Accuracy of Enzyme-Linked Immunosorbent Assays (ELISAs) in Detecting Antibodies against<i>Mycobacterium leprae</i>in Leprosy Patients: A Systematic Review and Meta-Analysis

Espinosa, Omar Ariel; Ferreira, Silvana Margarida Benevides; Longhi, Fabiana Gulin; Cortela, Denise da Costa Boamorte; Ignotti, Eliane

doi:10.1155/2018/9828023

Cited by 17 publications

(13 citation statements)

References 42 publications

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“…ApoA1 inhibits the recruitment of monocytes and macrophage chemotaxis ( 22 ), whereas CRP can recognize pathogens and activate the classical complement pathway ( 23 ). Together with αPGL-I IgM, the well-established biomarker for MB leprosy ( 24 ), the identified biomarkers were implemented in quantitative up-converting phosphor lateral flow assays (UCP-LFAs) ( 19 ). These user-friendly tests are applicable in resource-limited settings, essential for diagnostic tools in large-scale contact screening of leprosy contacts, and provide quantitative results.…”

Section: Introductionmentioning

confidence: 99%

Household Contacts of Leprosy Patients in Endemic Areas Display a Specific Innate Immunity Profile

et al. 2020

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Leprosy is a chronic infectious disease, caused by Mycobacterium leprae, that can lead to severe lifelong disabilities. The transmission of M. leprae is continuously ongoing as witnessed by the stable new case detection rate. The majority of exposed individuals does, however, not develop leprosy and is protected from infection by innate immune mechanisms. In this study the relation between innate immune markers and M. leprae infection as well as the occurrence of leprosy was studied in household contacts (HCs) of leprosy patients with high bacillary loads. Serum proteins associated with innate immunity (ApoA1, CCL4, CRP, IL-1Ra, IL-6, IP-10, and S100A12) were determined by lateral flow assays (LFAs) in conjunction with the presence of M. leprae DNA in nasal swabs (NS) and/or slit-skin smears (SSS). The HCs displayed ApoA1 and S100A12 levels similar to paucibacillary patients and could be differentiated from endemic controls based on the levels of these markers. In the 31 households included the number (percentage) of HCs that were concomitantly diagnosed with leprosy, or tested positive for M. leprae DNA in NS and SSS, was not equally divided. Specifically, households where M. leprae infection and leprosy disease was not observed amongst members of the household were characterized by higher S100A12 and lower CCL4 levels in whole blood assays of HCs in response to M. leprae. Lateral flow assays provide a convenient diagnostic tool to quantitatively measure markers of the innate immune response and thereby detect individuals which are likely infected with M. leprae and at risk of developing disease or transmitting bacteria. Low complexity diagnostic tests measuring innate immunity markers can therefore be applied to help identify who should be targeted for prophylactic treatment.

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Section: Introductionmentioning

confidence: 99%

Household Contacts of Leprosy Patients in Endemic Areas Display a Specific Innate Immunity Profile

et al. 2020

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“…The use of diagnostic tests has been largely discussed. A meta-analysis study regarding the accuracy of ELISAs in detecting antibodies against mycobacterium leprae concluded that traditional ELISAs have good accuracy in detecting MB leprosy and poor accuracy in detecting PB leprosy 40 . Another meta-analysis evaluating diagnostic accuracy of tests concluded that although the test accuracy looks reasonable, the studies suffered from heterogeneity and low methodological quality 41 .…”

Section: Discussionmentioning

confidence: 99%

Leprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients

Hacker

Sales

Duppré

et al. 2021

Sci Rep

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Reduction in incidence has been associated with the introduction of novel approaches, like chemo/immune-prophylaxis. Incidence determined through follow-up cohort studies can evaluate the implementation of these innovative policies towards control and prevention. We have assessed the incidence in our contacts cohort over past 33 years, considering the effect of demographic and clinical variables. Survival analysis was used to estimate the risk of leprosy. A total of 9024 contacts were evaluated, of which 192 developed leprosy, resulting in an overall incidence of 1.4/1000 person-years. The multivariate analysis showed that the major risk factors were (i) contact from MB index cases and (ii) consanguinity (iii) intra household contact. Lower risk was detected for contacts with BCG scar who were revaccinated. There was a significant decrease in accumulated risk between the 2011–2019 period compared with 1987, probably linked to the improvement in laboratory tools to monitor contacts, thereby providing early diagnosis of contacts at intake and reduction of transmission. Our findings suggest that a combination of contact surveillance and tracing, adequate neurodermatological examination, and availability of molecular tools is highly effective in supporting early diagnosis, while a second dose of the BCG vaccination can exert extra protection.

