evaluated by exploratory data analysis and reverse cumulative distribution curves. The IgG anti-PGL-I response did not have a defined pattern, being detected only at low levels. Our results indicate that leprosy patients, independently of their reactional status, produce high levels of IgM anti-PGL-I, demonstrating a strong correlation between the magnitude of antibody response and the BI. Patients with a higher BI were at least 3.4 times more prone to produce an antibody response compared to healthy controls.
目前用于麻风病检测的抗酚糖脂-I（PGL-I）检测被视为无症状感染、疾病早期诊断及治愈监测的早期标志物。其作为反应性预后标志物的应用仍存在争议。我们开展了一项病例对照研究，以调查IgM和IgG抗PGL-I抗体是否能够区分发生反应风险增加的患者。符合条件的病例为从巴西中部一家门诊就诊的600例同时新发现的未经治疗的麻风病患者中招募的1型和2型反应发作时的未经治疗的麻风病患者。对于有反应的患者，随机选择细菌指数（BI）、年龄和性别相匹配的大致相同数量的无反应麻风病病例。无临床麻风病的个体被评估为健康对照。使用PGL-I合成二糖-BSA抗原和1:300血清稀释度（临界值>或=0.2 OD）通过ELISA检测1型反应（N = 43）和2型反应（N = 26）患者的血清。通过探索性数据分析和反向累积分布曲线评估抗体谱。IgG抗PGL-I反应没有明确模式，仅在低水平检测到。我们的结果表明，麻风病患者无论其反应状态如何，都会产生高水平的IgM抗PGL-I，表明抗体反应强度与细菌指数之间存在强相关性。与健康对照相比，细菌指数较高的患者产生抗体反应的可能性至少高3.4倍。
