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. 2022 Dec;116(8):477-484.
doi: 10.1080/20477724.2021.2021045. Epub 2022 Jan 2.

Can anti-PGL-I antibody isotypes differentiate leprosy contacts and leprosy patients?

Andressa Almeida Albuquerque  1 , Camilla Dos Santos Mateus  1 , Raphael de Oliveira Rodrigues  1 , Évely Sampaio Lima  1 , Lucas Oliveira Lima  1 , Rayane Lima da Silva  2 , Maria Amanda Mesquita Fernandes  2 , Alexandre Casimiro de Macedo  1 , Clódis Maria Tavares  3 , Paula Sacha Frota Nogueira  2 , Aparecida Tiemi Nagao-Dias  1
Affiliations

Can anti-PGL-I antibody isotypes differentiate leprosy contacts and leprosy patients?

Andressa Almeida Albuquerque et al. Pathog Glob Health. 2022 Dec.

Abstract

Background: Serological tests for antibody measurement in leprosy have a series of limitations in discriminating contacts and patients. The present paper intends to evaluate if association of more than one antibody isotype in serum samples may be a useful tool in leprosy diagnosis.

Methods: This study evaluated 395 leprosy contacts and 71 leprosy index cases living in endemic municipalities in Northeastern Brazil. The participants were evaluated according to their anti-phenolic glycolipid antigen-I isotype (PGL-I) profile. Serum anti-PGL-I IgM, IgG, and IgA were measured by indirect ELISA.

Results: A strong association was found for antibody positivity in MB leprosy index cases. The odds ratios were 6.11 (95% CI 3.08 - 12.16) for IgM, 3.31 (1.66 - 6.61) for IgG, and 16.97 (8.39 - 34.2) for IgA. For IgM associated with one or more isotypes, the OR was 21.0 (95% CI 10.11 - 43.64), and for IgG + IgA, the OR was 17.58 (6.23 - 49.54). The highest diagnostic sensitivity of 76.0% (95% CI 61.8 - 86.9) was observed for IgM, and the lowest value was 24.1% (13.0 - 38.2), which was observed for IgG + IgA isotypes. Regarding presumptive positive predictive values, the lowest value was obtained for IgM at 24.7% (95% CI 18.1 - 32.3), and the highest values were observed for IgM+ one or more isotypes and for IgG + IgA isotype at 60.0% (44.3 - 74.3) and 66.7% (41.0 - 86.7), respectively.

Conclusions: The present work demonstrated that by associating two or more positive antibody isotypes, the risk of facing a real case of leprosy may increase.

Keywords: Leprosy contacts; anti-PGL-I; serum IgA; serum IgG; serum IgM.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Interquartile ranges and medians of anti-PGL-I IgM, IgG, and IgA levels in serum samples from MB (multibacillary) contacts without lesions/MB healthy contacts (HC; N = 251), MB contacts with suspected lesions (LC; N = 32), and MB leprosy index cases (IC; N = 50). The cutoff values were 1.1 for IgA and 1.2 for IgG and IgM isotypes.
Figure 2.
Figure 2.
Interquartile ranges and medians of anti-PGL-I IgM, IgG, and IgA levels in serum samples from PB (paucibacillary) contacts without lesions/PB healthy contacts (HC; N = 89), PB contacts with suspected lesions (LC; N = 23), and PB leprosy index cases (IC; N = 21). The cutoff values were 1.1 for IgA and 1.2 for IgG and IgM isotypes.
Figure 3.
Figure 3.
Interquartile ranges and medians of anti-PGL-I IgM, IgG, and IgA levels in serum samples from MB (multibacillary) contacts who were household (HH, N = 6), or MB peridomicilliary contacts (PD, N = 26), and MB leprosy index cases (N = 50). The cutoff values were 1.1 for IgA and 1.2 for IgG and IgM isotypes.
Figure 4.
Figure 4.
Interquartile ranges and medians of anti-PGL-I IgM, IgG, and IgA levels in serum samples from PB (paucibacillary) household contacts (HH, N = 14), PB peridomicilliary contacts (PD, N = 14), and PB leprosy index cases (N = 21). The cutoff values were 1.1 for IgA and 1.2 for IgG and IgM isotypes.
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