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“…IgM may be detected by enzyme-linked immunosorbent assays (ELISAs) based on phenolic glycolipid I (PGL-I) or natural disaccharide octyl bovine serum albumin (ND-O-BSA) as antigens; IgG response can be detected by an ELISA based on lipid droplet protein 1 (LID-1). A recent metanalyses showed no advantages in the overall estimated sensitivity for isolated LID-1 compared to PGL-I or ND-O-BSA 14 . In terms of outlook, validating and introducing serological tests with anti-PGL-I and natural disaccharide octyl and lipid droplet protein 1 (NDO-LID) combination for field use might support the diagnosis 14 .…”

mentioning

confidence: 93%

“…A recent metanalyses showed no advantages in the overall estimated sensitivity for isolated LID-1 compared to PGL-I or ND-O-BSA 14 . In terms of outlook, validating and introducing serological tests with anti-PGL-I and natural disaccharide octyl and lipid droplet protein 1 (NDO-LID) combination for field use might support the diagnosis 14 . Although additional biomarkers have been identified, validating and implementing their use remain challenging, and there is no reliable and rapid point-of-care (POC) test on the horizon.…”

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confidence: 93%

Perspectives for leprosy control and elimination

Ignotti

Steinmann

2020

Cad. Saúde Pública

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Recently, data and news about rising numbers of leprosy cases in some low endemic countries, as well as in certain areas of high-burden countries, have become prominent 1 . This increase leads us to reflect upon changes in transmission patterns and difficulties regarding interventions strategies for leprosy control.Leprosy is classified as a neglected tropical disease (NTD) targeted for elimination 2 . The goal of elimination as a public health problem was agreed upon by the Member States of the World Health Organization (WHO) in 1991 3 . Since the resolution, many countries have revised their leprosy strategies including a rigorous review and updating of databases, standardized declaration of cure upon multi-drug therapy (MDT) completion according to official protocols with reduced treatment time 4 etc. Additionally, countries invested considerable efforts in active case finding, including campaigns, decentralization of care, definition of priority areas for interventions and integration of activities with other NTDs 5 . More recently, integration with other chronic infectious diseases has also been explored 5 . Of note, even Mycobacterium leprae transmission prediction models suggest that case detection needs to be increased to reduce disease burden and achieve reduced transmission 6 .It is generally accepted that there are no sudden leprosy outbreaks due to the long incubation period and the slow evolution of the disease, which mean that the patients being diagnosed today were infected several years ago 7 . Consequently, changes in the trend of incidence indicators are slow, except for the effects of operational factors. In developing countries, active case finding efforts in vulnerable populations typically result in the detection of new patients, with the most vulnerable groups being the contacts of index patients, including domestic, neighbor and social contacts 8 , whose risk is dependent on proximity and contact duration, leprosy type of the index patient, and blood relationship. There is now also consensus that M. leprae circulate in the environment of endemic areas. This ecological component has recently been explored in more detail, but its epidemiological significance remains unclear 9 . Other etiological agents such as M. lepromatosis have also been described 10 .Treatment for leprosy has been made available for decades through the WHO to endemic countries, free of charge. Reported stock-outs of the medication are due to logistical issues. To complement the standard MDT, locally procured drugs are needed for special conditions, and to control so-called leprosy reactions.To sum up, by "leprosy" we are referring to a historically endemic, treatable, and curable infectious disease. Therefore, the basic surveillance recommendations are to ensure early diagnosis and

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Accuracy of Enzyme-Linked Immunosorbent Assays (ELISAs) in Detecting Antibodies againstMycobacterium lepraein Leprosy Patients: A Systematic Review and Meta-Analysis

Cited by 17 publications

References 42 publications

Household Contacts of Leprosy Patients in Endemic Areas Display a Specific Innate Immunity Profile

Household Contacts of Leprosy Patients in Endemic Areas Display a Specific Innate Immunity Profile

Leprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients

Perspectives for leprosy control and elimination

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