02912nas a2200289   4500000000100000008004100001260003700042653001400079653002400093653001700117653001200134653002900146100001800175700001700193700001700210700001400227700001600241700001200257700002200269700001100291245010400302856009800406300000900504490000700513520208800520022001402608       2024                            d  bPublic Library of Science (PLoS)10aBiomarker10aT. gondii infection10aEpidemiology10aLeprosy10a irreversible neuropathy1 aNascimento LS1 ade Castro YS1 aFigueira JDA1 aSouza RDC1 ada Silva JA1 aNahn EP1 aPeixoto-Rangel AL1 aAli MM00aToxoplasma gondii infection and high levels of IgE are associated to erythema nodosum leprosy (ENL)  uhttps://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0300704&type=printable  a1-120 v193 a<p>Leprosy is a chronic infectious disease caused by the bacillus Mycobacterium leprae. The disease may evolve for inflammatory reactions, reversal reaction (RR) and erythema nodosum leprosum (ENL), the major cause of irreversible neuropathy in leprosy, which occur in 1 in 3 people with leprosy, even with effective treatment of M. leprae. Leprosy remains persistently endemic in our region where it predominantly affects lowest socioeconomic conditions people, as Toxoplasma gondii infection in the municipality studied. Previously, we have shown T. gondii coinfection as a risk marker for leprosy, mainly in its severe form. This present study assessed whether T. gondii infection is also a risk factor for leprosy reactions and the predictive value of immunoglobulin production prior to development of leprosy reactions. Patients with leprosy (n = 180), co-infected or not with T. gondii, had their serum investigated for levels of IgA, IgE, IgG1, IgG2, IgG3 and IgG4 anti-PGL-1 by ELISA prior to development of leprosy reactions. The serologic prevalence for T. gondii infection was 87.7% in leprosy reaction patients reaching 90.9% in those with ENL. The leprosy reaction risk increased in T. gondii seropositive individuals was two-fold ([OR] = 2.366; 95% confidence interval [CI 95%]: 1.024–5.469) higher than those seronegative, and considering the risk of ENL, this increase was even more evident (OR = 6.753; 95% CI: 1.050–72.85) in coinfected individuals. When evaluated the prediction of anti-PGL-1 immunoglobulin levels for development of leprosy reactions in patients coinfected or not with T. gondii, only the increase IgE levels were associated to occurrence of reactional episodes of leprosy, specifically ENL type, in patients coinfected with T. gondii, compared to those not coinfected or no reaction. Thus, the immunomodulation in co-parasitism T. gondii–M. leprae suggest increased levels of IgE as a biomarker for early detection of these acute inflammatory episodes and thereby help prevent permanent neuropathy and disability in leprosy patients.</p>
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