ANTI M. leprae IgM ANTIBODY DETERMINATION BY ULTRAMICROIMMUNOENZYMATIC (UMELISA HANSEN) FOR THE DIAGNOSIS AND MONITORING LEPROSY

Abstract

The relationship between the IgM antibody response, antigenic load as well as the clinical improvement after chemotherapy was studied in order to obtain useful data for the early diagnosis and monitoring leprosy. A level of 82% (94/115) agreement was obtained between IgM UMELISA HANSEN and slit-skin smear examination. Discrepant results were observed in 16 patients who showed positive IgM response despite negative by the skin smear examination. In these patients, the IgM response was seen to be associated to the early signal for bacilli recurrence in the skin. In one of these patients the presence of bacilli was demonstrated in the skin, two months after IgM antibodies being detected by UMELISA HANSEN. Also in one of the treated patients positive by both diagnostic techniques, a remarkable decrease in the IgM antibody levels was seen, correlating with a significant clinical improvement. Moreover it was found a direct relationship between the IgM antibody response and bacterial antigenic load, regardless the time elapsed in the disease's evolution.

Pesquisa de anticorpos anti PGL-I através de ELISA em tatus selvagens do Brasil

“…This difference between these two polar forms occurs because the lepromatous form (MB) presents deterioration of the cellular immunity, a high antigenic load and high antibody levels, while the tuberculoid form (PB) presents intact parameters of cellular immunity, few bacilli and minimal elevation or no increase in antibody levels. This particular aspect of the polar disease means serology is mainly designated for MB diagnosis 19 . PB leprosy in the armadillo means subclinical infection, since few animals develop clinical signs of leprosy even when they are considered to present the lepromatous form (MB).…”