03479nas a2200613   4500000000100000008004100001260001300042653001000055653002400065653001500089653001100104653001300115653001100128653001100139653002100150653001200171653000900183653001600192653002500208653001000233653001300243653002500256653003200281653001800313653001600331100001200347700001500359700001400374700001900388700001500407700001100422700001300433700001300446700001600459700001500475700001300490700001400503700001300517700001300530700001400543700001400557700001000571700001200581700001500593700001500608700002200623245009000645856007200735300001000807490000700817050001400824520201300838022001402851       2009                            d  c2009 Mar10aAdult10aAntigens, Bacterial10aBangladesh10aBrazil10aEthiopia10aFemale10aHumans10aInterferon-gamma10aleprosy10aMale10aMiddle Aged10aMycobacterium leprae10aNepal10aPakistan10aRecombinant Proteins10aSensitivity and Specificity10aT-Lymphocytes10aYoung Adult1 aGeluk A1 aSpencer JS1 aBobosha K1 aPessolani MC V1 aPereira GM1 aBanu S1 aHonore N1 aReece ST1 aMacdonald M1 aSapkota BR1 aRanjit C1 aFranken K1 aZewdie M1 aAseffa A1 aHussain R1 aStefani M1 aCho S1 aOskam L1 aBrennan PJ1 aDockrell H1 aIdeal Consortium 00aFrom genome-based in silico predictions to ex vivo verification of leprosy diagnosis.  uhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2650876/pdf/0414-08.pdf  a352-90 v16  aGELUK20093 a<p>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 >or=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.</p>  a1556-679X