Molecular, immunological and neurophysiological evaluations for early diagnosis of neural impairment in seropositive leprosy household contacts.
In: PLoS Neglected Tropical Diseases, Jg. 12 (2018-05-21), Heft 5, S. 1-12
Online
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Zugriff:
Background: Household contacts constitute the highest risk group for leprosy development, and despite significant progress in the disease control, early diagnosis remains the primary goals for leprosy management programs. Methods: We have recruited 175 seropositive and 35 seronegative household contacts from 2014 to 2016, who were subjected to an extensive protocol that included clinical, molecular (peripheral blood qPCR, slit-skin smear qPCR, skin biopsy qPCR) and electroneuromyographic evaluations. Results/Principal findings: The positivity of peripheral blood qPCR of seropositive contacts was 40.6% (71/175) whereas only 8.6% (3/35) were qPCR positive in seronegative contacts (p = 0.0003). For the slit-skin smear, only 4% (7/175) of seropositive contacts presented positive bacilloscopy, whereas the qPCR detected 47.4% (83/175) positivity in this group compared with only 17.1% (6/35) in seronegative contacts (p = 0.0009). In the ENMG evaluation of contacts, 31.4% (55/175) of seropositives presented some neural impairment, and 13.3% (4/35) in seronegatives (p = 0.0163). The presence of neural thickening conferred a 2.94-fold higher chance of ENMG abnormality (p = 0.0031). Seropositive contacts presented a 4.04-fold higher chance of neural impairment (p = 0.0206). The peripheral blood qPCR positivity presented odds 2.08-fold higher towards neural impairment (OR, 2.08; p = 0.028). Contrarily, the presence of at least one BCG vaccine scar demonstrated 2.44-fold greater protection against neural impairment (OR = 0.41; p = 0.044). Conclusions/Sgnificance: ELISA anti-PGL-I is the most important test in determining the increased chance of neural impairment in asymptomatic leprosy household contacts. The combination of the two assays (ELISA anti-PGL-I and peripheral blood qPCR) and the presence of BCG scar may identify individuals with higher chances of developing leprosy neuropathy, corroborating with the early diagnosis and treatment. [ABSTRACT FROM AUTHOR]
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Molecular, immunological and neurophysiological evaluations for early diagnosis of neural impairment in seropositive leprosy household contacts.
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Autor/in / Beteiligte Person: | Santos, Diogo Fernandes dos ; Mendonça, Matheus Rocha ; Antunes, Douglas Eulálio ; Sabino, Elaine Fávaro Pípi ; Pereira, Raquel Campos ; Goulart, Luiz Ricardo ; Goulart, Isabela Maria Bernardes |
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Zeitschrift: | PLoS Neglected Tropical Diseases, Jg. 12 (2018-05-21), Heft 5, S. 1-12 |
Veröffentlichung: | 2018 |
Medientyp: | academicJournal |
ISSN: | 1935-2727 (print) |
DOI: | 10.1371/journal.pntd.0006494 |
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