01508nas a2200169   4500000000100000008004100001100001400042700001100056700001300067700001200080700001100092245007900103300001000182490000700192520112500199022001401324       2016                            d1 aSouza VNB1 aIyer A1 aLammas D1 aNaafs B1 aDas PK00aAdvances in leprosy immunology and the field application: A gap to bridge.  a82-950 v343 a<p>Advances concerning the hosts' immune response to Mycobacterium leprae infection have focused on elucidating the immune pathomechanisms involved, with the hope that predictive diagnostic and prognostic parameters (biomarkers) for field use would emerge; however, improvements in our understanding of the immunologic responses to this complex disease have, to date, somewhat failed to provide the effective and robust methods for improving its predictive diagnosis in the field situation, particularly in those patients suffering from paucibacillary disease. In this contribution we have attempted to review some of the advances both in the immunology and immunopathology of leprosy, and also highlight the limited clusters of immune parameters that are now available. Most importantly, we point out the limitations that still prevail in the provision of effective biomarkers in the field situation for either: (1) the diagnosis of indeterminate disease, (2) predictive diagnosis of individuals developing reactional states, (3) monitoring efficacy of treatment, or (4) monitoring treatment of reactional states.</p>
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