01850nas a2200253   4500000000100000008004100001260000900042653002400051653001600075653001100091653002300102653002100125653002500146653002500171653002500196653003000221653001400251100001600265245009100281300001000372490001500382520118500397022001401582       2008                            d  c200810aAntigens, Bacterial10aGlycolipids10aHumans10aImmunity, Cellular10aInterferon-gamma10aLeprosy, lepromatous10aLeprosy, Tuberculoid10aMycobacterium leprae10apolymerase chain reaction10aTh1 Cells1 aStefani MMA00aChallenges in the post genomic era for the development of tests for leprosy diagnosis.  a89-940 v41 Suppl 23 a<p>Leprosy diagnosis is based mainly on clinical manifestations and no laboratory test is available to diagnose asymptomatic disease or to predict disease progression among exposed individuals. Novel comparative genomic in silico analyses and molecular biology tools have discovered unique Mycobacterium leprae proteins with potential diagnostic application. Tuberculoid paucibacillary leprosy (PB) shows low antibodies titers and strong Th1 type/ IFN-gamma specific cell mediated immunity (CMI), while lepromatous multibacillary patients (MB) show high antibody titers and low CMI. Therefore, laboratory tests for PB and MB leprosy diagnosis will require CMI and antibody based assays. Serologically reactive recombinant Mycobacterium leprae proteins were identified and may be used in conjunction with PGL-I to improve MB patient diagnosis. Mycobacterium leprae recombinant proteins and synthetic peptides have been tested for CMI-interferon gamma based assays for PB diagnosis. Modified PGL-I serology incorporating new Mycobacterium leprae antigens and CMI tests based on IFN-gamma gamma production may permit the detection of leprosy PB and MB forms in endemic countries.</p>  a1678-9849