ArticlePLoS neglected tropical diseases2017
Leprosy reactions: The predictive value of Mycobacterium leprae-specific serology evaluated in a Brazilian cohort of leprosy patients (U-MDT/CT-BR).
Article in PLoS neglected tropical diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00669643 (Independent Study to Establish the Efficacy of the Six Doses Uniform MDT Regimen), which is not on this map. Cited by 22 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Independent Study to Establish the Efficacy of the Six Doses Uniform MDT Regimen (U-MDT) for Leprosy Patients
Who cites it
22 citing papers in PubMed, 41 citations in OpenAlex.
- Leprosy neuropathy and demyelinating impairment: How should we interpret this neurophysiological pattern?PloS one · 2026Observational
- A socio-ecological model of the management of leprosy reactions in Indonesia and India using the experiences of affected individuals, family members and healthcare providers.BMC health services research · 2025Article
- Neurological features of Hansen disease: a retrospective, multicenter cohort study.Scientific reports · 2024Article
- Analysis of interleukin 7 and platelet-derived growth factor-BB mRNA expression as potential markers in erythema nodosum leprosum.Dermatology reports · 2024Article
- Challenges and advances in serological and molecular tests to aid leprosy diagnosis.Experimental biology and medicine (Maywood, N.J.) · 2023Review
- Qua vadis leprosy?The Indian journal of medical research · 2023Article
- Understanding leprosy reactions and the impact on the lives of people affected: An exploration in two leprosy endemic countries.PLoS neglected tropical diseases · 2022Article
- Clinical, epidemiological, and laboratory prognostic factors in patients with leprosy reactions: A 10-year retrospective cohort study.Frontiers in medicine · 2022Article
- Host-Related Laboratory Parameters for Leprosy Reactions.Frontiers in medicine · 2021Review
- Neutrophil NETworking in ENL: Potential as a Putative Biomarker: Future Insights.Frontiers in medicine · 2021Review
- Leprosy surveillance study in a highly endemic Brazilian area using leprosy specific serologic tests and IFNγ whole blood assay.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Article
- Recombinant polypeptide of Mycobacterium leprae as a potential tool for serological detection of leprosy.AMB Express · 2019Article
- Three drugs are unnecessary for treating paucibacillary leprosy-A critique of the WHO guidelines.PLoS neglected tropical diseases · 2019Article
- A novel integrated molecular and serological analysis method to predict new cases of leprosy amongst household contacts.PLoS neglected tropical diseases · 2019Article
- Differential immunoglobulin and complement levels in leprosy prior to development of reversal reaction and erythema nodosum leprosum.PLoS neglected tropical diseases · 2019Article
- Article
- A Study of NLRC4 in Patients with Leprosy.Indian journal of dermatologyArticle
- Leprosy: clinical and immunopathological characteristics.Anais brasileiros de dermatologiaReview
- Drug Resistance inIndian dermatology online journalArticle
- What is New in the Pathogenesis and Management of Erythema Nodosum Leprosum.Indian dermatology online journalReview
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLeprosy reactions, reversal reactions/RR and erythema nodosum leprosum/ENL, can cause irreversible nerve damage, handicaps and deformities. The study of Mycobacterium leprae-specific serologic responses at diagnosis in the cohort of patients enrolled at the Clinical Trial for Uniform Multidrug Therapy Regimen for Leprosy Patients in Brazil/U-MDT/CT-BR is suitable to evaluate its prognostic value for the development of reactions. METHODOLOGY: IgM and IgG antibody responses to PGL-I, LID-1, ND-O-LID were evaluated by ELISA in 452 reaction-free leprosy patients at diagnosis, enrolled and monitored for the development of leprosy reactions during a total person-time of 780,930 person-days, i.e. 2139.5 person-years, with a maximum of 6.66 years follow-up time. PRINCIPAL
findingsAmong these patients, 36% (160/452) developed reactions during follow-up: 26% (119/452) RR and 10% (41/452) had ENL. At baseline higher anti-PGL-I, anti-LID-1 and anti-ND-O-LID seropositivity rates were seen in patients who developed ENL and RR compared to reaction-free patients (p<0.0001). Seroreactivity in reactional and reaction-free patients was stratified by bacilloscopic index/BI categories. Among BI negative patients, higher anti-PGL-I levels were seen in RR compared to reaction-free patients (p = 0.014). In patients with 0<BI<3, (36 RR, 36 reaction-free), higher antibody levels to PGL-I (p = 0.014) and to LID-1 (p = 0.035) were seen in RR while difference in anti-ND-O-LID positivity was borderline (p = 0.052). Patients with BI≥3 that developed ENL had higher levels of anti-LID-1 antibodies (p = 0.028) compared to reaction-free patients. Anti-PGL-I serology had a limited predictive value for RR according to receiver operating curve/ROC analyses (area-under-the-curve/AUC = 0.7). Anti LID-1 serology at baseline showed the best performance to predict ENL (AUC 0.85).
conclusionsOverall, detection of anti-PGL-I, anti-LID-1 and anti-ND-O-LID antibodies at diagnosis, showed low sensitivity and specificity for RR prediction, indicating low applicability of serological tests for RR prognosis. On the other hand, anti-LID-1 serology at diagnosis has shown prognostic value for ENL development in BI positive patients.
trial registrationClinicalTrials.gov NCT00669643.
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