Development of LepReact, a defined skin test for paucibacillary leprosy and low-level M. leprae infection. 2020

Malcolm S Duthie, and Maria T Pena, and Amit P Khandhar, and Alessandro Picone, and Zachary MacMIllen, and Richard W Truman, and Linda B Adams, and Steven G Reed
Host Directed Therapeutics (HDT) Biocorp, 1616 Eastlake Ave E, Seattle, WA, 98102, USA. malcolm.duthie@hdtbiocorp.com.

The persistence of new leprosy cases in endemic areas such as India, Brazil, Bangladesh, and the Philippines has encouraged studies of chemoprophylaxis among contacts of patients. Epidemiological screening tools to enable early detection of infected individuals in endemic populations would be critical to target individuals most in need of intervention. Despite decades of attempts, however, there still are no tests available for the early detection of low-level infection with Mycobacterium leprae. In this report, we describe the development of a leprosy skin test using M. leprae-specific antigens. We selected the chimeric LID-1 fusion protein, formulated to achieve maximum performance at a minimal dose, as a skin test candidate based on its ability to elicit delayed-type hypersensitivity (DTH) reactions in M. leprae immune guinea pigs in a sensitive and specific manner, i.e., with no cross-reactivity observed with other mycobacterial species. Importantly, evaluations in armadillos indicated that intradermal inoculation of formulated LID-1 could distinguish uninfected from M. leprae-infected animals manifesting with symptoms distinctly similar to the PB presentation of patients. Together, our data provide strong proof-of-concept for developing an antigen-specific skin test to detect low-level M. leprae infection. Such a test could, when applied with appropriate use of chemo- and/or immunoprophylaxis, be instrumental in altering the evolution of clinical disease and M. leprae transmission, thus furthering the objective of zero leprosy.

UI MeSH Term Description Entries
D006968 Hypersensitivity, Delayed An increased reactivity to specific antigens mediated not by antibodies but by sensitized T CELLS. Hypersensitivity, Tuberculin-Type,Hypersensitivity, Type IV,Tuberculin-Type Hypersensitivity,Type IV Hypersensitivity,Delayed Hypersensitivity,Delayed Hypersensitivities,Hypersensitivity, Tuberculin Type,Tuberculin Type Hypersensitivity,Tuberculin-Type Hypersensitivities,Type IV Hypersensitivities
D007271 Injections, Intradermal The forcing into the skin of liquid medication, nutrient, or other fluid through a hollow needle, piercing the top skin layer. Intradermal Injections,Injection, Intradermal,Intradermal Injection
D009166 Mycobacterium leprae A species of gram-positive, aerobic bacteria that causes LEPROSY in man. Its organisms are generally arranged in clumps, rounded masses, or in groups of bacilli side by side.
D005260 Female Females
D006168 Guinea Pigs A common name used for the genus Cavia. The most common species is Cavia porcellus which is the domesticated guinea pig used for pets and biomedical research. Cavia,Cavia porcellus,Guinea Pig,Pig, Guinea,Pigs, Guinea
D000075082 Proof of Concept Study An empirical investigation which pertains to the development of prototypes or models that demonstrate the feasibility of novel concepts, ideas, principles, schema or their practical application. Proof of Concept Approach,Proof of Concept Demonstration,Proof of Concept Evaluation,Proof of Concept Experiment,Proof of Concept Investigation,Proof of Concept Model,Proof of Concept Prototype,Proof of Concept Research,Proof of Concept Studies,Proof of Concept Testing,Approach Proof, Concept,Approach Proofs, Concept,Concept Approach Proof,Concept Approach Proofs,Concept Demonstration Proof,Concept Evaluation Proof,Concept Evaluation Proofs,Concept Experiment Proof,Concept Experiment Proofs,Concept Investigation Proof,Concept Model Proof,Concept Model Proofs,Concept Prototype Proof,Concept Prototype Proofs,Concept Research Proof,Concept Research Proofs,Concept Study Proof,Concept Testing Proof,Concept Testing Proofs,Demonstration Proof, Concept,Evaluation Proof, Concept,Experiment Proof, Concept,Investigation Proof, Concept,Model Proof, Concept,Prototype Proof, Concept,Research Proof, Concept,Study Proof, Concept,Testing Proof, Concept,Testing Proofs, Concept
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D000942 Antigens, Bacterial Substances elaborated by bacteria that have antigenic activity. Bacterial Antigen,Bacterial Antigens,Antigen, Bacterial
D001135 Armadillos Burrowing, chiefly nocturnal mammals of the family Dasypodidae having bodies and heads encased in small bony plates. They are widely distributed in the warmer parts of the Americas. Armadillo
D001426 Bacterial Proteins Proteins found in any species of bacterium. Bacterial Gene Products,Bacterial Gene Proteins,Gene Products, Bacterial,Bacterial Gene Product,Bacterial Gene Protein,Bacterial Protein,Gene Product, Bacterial,Gene Protein, Bacterial,Gene Proteins, Bacterial,Protein, Bacterial,Proteins, Bacterial

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