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Challenges in immunodiagnostic tests for leprosy
1Leiden University Medical Center (LUMC), Department of Infectious Diseases, Leiden, The Netherlands. a.geluk@lumc.nl
Introduction:
Despite the effectiveness of multidrug therapy, leprosy still represents a significant global health problem: transmission of Mycobacterium leprae (M. leprae) is not sufficiently reduced as witnessed by unwavering new case rates in leprosy-endemic countries. Early detection of M. leprae infection (before clinical manifestations occur) is vital to reduction of transmission. Current diagnosis relies on detection of clinical signs since there are no tests available to detect asymptomatic M. leprae infection or predict progression to leprosy.
Areas Covered:
Identification of risk factors (immunological or genetic biomarkers) for disease development and/or onset of leprosy reactions is imperative for efficient diagnosis. Tests simultaneously detecting biomarkers specific for cellular and humoral immunity are well suited for diagnosis of different clinical outcomes of leprosy. This review describes the challenges of discovery of biomarkers for M. leprae infection and their implementation in field-friendly tests.
Expert Opinion:
In view of the complicated nature of M. leprae infections, it is essential to invest in longitudinal studies allowing intra-individual comparison of immune and genetic biomarkers in various leprosy-endemic areas. Furthermore, the effect of co-infections on biomarker profiles should also be taken into account. Diagnostic tests based on such biomarkers can contribute significantly to early detection of leprosy (reactions) thus helping reduce nerve damage.
Insights
Early detection of Mycobacterium leprae (M. leprae) infection is crucial for reducing leprosy transmission. Identifying immune and genetic biomarkers can lead to diagnostic tests for asymptomatic cases, aiding early intervention and preventing nerve damage.
Area of Science:
- Infectious Diseases
- Immunology
- Genetics
Background:
- Leprosy remains a global health issue due to persistent Mycobacterium leprae (M. leprae) transmission.
- Current diagnostic methods rely on clinical signs, lacking tests for asymptomatic M. leprae infection or predicting disease progression.
Purpose of the Study:
- To review the challenges in discovering biomarkers for M. leprae infection.
- To discuss the implementation of these biomarkers in field-friendly diagnostic tests.
Main Methods:
- Identification of immunological or genetic biomarkers for disease development and leprosy reactions.
- Review of tests detecting biomarkers for cellular and humoral immunity.
Main Results:
- Biomarker discovery for M. leprae infection faces significant challenges.
- Simultaneous detection of cellular and humoral immunity biomarkers shows promise for diagnosing leprosy outcomes.
Conclusions:
- Longitudinal studies comparing immune and genetic biomarkers are essential in endemic areas.
- Investigating co-infections' impact on biomarker profiles is necessary.
- Biomarker-based diagnostic tests can significantly aid early leprosy detection and reduce nerve damage.
