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Clinical and Vaccine Immunology, March 2009, p. 352-359, Vol. 16, No. 3
1071-412X/09/$08.00+0     doi:10.1128/CVI.00414-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

From Genome-Based In Silico Predictions to Ex Vivo Verification of Leprosy Diagnosis ^,

Annemieke Geluk,^1* John S. Spencer,² Kidist Bobosha,⁹ Maria C. V. Pessolani,³ Geraldo M. B. Pereira,^3,4 Sayera Banu,⁵ Nadine Honoré,⁶ Stephen T. Reece,⁷ Murdo MacDonald,⁸ Bishwa Raj Sapkota,⁸ Chaman Ranjit,⁸ Kees L. M. C. Franken,¹ Martha Zewdie,⁹ Abraham Aseffa,⁹ Rabia Hussain,¹⁰ Mariane M. Stefani,¹¹ Sang-Nae Cho,¹² Linda Oskam,¹³ Patrick J. Brennan,² Hazel M. Dockrell,^8,14 on behalf of the IDEAL Consortium

Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands,¹ Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado,² Laboratory of Cellular Microbiology, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil,³ Laboratory of Immunopathology, School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil,⁴ International Center for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh,⁵ Institute Pasteur, Paris, France,⁶ Infectious Disease Research Institute, Seattle, Washington,⁷ Mycobacterial Research Laboratory, Anandaban Hospital, Anandaban, Nepal,⁸ Armauer Hansen Research Institute, Addis Ababa, Ethiopia,⁹ Aga Khan University, Karachi, Pakistan,¹⁰ Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Brazil,¹¹ Yonsei University, Seoul, South Korea,¹² Royal Tropical Institute, Amsterdam, The Netherlands,¹³ London School of Hygiene & Tropical Medicine, London, United Kingdom,¹⁴

Received 8 November 2008/ Returned for modification 3 December 2008/ Accepted 23 December 2008

The detection of hundreds of thousands of new cases of leprosy every year suggests that transmission of Mycobacterium leprae infection still continues. Unfortunately, tools for identification of asymptomatic disease and/or early-stage M. leprae infection (likely sources of transmission) are lacking. The recent identification of M. leprae-unique genes has allowed the analysis of human T-cell responses to novel M. leprae antigens. Antigens with the most-promising diagnostic potential were tested for their ability to induce cytokine secretion by using peripheral blood mononuclear cells from leprosy patients and controls in five different areas where leprosy is endemic; 246 individuals from Brazil, Nepal, Bangladesh, Pakistan, and Ethiopia were analyzed for gamma interferon responses to five recombinant proteins (ML1989, ML1990, ML2283, ML2346, and ML2567) and 22 synthetic peptides. Of these, the M. leprae-unique protein ML1989 was the most frequently recognized and ML2283 the most specific for M. leprae infection/exposure, as only a limited number of tuberculosis patients responded to this antigen. However, all proteins were recognized by a significant number of controls in areas of endemicity. T-cell responses correlated with in vitro response to M. leprae, suggesting that healthy controls in areas where leprosy is endemic are exposed to M. leprae. Importantly, 50% of the healthy household contacts and 59% of the controls in areas of endemicity had no detectable immunoglobulin M antibodies to M. leprae-specific PGL-I but responded in T-cell assays to 1 M. leprae protein. T-cell responses specific for leprosy patients and healthy household contacts were observed for ML2283- and ML0126-derived peptides, indicating that M. leprae peptides hold potential as diagnostic tools. Future work should concentrate on the development of a sensitive and field-friendly assay and identification of additional peptides and proteins that can induce M. leprae-specific T-cell responses.

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* Corresponding author. Mailing address: Department of Infectious Diseases, LUMC, P.O. Box 9600, 2300 RC Leiden, The Netherlands. Phone: 31-71-526-3800. Fax: 31-71-526-1974. E-mail: a.geluk{at}lumc.nl

Published ahead of print on 28 January 2009.

Supplemental material for this article may be found at http://cvi.asm.org/.

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Clinical and Vaccine Immunology, March 2009, p. 352-359, Vol. 16, No. 3
1071-412X/09/$08.00+0     doi:10.1128/CVI.00414-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.