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Background Acute inflammatory reactions are a frequently occurring, tissue destructing phenomenon in infectious- as well as autoimmune diseases, providing clinical challenges for early diagnosis. In leprosy, an infectious disease initiated by Mycobacterium leprae (M. leprae), these reactions represent the major cause of permanent neuropathy. However, laboratory tests for early diagnosis of reactional episodes which would significantly contribute to prevention of tissue damage are not yet available. Although classical diagnostics involve a variety of tests, current research utilizes limited approaches for biomarker identification. In this study, we therefore studied leprosy as a model to identify biomarkers specific for inflammatory reactional episodes. Methods To identify host biomarker profiles associated with early onset of type 1 leprosy reactions, prospective cohorts including leprosy patients with and without reactions were recruited in Bangladesh, Brazil, Ethiopia and Nepal. The presence of multiple cyto-/chemokines induced by M. leprae antigen stimulation of peripheral blood mononuclear cells as well as the levels of antibodies directed against M. leprae-specific antigens in sera, were measured longitudinally in patients. Results At all sites, longitudinal analyses showed that IFN-γ-, IP-10-, IL-17- and VEGF-production by M. leprae (antigen)-stimulated PBMC peaked at diagnosis of type 1 reactions, compared to when reactions were absent. In contrast, IL-10 production decreased during type 1 reaction while increasing after treatment. Thus, ratios of these pro-inflammatory cytokines versus IL-10 provide useful tools for early diagnosing type 1 reactions and evaluating treatment. Of further importance for rapid diagnosis, circulating IP-10 in sera were significantly increased during type 1 reactions. On the other hand, humoral immunity, characterized by M. leprae-specific antibody detection, did not identify onset of type 1 reactions, but allowed treatment monitoring instead. Conclusions This study identifies immune-profiles as promising host biomarkers for detecting intra-individual changes during acute inflammation in leprosy, also providing an approach for other chronic (infectious) diseases to help early diagnose these episodes and contribute to timely treatment and prevention of tissue damage. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1128-0) contains supplementary material, which is available to authorized users.

Leprosy epidemiological studies have been restricted to Mycobacterium leprae DNA detection in nasal and oral mucosa samples with scarce literature on peripheral blood. We present the largest study applying quantitative real-time PCR (qPCR) for the detection of M. leprae DNA in peripheral blood samples of 200 untreated leprosy patients and 826 household contacts, with results associated with clinical and laboratory parameters. To detect M. leprae DNA a TaqMan qPCR assay targeting the M. leprae ML0024 genomic region was performed. The ML0024 qPCR in blood samples detected the presence of bacillus DNA in 22.0% (44/200) of the leprosy patients: 23.2% (16/69) in paucibacillary (PB), and 21.4% (28/131) in multibacillary (MB) patients. Overall positivity among contacts was 1.2% (10/826), with similar percentages regardless of whether the index case was PB or MB. After a follow-up period of 7 years, 26 contacts have developed leprosy. Comparing the results of healthy contacts with those that become ill, ML0024 qPCR positivity at the time of diagnosis of their index case represented an impressive 14.78-fold greater risk for leprosy onset (95% CI 3.6–60.8; p

Leprosy transmission still occurs despite the availability of highly effective treatment. The next step towards successfully eliminating leprosy is interrupting the chain of transmission of the aetiological agent, Mycobacterium leprae. In this investigation, we provide evidence that household contacts (HHCs) of leprosy patients might not only have subclinical infections, but may also be actively involved in bacilli transmission. We studied 444 patients and 1,352 contacts using anti-phenolic glycolipid-I (PGL-I) serology and quantitative polymerase chain reaction (qPCR) to test for M. leprae DNA in nasal swabs. We classified the patients according to the clinical form of their disease and the contacts according to the characteristics of their index case. Overall, 63.3% and 34.2% of patients tested positive by ELISA and PCR, respectively. For HHCs, 13.3% had a positive ELISA test result and 4.7% had a positive PCR test result. The presence of circulating anti-PGL-I among healthy contacts (with or without a positive PCR test result from nasal swabs) was considered to indicate a subclinical infection. DNA detected in nasal swabs also indicates the presence of bacilli at the site of transmission and bacterial entrance. We suggest that the concomitant use of both assays may allow us to detect subclinical infection in HHCs and to identify possible bacilli carriers who may transmit and disseminate disease in endemic regions. Chemoprophylaxis of these contacts is suggested.

