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Download Download Dermatology Reports 2019; volume 11(s1):8057 The correlation of Ig M Mycobacterium leprae (M. leprae). Leprosy Anti PGL-1 antibody between can be cured but it still continues to cause Correspondence: Medhi Denisa Alinda, significant health problems in many parts of Dermatology Venereology Dept, Faculty of blood veins and dryed capillary the world. World Health Organization Medicine, Universitas Airlangga - DR blood on filter papers in house- (WHO) reported the number of new cases Soetomo Teaching Hospital, Jl. Mayjen. Prof. Dr. Moestopo, No. 47, Airlangga, Gubeng, of leprosy in Southeast Asia in 2015 as hold contact Surabaya, Jawa Timur, 60286, Indonesia. of leprosy patient many as 154,834 cases where Indonesia Tel.: +6285645050746. ranks third largest after Brazil is as many as E-mail: [email protected] 1 17,025 cases. [email protected] Anisha Calista Prakoeswa,1 Leprosy is still a health problem in Bayu Bijaksana Rumondor,1 Indonesia, including East Java. Key words: household contact of leprosy, IgM Meva Nareza Trianita,1 Iswahyudi,2 Transmission of leprosy is still high enough anti-PGL-1, capillary blood on filter paper, cubital vein. Fatma Rosida,3 Linda Astari,3 with the incidence rate of new leprosy in 3 2 M. Yulianto Listiawan, East Java which in 2014 found 4,114 cases. Contributions: the authors contributed equally. Indropo Agusni,3 Shinzo Izumi,2 In Dr. Soetomo General Hospital, Surabaya, Medhi Denisa Alinda3 Indonesia, there are 713 (6.49%) new lep- Conflict of interest: the authors declare no 1 rosy patients from a total of 10,970 leprosy potential conflict of interests. Faculty of Medicine Universitas patients in the Outpatient Clinic 2011- Airlangga, Dr. Soetomo Teaching 2015.3 Received for publication: 1 February 2019. 2 Hospital; Leprosy Study Group, The failure of leprosy elimination is Accepted for publication: 13 February 2019. Institute of Tropical Diseases, caused by the failure of the transmission 3 This work is licensed under a Creative Universitas Airlangga; Department of chain termination, namely the difficulty of Commons Attribution-NonCommercial 4.0 Dermatology and Venereology Faculty of early detection of Subclinical Leprosy (SL), International License (CC BY-NC 4.0). Medicine Universitas Airlangga, a condition characterized by specific anti- Dr. Soetomo Teaching Hospital, bodies against M. leprae high enough in the ©Copyrightonly A.C. Prakoeswa et al., 2019 Surabaya, Indonesia blood without any clinical symptoms. SL is Licensee PAGEPress, Italy thought to be primarily derived from house- Dermatology Reports 2019; 11(s1):8057 hold contacts of leprosy patients, because doi:10.4081/dr.2019.8057 until now it is believed that the main trans- Abstract use mission of leprosy is from Multi bacillary samples taken have to be sent from the field 4,5 Delays of leprosy detection and treat- leprosy patients. to the central laboratory at a controlled tem- ment can lead to disability and potential Early diagnosis of leprosy is an impor- perature to ensure stability; still need a cen- transmission. Serologic examination has the tant issue as late detection and treatment trifuge for serum taking; and in certain advantage in detecting Subclinical Leprosy. can result in disability as well as the psy- cases such as children and the elderly, the The procedure of serologic test, which is chosocial impacts due to the persistent process of taking blood is difficult to per- one of its main limitation, could be simpli- stigmatization of the disease in the commu- form. If the time period since the blood fied by the use filter paper. This study aims nity. In addition, it is also necessary to sample is taken until the serum is examined to assess the effectiveness of the use of cap- watch out for potential transmission of lep- in the laboratory long enough, preservatives illary blood dropped on filter paper as a sub- rosy in cases that are too late to be detected. and special storage are required. All of the stitute for venous blood in household con- Various studies on leprosy diagnostic sero- above obstacles cause leprosy serology tests tact of leprosy patients. Seventeen samples logic examination continue to be developed. are difficult to do on a large scale in leprosy of capillary blood dried on filter paper and Phenolic Glycolipid-1 (PGL-1) is a specific endemic areas. It is well known that the venous blood samples from the same indi- antigen for M. leprae which was first dis- serum of blood required for serological tests vidual were examined by ELISA method to covered in the 1980s. Ig M anti PGL-1 anti- does not need too much, just 50 µl of blood determine the levels of IgM anti-Phenolic bodies indirectly indicate the presence of M. serum can be obtained from a few drops of glycolipid-1 (PGL-1). The mean Non-commercialof anti- leprae in individuals, which may reflect blood. For that we need to develop a more PGL-1 IgM levels of filter paper samples both SL and leprosy. Seropositivity of IgM practical blood-taking method that is 163.31±126.16; whereas the mean of levels anti-PGL-1 antibodies was found to be 80- through filter paper that can absorb the from venous samples was 473.16±411.26. 