Sorologia da hanseníase utilizando PGL-I: revisão sistemática

Abstract

Serology using a species-specific antigen for Mycobacterium leprae, PGL-I, could be a marker for the bacterial load of patients with leprosy. Various studies have identified the potential use of serology in the classification of patients for treatment purposes, case monitoring, identification of the risk of relapse and selection of household contacts with a higher risk of contracting the disease. A systematic review of the literature was conducted and 26 articles were included in this comparative analysis. The results of the use of PGL-I serology in different situations, its limitations and possible applications were evaluated. Studies show the efficacy of PGL-I serology in the classification of patients, treatment monitoring and as a predictive test for leprosy reactions. To improve early diagnosis and follow-up of the population at greatest risk of developing leprosy, the methodologies used in the past have yet to show a favorable cost-benefit ratio, although studies indicate that the use of the test might positively influence leprosy control programs. With simple and robust techniques, the use of PGL-I serology is viable.

Characterization of MicroRNA Expression Profiles and Identification of Potential Biomarkers in Leprosy

“…Currently, the gold standard for leprosy diagnosis is based on clinical examination and skin biopsy. Techniques based on PCR technology and serological analysis have been developed but were not able to diagnose leprosy with acceptable sensitivity and specificity taking into consideration the different clinical forms and/or bacterial burden (11,(14)(15)(16)(18)(19)(20)(21). Accordingly, identification of biomarkers that allow the diagnosis of leprosy with a greater sensitivity and specificity is still needed.…”

“…Molecular techniques using PCR technology and serological tests were developed; however, specificity and sensitivity were limited (11,(14)(15)(16)(17)(18)21). In this context, the identification of biomarkers that allow early diagnosis of leprosy and differentiation between forms of the disease with an adequate sensitivity and specificity is still required.…”

The Analysis of the Mycobacterium Leprae Resistance Against Ofloxacin After the Rifampicin Ofloxacin Minocycline (ROM) Therapy

“…Individuals with IgM anti PGL-1 positive had a 7.2 times higher risk of suffering from leprosy when compared with individuals with IgM anti PGL-1 negative. (16) From the results of polymerase chain reaction (PCR) showed as many as 21 samples (100%) negative results are found gyrA genes mutation. PCR is a new method for detecting the presence of organisms with specific DNA amplification (1) Further development of this PCR is to study the bacterial resistance to treatment.…”

Hanseníase: considerações sobre o desenvolvimento e contribuição (institucional) de instrumento diagnóstico para vigilância epidemiológica

“…O PGL-I identifica pacientes do polo virchowiano que induz à produção de grandes quantidades de anticorpos ou imunoglobulinas do tipo IgM, conferindo soropositividade de 80 a 100%; porém, entre pacientes do polo tuberculoide, ocorre fraca produção de anticorpos IgM ou baixos níveis de detecção, conferindo soropositividade de 30 a 60% 17,18,19,20 .…”

“…Entre os contatos de pacientes com hanseníase, especialmente entre os que residem no mesmo domicílio com algum portador dessa doença, os quais são classificados como contatos intradomiciliares e são soropositivos para anti-PGL-I, existe um maior risco de desenvolverem hanseníase no futuro, comparados aos soronegativos 19 . O estudo de Douglas et al 21 demonstrou um risco 30 vezes maior de o contato positivo ao PGL-I vir a adoecer de hanseníase, comparado ao negativo.…”