Although curable, leprosy requires better diagnostic and prognostic tools to accompany therapeutic strategies. We evaluated the serum samples of leprosy patients from Venezuela and Brazil for reactivity against the specific recombinant proteins, ML0405 and ML2331, and the LID-1 fusion protein that incorporates both of these antigens. Antigen-specific IgG was highest in lepromatous leprosy patients (LL) and decreased across the disease spectrum, such that only a small subset of true tuberculoid patients (TT) tested positive. The impact of multidrug therapy (MDT) on these antibody responses was also examined. Several years after treatment, the vast majority of Venezuelan patients did not possess circulating anti-LID-1, anti-ML0405, and anti-ML2331 IgG, and the seropositivity of the remaining cases could be attributed to irregular treatment. At discharge, the magnitude and proportion of positive responses of Brazilian patients against the proteins and phenolic glycolipid (PGL)-I were lower for most of the clinical forms. The monthly examination of IgG levels in LL patient sera after MDT initiation indicated that these responses are significantly reduced during treatment. Thus, responses against these antigens positively correlate with bacillary load, clinical forms, and operational classification at diagnosis. Our data indicate that these responses could be employed as an auxiliary tool for the assessment of treatment efficacy and disease relapse.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:44:58Z No. of bitstreams: 1 S1984-29612009000500005.pdf: 481013 bytes, checksum: 708d048a36a14765b899a4725278c731 (MD5) Made available in DSpace on 2013-08-22T18:44:58Z (GMT). No. of bitstreams: 1 S1984-29612009000500005.pdf: 481013 bytes, checksum: 708d048a36a14765b899a4725278c731 (MD5) Previous issue date: 2009-12-01 Made available in DSpace on 2013-09-30T17:54:57Z (GMT). No. of bitstreams: 2 S1984-29612009000500005.pdf: 481013 bytes, checksum: 708d048a36a14765b899a4725278c731 (MD5) S1984-29612009000500005.pdf.txt: 25087 bytes, checksum: d5b7b5d89990430740eccde11cbba139 (MD5) Previous issue date: 2009-12-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T13:15:24Z No. of bitstreams: 2 S1984-29612009000500005.pdf: 481013 bytes, checksum: 708d048a36a14765b899a4725278c731 (MD5) S1984-29612009000500005.pdf.txt: 25087 bytes, checksum: d5b7b5d89990430740eccde11cbba139 (MD5) Made available in DSpace on 2014-05-20T13:15:24Z (GMT). No. of bitstreams: 2 S1984-29612009000500005.pdf: 481013 bytes, checksum: 708d048a36a14765b899a4725278c731 (MD5) S1984-29612009000500005.pdf.txt: 25087 bytes, checksum: d5b7b5d89990430740eccde11cbba139 (MD5) Previous issue date: 2009-12-01 Considerando a importância da neosporose interferindo na produtividade animal, avaliou-se a frequência de anticorpos anti-Neospora caninum em amostras de soros de bovinos leiteiros da Região Sudoeste do Estado de Mato Grosso, Brasil, complementando-se com amostras sorológicas colhidas de cães e de humanos que conviviam nas mesmas propriedades rurais amostradas. Um total de 1.036 amostras de soros foram analisadas, sendo 932 de fêmeas bovinas leiteiras, 37 de cães e 67 de humanos, provenientes de 24 propriedades e examinados por meio da reação de imunofluorescência indireta (RIFI). As amostras de soros humanos reagentes foram testadas novamente por Western-blotting para confirmação dos resultados. Anticorpos anti-N. caninum foram encontrados em 499 bovinos (53,5%), em pelo menos um animal positivo por propriedade, em 25 caninos (67,6%) e em sete humanos (10,5%). Não houve diferença significativa no número de bovinos positivos por faixa etária. Os resultados obtidos indicam uma ampla disseminação de N. caninum na região estudada. Considering the importance of neosporosis in the animal health and production, the frequency of antibodies to Neospora caninum was evaluated in dairy cattle of the Southwestern region of Mato Grosso State, Brazil, in addition to serum samples obtained from dogs and humans living in the farms. A total of 1036 serum samples were analyzed, from which 932 were from dairy bovine females, 37 from dogs and 67 from humans, from 24 farms and examined by the indirect fluorescent antibody test (IFAT). Reactive human serum samples were retested by Western-blotting to confirm the results. Antibodies to N. caninum were found in 499 cattle sera (53.5 %), with at least one positive in each farm, 25 dog sera (67.6 %) and seven human sera (10.5 %). There was no significant difference in the number of positive cattle sera according to age group. The results indicate a wide dissemination of N. caninum in the studied region. Universidade de Cuiabá Faculdade de Medicina Veterinária Universidade Estadual Paulista Faculdade de Ciências Agrárias e Veterinárias Centro de Pesquisas em Sanidade Animal Universidade Estadual Paulista Faculdade de Ciências Agrárias e Veterinárias Departamento de Medicina Veterinária Preventiva e Reprodução Animal Universidade Federal de Uberlândia Instituto de Ciências Biomédicas Laboratório de Imunoparasitologia Universidade de São Paulo Faculdade de Medicina Veterinária e Zootecnia Departamento de Medicina Veterinária Preventiva e Saúde Animal Universidade Estadual Paulista Faculdade de Ciências Agrárias e Veterinárias Centro de Pesquisas em Sanidade Animal Universidade Estadual Paulista Faculdade de Ciências Agrárias e Veterinárias Departamento de Medicina Veterinária Preventiva e Reprodução Animal

