02434nas a2200337   4500000000100000008004100001260001200042653001200054653000800066653001400074653001500088653002700103100001200130700001000142700001700152700001200169700001100181700001100192700001100203700001100214700000900225700000900234700001000243700001100253245016200264856008100426300001100507490000700518520155700525022001402082       2022                            d  c01/202210aELISPOT10aPCR10adiagnosis10anested PCR10aPaucibacillary leprosy1 aJiang H1 aShi Y1 aChokkakula S1 aZhang W1 aLong S1 aWang Z1 aKong W1 aLong H1 aWu L1 aHu L1 aYao Q1 aWang H00aUtility of Multi-target Nested PCR and ELISPOT Assays for the Detection of Paucibacillary Leprosy: A Possible Conclusion of Clinical Laboratory Misdiagnosis.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9036522/pdf/fcimb-12-814413.pdf  a8144130 v123 a<p>The diagnosis of paucibacillary (PB) leprosy often possesses a diagnostic challenge, especially for pure neuritic and lesser skin lesions with the zero bacillary load, requiring a sensitive and accurate diagnostic tool. We have included 300 clinically diagnosed new leprosy cases (comprising 98 PB cases) and analyzed the sensitivity and specificity of PB leprosy cases by nested PCR with , , , , and and Enzyme-linked Immunospot Assay test (ELISPOT) with MMPII, NDO-BSA, and LID-1 antigens by detecting interferon gamma (IFN-γ) release. The overall positivity rates of genes tested in 300 clinical specimens were identified as 55% of , 59% of , 59.3% of , 57.3% of , 61% of while 90% of nested , 92.6% of nested , and 95% of nested , and 285 (95%) of at least one gene positive cases. For PB specimens, 95% PCR positivity was achieved by three tested genes in nested PCR. The data obtained from ELISPOT for three antigens were analyzed for IFN-γ expression with 600 subjects. Among 98 PB leprosy cases, the sensitivity of MMP II, LID-1, and NDO-BSA was 90%, 87%, and 83%, respectively, and the specificity was 90%, 91%, and 86%, respectively. The total number of cases positive for at least one antigen was 90 (91.8%) in PB, which is significantly higher than that in multibacillary (MB) leprosy (56.7%). The combination of multi-targets nested PCR and ELISPOT assay provides a specific tool to early clinical laboratory diagnosis of PB leprosy cases. The two assays are complementary to each other and beneficial for screening PB patients.</p>
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