Leprosy Diagnostic Test Development As a Prerequisite Towards Elimination: Requirements from the User’s Perspective

Bahmanyar, Édith Roset; Smith, W. C.; Brennan, Patrick J.; Cummings, Ray; Duthie, Malcolm S.; Richardus, Jan Hendrik; Saunderson, Paul; Shwe, Tin; Rosen, Steven L.; Geluk, Annemieke

doi:10.1371/journal.pntd.0004331

Cited by 27 publications

(24 citation statements)

References 22 publications

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“…The obvious incessant transmission of M. leprae has brought about increased focus in leprosy research on discovery of biomarkers to improve diagnosis. Nevertheless, thus far only few biomarkers for leprosy are recommended by expert panels 11 . Consequently, there is a growing need for new and sensitive diagnostic tools based on specific biomarkers which should, ideally, allow straightforward translation into field-friendly tests.…”

Section: Discussionmentioning

confidence: 99%

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Quantitative lateral flow strip assays as User-Friendly Tools To Detect Biomarker Profiles For Leprosy

Hooij

Fat

Richardus

et al. 2016

Sci Rep

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Leprosy is a debilitating, infectious disease caused by Mycobacterium leprae. Despite the availability of multidrug therapy, transmission is unremitting. Thus, early identification of M. leprae infection is essential to reduce transmission. The immune response to M. leprae is determined by host genetics, resulting in paucibacillary (PB) and multibacillary (MB) leprosy associated with dominant cellular or humoral immunity, respectively. This spectral pathology of leprosy compels detection of immunity to M. leprae to be based on multiple, diverse biomarkers. In this study we have applied quantitative user friendly lateral flow assays (LFAs) for four immune markers (anti-PGL-I antibodies, IL-10, CCL4 and IP-10) for whole blood samples from a longitudinal BCG vaccination field-trial in Bangladesh. Different biomarker profiles, in contrast to single markers, distinguished M. leprae infected from non-infected test groups, patients from household contacts (HHC) and endemic controls (EC), or MB from PB patients. The test protocol presented in this study merging detection of innate, adaptive cellular as well as humoral immunity, thus provides a convenient tool to measure specific biomarker profiles for M. leprae infection and leprosy utilizing a field-friendly technology.

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Section: Discussionmentioning

confidence: 99%

“…These hurdles contributed to the current lack of tests for detection of asymptomatic M. leprae infection and diagnosis of early stage leprosy 11 . As clinical resistance to commonly used antibiotics in leprosy treatment is increasingly occurring 12 13 , such tests should be highly specific to prevent redundant use of antibiotics.…”

mentioning

confidence: 99%

Quantitative lateral flow strip assays as User-Friendly Tools To Detect Biomarker Profiles For Leprosy

Hooij

Fat

Richardus

et al. 2016

Sci Rep

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“…61 There is a clear need for inexpensive point-of-care diagnostic tests that are highly specific and sensitive, can detect subclinical infection, and could be used either to confirm diagnosis in people with suspected leprosy lesions or to screen contacts of index patients or other population groups at a high risk for leprosy. 62,63 Serological test kits often rely on the measurement of antibodies against phenolic glycolipid (PGL)-I. However, anti-PGL-I antibody levels are often detected at low titers in PB leprosy patients.…”

Section: Diagnostic Toolsmentioning

confidence: 99%

Innovative tools and approaches to end the transmission of Mycobacterium leprae

Steinmann

Reed

Mirza

et al. 2017

The Lancet Infectious Diseases

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Leprosy control has seen little innovation and only limited progress in the past decade. However, research on the disease has increased and important innovations are underway. Here, we comment on efforts to develop tools and approaches to detect leprosy and to stop the transmission of Mycobacterium leprae, the causative bacillus of the disease. The tracing and screening of contacts of known patients with leprosy promises to strengthen early diagnosis, while preventive chemotherapy will reduce the risk of contacts developing the disease by 50-60% within 2 years of administration. Until now, diagnosis has been mainly based on the presence of signs and symptoms, but efforts are underway to develop inexpensive, reliable, point-of-care tests to diagnose infection. Development of a leprosy-specific vaccine that boosts long-lasting T-cell responses is also a research objective. As for launching a programme to interrupt transmission, two interlinked tools-epidemiological modelling and the concept of an investment case-are being developed to explore the feasibility and costs of such a programme and its overall effect on individuals and society. We believe that sustained innovation is needed and that only a combination of tools and approaches holds promise to end M leprae transmission.