Considering the importance of neosporosis in the animal health and production, the frequency of antibodies to Neospora caninum was evaluated in dairy cattle of the Southwestern region of Mato Grosso State, Brazil, in addition to serum samples obtained from dogs and humans living in the farms. A total of 1036 serum samples were analyzed, from which 932 were from dairy bovine females, 37 from dogs and 67 from humans, from 24 farms and examined by the indirect fluorescent antibody test (IFAT). Reactive human serum samples were retested by Western- blotting to confirm the results. Antibodies to N. caninum were found in 499 cattle sera (53.5%), with at least one positive in each farm, 25 dog sera (67.6%) and seven human sera (10.5%). There was no significant difference in the number of positive cattle sera according to age group. The results indicate a wide dissemination of N. caninum in the studied region.

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2014-02-26T17:24:16Z No. of bitstreams: 1 WOS000235369300010.pdf: 231346 bytes, checksum: 5213f2e7aec23c3c699a871a8995b890 (MD5) Made available in DSpace on 2014-02-26T17:24:16Z (GMT). No. of bitstreams: 1 WOS000235369300010.pdf: 231346 bytes, checksum: 5213f2e7aec23c3c699a871a8995b890 (MD5) Previous issue date: 2006-01-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:30:14Z No. of bitstreams: 1 WOS000235369300010.pdf: 231346 bytes, checksum: 5213f2e7aec23c3c699a871a8995b890 (MD5) Made available in DSpace on 2014-05-20T15:30:14Z (GMT). No. of bitstreams: 1 WOS000235369300010.pdf: 231346 bytes, checksum: 5213f2e7aec23c3c699a871a8995b890 (MD5) Previous issue date: 2006-01-01 Considering that little is known about the epidemiology of Neospora caninum infection in humans, particularly in populations with high Toxoplasma gondii infection rates, the present study aimed to investigate the presence of antibodies to N. caninum in T. gondii-seropositive and -seronegative individuals. A total of 256 serum samples divided into four groups (61 samples from human immunodeficiency virus [HIV]-positive patients, 50 samples from patients with neurological disorders, 91 samples from newborns, and 54 samples from healthy subjects) were assessed for N. caninum and T. gondii serologies by indirect fluorescent-antibody test, enzyme-linked immunosorbent assay, and immunoblotting (IB). Immunoglobulin G antibodies to N. caninum were predominantly detected in HIV-infected patients (38%) and patients with neurological disorders (18%), while newborns and healthy subjects showed lower seropositivity rates (5% and 6%, respectively). Seropositivity to N. caninum was significantly associated with seropositivity to T. gondii in both HIV-infected patients and patients with neurological disorders. Seroreactivity to N. caninum was confirmed by IB, with positive sera predominantly recognizing the 29-kDa antigen of N. caninum. The results of this study indicate the presence of N. caninum infection or exposure in humans, particularly in HIV-infected patients or patients with neurological disorders, who could have opportunistic and concurrent infections with T. gondii. These findings may bring a new concern for the unstable clinical health of HIV-infected patients and the actual role of N. caninum infection in immunocompromised patients. Universidade Federal de Uberlândia (UFU), Immunol Lab, BR-38400902 Uberlandia, MG, Brazil Universidade Federal de Uberlândia (UFU), Parasitol Lab, BR-38400902 Uberlandia, MG, Brazil Universidade Federal de Uberlândia (UFU), Clin Hosp, Sect Infect Dis, BR-38400902 Uberlandia, MG, Brazil UNESP, FCAV, Lab Immunoparasitol, Jaboticabal, SP, Brazil UNESP, FCAV, Lab Immunoparasitol, Jaboticabal, SP, Brazil

