02843nas a2200397 4500000000100000008004100001260001300042653002600055653003100081653002400112653002300136653001600159653001100175653001200186653002500198653002500223653002500248653003100273100001300304700001300317700001500330700001500345700001100360700001300371700001700384700001500401700001500416700001100431245010000442856007200542300001100614490000700625050001400632520178500646022001402431 2006 d c2006 Mar10aAntibodies, Bacterial10aAntigen-Antibody Reactions10aAntigens, Bacterial10aBacterial Proteins10aGlycolipids10aHumans10aleprosy10aLeprosy, lepromatous10aLeprosy, Tuberculoid10aMycobacterium leprae10aSequence Analysis, Protein1 aReece ST1 aIreton G1 aMohamath R1 aGuderian J1 aGoto W1 aGelber R1 aGroathouse N1 aSpencer JS1 aBrennan PJ1 aReed S00aML0405 and ML2331 are antigens of Mycobacterium leprae with potential for diagnosis of leprosy. uhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1391965/pdf/0365-05.pdf a333-400 v13 aREECE20063 a

Despite the success of multidrug therapy in reducing the number of registered leprosy cases worldwide, evidence suggests that Mycobacterium leprae continues to be transmitted. A serological diagnostic test capable of identifying and allowing treatment of early-stage disease could reduce transmission and prevent the onset of the disability, a common complication of the disease in later stages. Serological diagnosis based on antibody recognition of phenolic glycolipid I (PGL-I) cannot reliably identify individuals with lower bacterial indices (BI). One strategy that might improve this situation is the provision of highly specific serological antigens that may be combined with PGL-I to improve the sensitivity of diagnosis. Using serological expression cloning with a serum pool of untreated lepromatous leprosy (LL) patients, we identified 14 strongly reactive M. leprae proteins, 5 of which were previously unstudied. We present results suggesting that two of these proteins, ML0405 and ML2331, demonstrate the ability to specifically identify LL/borderline lepromatous (BL) patients on the basis of immunoglobulin G (IgG) reactivity. In a household contact study, LL index cases were identified on the basis of this reactivity, while household contacts of these patients demonstrated undetectable reactivity. At a serum dilution of 1:800, suitable to reduce background PGL-I IgM reactivity, two BL patients with a BI of <4 showed anti-human polyvalent immunoglobulin G, A, and M reactivity measured with a combination of ML0405, ML2331, and natural disaccharide O-linked human serum albumin (NDOHSA) (synthetic PGL-I) that was markedly higher than IgM reactivity to NDOHSA alone. We suggest that ML0405 and ML2331 may have utility in serological leprosy diagnosis.

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