RESUMO
Based on the discovery of three single nucleotide polymorphisms (SNPs) in Mycobacterium leprae, it has been previously reported that there are four major SNP types associated with different geographic regions around the world. Another typing system for global differentiation of M. leprae is the analysis of the variable number of short tandem repeats within the rpoT gene. To expand the analysis of geographic distribution of M. leprae, classified by SNP and rpoT gene polymorphisms, we studied 85 clinical isolates from Thai patients and compared the findings with those reported from Asian isolates. SNP genotyping by PCR amplification and sequencing revealed that all strains like those in Myanmar were SNP type 1 and 3, with the former being predominant, while in Japan, Korea, and Indonesia, the SNP type 3 was found to be more frequent. The pattern of M. leprae distribution in Thailand and Myanmar is quite similar, except that SNP type 2 was not found in Thailand. In addition, the 3-copy hexamer genotype in the rpoT gene is shared among the isolates from these two neighboring countries. On the basis of these two markers, we postulate that M. leprae in leprosy patients from Myanmar and Thailand has a common historical origin. Further differentiation among Thai isolates was possible by assessing copy numbers of the TTC sequence, a more polymorphic microsatellite locus.
Assuntos
Proteínas de Bactérias/genética , Hanseníase/transmissão , Mycobacterium leprae/genética , Polimorfismo de Nucleotídeo Único , Fator sigma/genética , Técnicas de Tipagem Bacteriana , Variações do Número de Cópias de DNA , DNA Bacteriano/genética , Genes Bacterianos , Loci Gênicos , Marcadores Genéticos , Genótipo , Humanos , Indonésia/epidemiologia , Japão/epidemiologia , Coreia (Geográfico)/epidemiologia , Hanseníase/epidemiologia , Hanseníase/microbiologia , Mycobacterium leprae/classificação , Mycobacterium leprae/isolamento & purificação , Reação em Cadeia da Polimerase , Tailândia/epidemiologiaRESUMO
This is a prospective study of 10 cases, 14 lower extremities lymphedema were treated by microsurgical lymphonodovenous implantation from October 2001 to July 2003. All of the presented patients suffered from filariasis with obstructive lymphedema of the lower limbs. The surgical technique is described. The results have been satisfactory. The average reduction in the circumference of the affected limb was 7.37 cm at 16 cm below the knee joint level, with an average follow up of 4.5 months. Subjective and objective signs were improved.
