The effects of chemotherapy on antibody levels in lepromatous patients

Abstract

We compare whole cell ELISA antigens (Mycobacterium leprae) and two specific antigens: PG-I, phenolic glycolipid I of M. leprae and M-BGG, a synthetic antigen representing the terminal sugar ofPG-1 for their effectiveness in detecting anti body during chemotherapy. By the end of the 1 st year of treatment, antibody levels to M-BGG had declined by 42% of the initial EL ISA values, by the end of the 2nd year by 61 % and at the end of 3 years by 68%. Declines of similar magnitude were seen with the other antigens. We examined these sera by RID for changes in levels of IgG, IgM and IgA antibodies. The levels of IgG remained abnormally high throughout the 3 years of antimicrobial therapy. The serum levels of IgM and IgA antibodies remained at the upper limits of normal range. The decline seen with antibody to M. leprae antigens was not reflected by a similar decline of serum immunoglobulin levels. Thus, application of ELISA monitoring during the course of treatment may be valuable in measuring the effectiveness of chemotherapy.

Purification and Characterization of a 36 kDa Antigen of Mycobacterium leprae

“…However, since these subjects were from an endemic area, we cannot exclude the possibility that they had been infected with M. leprae. Higher seropositivity rates in control subjects from endemic areas compared to those from nonendemic areas have been reported before in studies using the 36 kDa antigen (Klatser et al, 1985) or the phenolic glycolipid antigen of M. leprae (Douglas et al, 1987). The results of this pilot study showed a positive correlation (Pearson correlation test, P < 0.01)…”

Application of RLEP Real-Time PCR for Detection of M. leprae DNA in Paraffin-Embedded Skin Biopsy Specimens for Diagnosis of Paucibacillary Leprosy

“…2 Serological tests based on specific M. leprae antigens do not detect all clinical cases because most of the patients at the paucibacillary (PB) stage of infection do not develop significant levels of antibody response. 3,4 This group potentially consists of patients with diverse clinical, bacteriological, and histopathological features. Frequently, M. leprae cannot be detected in the tissues of early lesions, histopathology can be non-specific, clinical findings are inconclusive, and patient histories can be unreliable, making diagnosis of early stage leprosy very difficult.…”

Use of anti-PGL-1 antibodies to monitor therapy regimes in leprosy patients

“…It has been repeatedly shown that macrophages in MB leprosy patients are not able to clear M. leprae efficiently from lesions because dead organisms and their fragments continue to persist even after the end of treatment (21). Furthermore, in lepromatous patients under therapy, the duration of treatment seems to be a very important factor for the development of anti-PGL-1 levels, since patients treated for as long as 18 months had positive anti-PGL-1 levels, whereas patients treated for a long time (5 years or more) had normal antibody levels (11). A serologic test for the diagnosis of subclinical infection and for therapeutic follow-up has been applied, despite the high specificity and controversies surrounding the correlation of high levels of anti-PGL-1 antibodies with active, previous or future disease (11,12).…”

“…Serology could provide a method to monitor leprosy patients under treatment since the levels of anti-PGL-1 antibodies decrease during the administration of specific therapy (1). A serologic test for the diagnosis of subclinical infection and therapeutic follow-up has been applied, despite the high specificity and controversies surrounding the correlation of high levels of anti-PGL-1 antibodies with active, previous or future disease (11,12).…”