Autoantibodies in leprosy

Chronic Hand Swelling and Dactylitis in Leprosy: A Case Report and Review of the Literature

Leprosy is an infectious disease that is associated with various types of presentations. Diagnosis of the disease can be tricky in cases of atypical presentations. We report a unique case of leprosy characterized by chronic hand swelling, dactylitis, and seropositive laboratory markers, which was diagnosed in a rheumatology clinic.

Immunoreactivity of nerve lipid antigens in leprosy

Neural lipid antigens, namely, galactocerebroside and ganglioside, have been implicated in demyelinating diseases. We were interested in finding the role of these antigens in leprosy neuritis. The humoral immune response to these lipid antigens was quantitated by enzyme-linked immunosorbent assay in sera from 91 leprosy patients and 18 normal individuals. Our data revealed the presence of antibodies to total nerve lipids (TNL) and galactocerebroside (GalC) and a significantly low level to ganglioside (Gg) in all the categories of leprosy. No antilipid antibodies were detected in normals. Anti-TNL and anti-GalC antibodies were highest in tuberculoid leprosy patients. Statistically significant positive correlation was observed between anti-TNL and anti-GalC antibodies in lepromatous borderline, tuberculoid, and neuritic patients.

A patient with lepromatous leprosy and anticytoskeletal antibodies

Sera from 34 patients with lepromatous leprosy were screened for the presence of autoantibodies by indirect immunofluorescence using two epithelial cell lines, PTK2 and HEp2, as substrates. Indirect immunofluorescence staining of both substrates with the serum of a patient with lepromatous leprosy revealed a cytoplasmic intermediate filament staining pattern. After exposure of PTK2 cells to colchicine, the filaments collapsed into thick perinuclear coils, confirming the presence of intermediate filament reactivity. Immunofluorescence of rat fibroblasts with the same serum also revealed an intermediate filamentous staining pattern. Human keratinocytes exposed to the patient's serum revealed a diffuse cytoplasmic staining pattern. Our study suggests the presence of autoantibodies to cytoskeletal intermediate filaments or to molecules associated with vimentin and possibly keratin subunit proteins in the serum of a patient with lepromatous leprosy.

Evaluation of circulating immune complexes and antinuclear antibodies in Japanese patients with leprosy

In 79 patients with leprosy a significant increase of anti-extractable nuclear antigen (ENA) antibodies and circulating immune complexes (CIC) was found. No correlation between CIC and anti-ENA antibodies was demonstrable. Since such a correlation is known from antinuclear antibodies and CIC in patients with systemic lupus erythematosus, it appears likely that anti-ENA antibodies do not play a causative role in CIC-mediated pathogenesis of leprosy.

The significance of the fluorescent treponemal antibody (FTA-ABS) test in collagen disorders and leprosy

A test is described to distinguish the immunofluorescence seen on T. pallidum in syphilis from that due to antibodies against DNA. The method consists of comparing the results of the fluorescent treponemal antibody (FTA-ABS) test with the staining obtained with T. gondii and T. cruzi using an indirect fluorescent technique. The ability of a particular serum to stain other organisms, in addition to T. pallidum, at a significant titre indicates that the treponemal fluorescence is not specific, and the loss of this staining property when organisms are pretreated with deoxyribonuclease suggests that the common microbial antigen is DNA. The isolated treponemal fluorescence found in syphilis is unaffected by pretreatment of T. pallidum. When 123 sera from patients with collagen disorders were examined, non-specific bacterial fluorescence was observed in six sera, while in 95 sera from patients with lepromatous leprosy, a positive FTA-ABS reaction was obtained in 14. There was no accompanying immunofluorescence on other protozoa. Therefore the antibody reacting in the FTA-ABS test in leprosy is likely to be treponemal in origin. A mitochondrial antibody was found in seven out of the 15 sera from patients with lepromatous leprosy.