Diagnosis of Neospora caninum infection in dogs is based on serological assays such as the indirect fluorescent antibody test (IFAT) and enzyme-linked immunosorbent assays (ELISA). This study evaluated two serological tests (IFAT and ELISA) for the detection of IgG antibodies to N. caninum in 300 serum samples of dogs through the optimization of cut off titers by using the two-graph receiver-operating characteristic (TG-ROC) curve. In addition, the identification of major cross-reactive antigens with Toxoplasma gondii was investigated by inhibition ELISA and immunoblotting (IB) assays. IFAT and ELISA results showed 74% agreement, with a good negative concordance (P(neg)=0.83), but a poor positive concordance (P(pos)=0.42). The great majority (86%) of sera with positive concordant results (IFAT+/ELISA+) recognized at least two out of three N. caninum immunodominant antigens, particularly the 29-32 and 35-37 kDa bands. Optimization of cut off titers in IFAT and ELISA was performed considering the reactivity to at least two out of three N. caninum immunodominant antigens as infection markers, obtaining a titer of 50 for IFAT and 200 for ELISA. Seropositivity to N. caninum was significantly associated with T. gondii-seropositive samples, particularly in ELISA (55.4%). Inhibition ELISA curves for N. caninum showed a partial heterologous inhibition, indicating some degree of cross-reactivity between N. caninum and T. gondii antigens. Inhibition IB assays showed a moderate heterologous inhibition for N. caninum antigens above 45-50 kDa. These results indicate that ELISA should be used critically when crude tachyzoite antigen preparations are employed, due to possible cross-reactivity with other related parasites as T. gondii. Also, the cut off dilution of 1:50 in IFAT showed to be the most appropriated for N. caninum serology in dogs. Therefore, we suggest that N. caninum immunodominant antigens, specially the 17 and 29-32 kDa proteins, should be selected markers in serological assays for canine neosporosis.

Our aim was to compare the performance of three serological assays in leprosy patients and their household contacts utilising two quantitative ELISA tests using native PGL-I (PGL-1 ELISA), synthetic ND-O-HSA (ND-O-HSA ELISA), and the semi-quantitative lateral flow test (ML Flow).Comparisons among three immunological assays, PGL-I ELISA, ND-O-HSA ELISA, and ML Flow were performed in 154 leprosy patients, 191 household contacts and 52 health subjects.The sensitivity results of the PGL-1, ND-O-HSA, and ML Flow were 68.83%, 63.84%, and 60.65%, respectively, with specificity of 98% for both ELISA assays. The native and synthetic PGL-I ELISA assays detected antibodies in 22.73% and 31.82% of the paucibacillary (PB) patients, respectively and the ML Flow test did not detect antibodies in this group. The ML Flow test was able to discriminate patients into PB or multibacillary (MB) forms, while the native PGL-I and ND-O-HSA was correlated with the bacillary load and the Ridley-Jopling clinical forms. In household contacts, the native PGL-I, ND-O-HSA, and ML Flow assays detected seropositivity of 25%, 17%, and 10%, respectively.The use of ELISA and ML Flow tests are thus recommended as additional tools in the diagnosis and classification of the clinical forms, aiding in prescribing the correct treatment regimen to prevent subsequent nerve damage and disability, and besides, the PGL-I ELISA may be used to detect subclinical infection in leprosy.