100% in untreated untreated multibasilar blood and then dissolved by soaking There was significant difference and corre- (MB) leprosy patients, whereas in patients process. Blood storage to filter paper has lation between these two groups. Samples with pausibasiler (PB) type, there was a several advantages such as it does not on filter paper in household contact can be lower titer of IgM antibodies with 30-60% require complicated sample processing and 6-8 used to determine the level of anti-PGL-1 seropositivity. samples can be stored for long periods so as IgM in serum by converting on the regres- Detection of antibodies against PGL-1 to facilitate serological examination in lep- sion basis. Further study is required to eval- has been widely used for community sur- rosy endemic areas that generally have lim- uate the potency of filter paper methods to veys, early diagnosis, treatment monitoring, ited health facilities and infrastructure. In conduct large-scale serological screening. reaction monitoring and identification of addition, blood sampling could derived relapses. At this time serology was per- from an easier location such as from a fin- formed mostly using a blood serum sample gertip. from the cubital vein. The main obstacles to Prakoeswa in 2013 reported that 6% Introduction this serologic examination in addition to the subclinical leprosy with high IgM anti- relatively expensive costs are often a prob- PGL-1 titers become manifest leprosy in 4 Leprosy or Hansen’s disease is a chron- lem in the field associated with fairly com- years, that means 1.5% annually. Range of ic infectious disease caused by plex sample treatments such as: the blood Ig M anti-PGL-1 antibody titer in leprosy [page 106] [Dermatology Reports 2019; 11(s1):8057] Article patients with seropositive range between who live in the house and close contact for tometer (Elisa reader) with Optical Density 605 units / ml (cut off for population of East at least 6 months with multibacillary lep- (OD) unit at 492 nm. Further data is stored Java) up to > 5300 units / ml. While the rosy patients (spouses, parents, or children) and processed with Biolyse / X read pro- anti-PGL-1 titer study was conducted in maximum of 3 domestic people. Blood gram. The result is quantitative data with East Java populations divided into seropos- samples were collected following local unit / mL unit. itive +1 (605-1,000 u / ml), +2 (1,000-2000 ethics committee approval from Dr. u / ml), +3 (2,000-3,000 u / ml) and +4 (> Soetomo General Hospital and after partici- 3,000 u / ml). Individuals with +3 and +4 pants signed their informed consent forms. Results seropositivity are potentially become mani- A sample of 10 µL of capillary blood fest leprosy.9 from a vaccinotile / Micro Hematocrit cap- Seventeen fingertips blood capillaries Until now there has been no research on illary tube/plain (MHC tube) wound on the samples of household contact were dried on the examination of Ig M anti-PGL-1 anti- fingertips was taken by a capillary micro filter paper and 17 cubital vein blood sam- body levels by using capillary blood on fil- tube containing heparin. The blood is ples from the same individuals were exam- ter paper in household contact of leprosy impregnated on Whatman chromatography ined by ELISA method to determine the patients in Outpatient Clinic Dermatology paper (Whatman International Ltd, levels of IgM anti PGL-1. ELISA examina- Venereology, Dr. Soetomo General Maidstone, UK) filter and dried at room tion revealed the mean of IgM anti-PGL-1 Hospital, Surabaya. The aim of this study temperature, subsequently labeled and level from capillary blood sample on filter was to evaluate the effectiveness of the use inserted in a plastic bag. After that, it was paper was 163.31±126.16; whereas the of capillary blood using filter paper as a inserted in eppendorf tube, plus 900 µl dilu- mean of IgM anti-PGL-1 levels from serum substitute for serum samples by proving the tion buffer (PBRT and Skim milk) and filter samples cubital vein was 473.16±411.26. presence of correlation between anti-PGL-1 paper for 2 hours to get optimum result, fol- There was significant difference between IgM levels in fingertip capillary blood using lowed by Vortex for 5 minutes to dissolve capillary sample and cubital vein (p=0,006). filter paper with serum IgM anti-PGL-1 serum. Dilution of 1: 300 with dilution In Figure 1, we can see the difference of serologic level from cubital vein blood of buffer is then subsequently stored at a tem- IgM anti-PGL-1 levels in capillary blood household contact.
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