Evaluation of a rapid serological test for leprosy classification using human serum albumin as the antigen carrier.

The presence of anti-BSA antibodies may interfere in serological tests, as ELISA or immunochromatographic assays. BSA is frequently used as a blocking agent or as "inert" carrier of antigens, such as the NT-P-BSA, the semi-synthetic trisaccharide analogue of the PGL-I (phenolic glycolipid-I) antigen from the cell wall of the Mycobacterium leprae. PGL-I was prepared and linked to human serum albumin based in the hypothesis that replacing BSA by a human protein carrier would enhance the performance of leprosy serological tests. A total of 1162 serum samples were tested by ELISA and by the ML Flow rapid test using NT-P-BSA or NT-P-HSA antigens. When grouping leprosy patients as paucibacillary (PB) or multibacillary (MB) according to the Ridley & Jopling classification, ML Flow BSA and ML Flow HSA tests correctly allocated 70.9% and 68.6% of patients in the PB group, and 87% and 81% of patients in the MB group, respectively. Concordant results were found in 82.0% (953/1162) (kappa value=0.637; sd=0.023) of samples between ML Flow tests and 85.7% (996/1162) (kappa value=0.703; sd=0.021) between ELISA tests. ML Flow results were statistically similar and the same was true for ELISA tests using HSA or BSA. However, we noticed a tendency to decreased capacity to detect MB patients and an increased positivity among PB patients, HHC, TB patients and healthy controls by the HSA carrier in both ML Flow and ELISA. The PGL-I serology performed by the ML Flow test with BSA or HSA as antigen carriers can be a useful, friendly auxiliary tool to identify patients with higher bacterial load.

Absence from sera from normal individuals or from rifampin-treated leprosy patients (THELEP trials) of antibody to rifamycin-protein or rifamycin-membrane conjugates.

It has been reported that normal individuals have precipitating antibody which binds to rifamycin-conjugated proteins. An enzyme-linked immunosorbent assay has failed to confirm this claim, although antibodies demonstrable in a solid-phase binding assay are easily raised in mice if complete adjuvant is used. Moreover, no antibodies to rifamycin-protein conjugates were found in sera from the patients included in THELEP trials of six rifampin-containing regimens. Similarly, there was no antibody by the indirect Coombs test performed in another laboratory. Further studies using rifamycin-membrane conjugates regarded as more likely to be immunogenic in vivo also failed to reveal antibody in patients' sera, although this technique revealed an interesting antibody in one of four control sera known to be positive by the indirect Coombs test.

Behandlung eines subakut-kutanen Lupus erythematodes mit Thalidomid / Treatment of subacute cutaneous lupus erythematosus with thalidomide

A patient with subacute-cutaneous lupus erythematosus showed no response to corticosteroids and azathioprine. Treatment with thalidomide resulted in a dramatic clearing of skin lesions but failed to improve pathological laboratory tests.