In search of biomarkers for leprosy diagnosis : in silico identification, screening & field application

Globally more than 200,000 people develop leprosy every year and 2-3 million people live with leprosy associated disabilities. Despite the availability of multi drug therapy, leprosy has continued affecting many individuals, including children because of the uninterrupted transmission in the population. Untreated multi bacillary cases as well as non-symptomatic M. leprae infected individuals in the population are believed to be the major sources of M. leprae infection and transmission. Leprosy reactions are also the major causes of disabilities. However, no tools are available to predict their occurrence. This thesis focuses on in vitro assessment of recombinant M. leprae proteins and synthetic peptides for their immunogenicity and specificity in populations with different genetic backgrounds by measuring cell mediated immunity and this has shown the presence of potential antigens. Further in depth analysis of the host immune responses against these unique antigens in leprosy patients, their household contacts and healthy endemic controls has led to identification of potential biomarkers with an immense importance in development of diagnostic tools for detection of M. leprae infection and early diagnosis of leprosy reactions. Currently, field friendly tests for early detection are developed at the LUMC using identified M. leprae antigens and host biomarkers with diagnostic potential.the Netherlands Leprosy Relief Foundation (NLR) ILEP#: 702.02.65 and ILEP#: 701.02.49, the Q.M. Gastmann-Wichers Foundation, NLR (ILEP#: 7.01.02.48) and the Turing Foundation as part of the IDEAL (Initiative for Diagnostic and Epidemiological Assays for Leprosy) Consortium and UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR).LUMC / Geneeskund