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“…En tal sentido, un grupo de expertos en lepra, los investigadores que más saben del problema en el mundo, recientemente emitieron el concepto en PLoS NTD 10 , explicando claramente que para eliminar la lepra se requiere contar con un test serológico con unas características dadas que debe ser aplicado como tamiz a la población expuesta.…”

Section: Titulo Corto: Vigilancia Epidemiológica De Lepraunclassified

Vigilancia epidemiológica de lepra aplicable a sitios de baja prevalencia: una necesidad vigente

Guerrero

2017

Infect

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Cómo citar este artículo: Guerrero MI. Vigilancia epidemiológica de lepra aplicable a sitios de baja prevalencia: una necesidad vigente. Infectio 2016. http://dx.doi.org/10.22354/in.v21i1.634 TITULO CORTO: Vigilancia epidemiológica de lepraSi bien es cierto que la lepra es la menos contagiosa de las enfermedades transmisibles, no deja de ser una enfermedad infecto-contagiosa y como tal debe manejarse. Se debe subrayar que el daño del nervio periférico se presenta en todos los individuos infectados con el Mycobacterium leprae y que en términos cuantitativos se ha reportado que más del 60% de los casos hay daño del nervio periférico al momento del diagnóstico 1 . Este es un hallazgo lógico, si se tiene en cuenta que el bacilo de Hansen presenta un tropismo exquisito por los nervios periféricos adonde llega invadiendo las células de Schwann, causando su desmielinización 2 . Por lo tanto el pronto diagnóstico y tratamiento es el único método para impedir que la discapacidad neurológica avance y se torne irreversible 3 .Es importante recordar que SIVIGILA reportó en Colombia 444 casos nuevos de lepra en 2014, provenientes de 195 municipios y aunque se considere un número bajo, lo preocupante es que en estos municipios habita el 66% de la población colombiana, lo cual quiere decir que en Colombia casi el 70% de la población estaría expuesta al bacilo y con posibilidad de infectarse. Sin embargo, en nuestro país nos contentamos con repetir que "se eliminó la lepra en Colombia" 4 , desconociendo que muy seguramente los municipios que no reportan casos nuevos son los más pobres y no tienen la infraestructura y capacidad técnica para hacer la notificación de casos. Es interesante que a escala global, actualmente se haya retomado el tema, por algún tiempo olvidado en los países desarrollados, y es que si revisamos la literatura veremos como en España 5 , Italia 6 , Suiza 7 y USA 8 , entre otros, se han incrementado o han resurgido los reportes de casos de esta enfermedad, siendo países en los que había desaparecido y es con certeza que este resurgimiento se puede explicar como resultado de las migraciones.En este contexto, ya es claro para el mundo, que por ser una enfermedad asociada con la pobreza de las comunidades y por lo tanto desatendida, es necesario contar con herramientas que ayuden a su pronta sospecha y diagnóstico, lo cual sin duda alguna, se lograría realizando vigilancia epidemiológica con pruebas moleculares y especialmente las serológicas 9 . En tal sentido, un grupo de expertos en lepra, los investigadores que más saben del problema en el mundo, recientemente emitieron el concepto en PLoS NTD 10 , explicando claramente que para eliminar la lepra se requiere contar con un test serológico con unas características dadas que debe ser aplicado como tamiz a la población expuesta.Investigadores de los países donde la lepra es endémica, nacionales 11 e internacionales 12 ya habían visualizado la conveniencia de realizar vigilancia epidemiológica con pruebas serológicas simples y rápidas aplicables a la población ...

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Leprosy Diagnostic Test Development As a Prerequisite Towards Elimination: Requirements from the User’s Perspective

Cited by 27 publications

References 22 publications

Quantitative lateral flow strip assays as User-Friendly Tools To Detect Biomarker Profiles For Leprosy

Quantitative lateral flow strip assays as User-Friendly Tools To Detect Biomarker Profiles For Leprosy

Innovative tools and approaches to end the transmission of Mycobacterium leprae

Vigilancia epidemiológica de lepra aplicable a sitios de baja prevalencia: una necesidad vigente

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