STRING: 6239.ZK381.4b
UniGene: Cel.23408
PGL-1 antibodies are primarily detected via enzyme-linked immunosorbent assay (ELISA) using synthetic analogs like ND-O-HSA or NT-P-HSA. Key steps include:
Serum collection: Baseline and post-treatment samples.
Antigen preparation: Synthetic PGL-1 analogs or native antigen extracted from Mycobacterium leprae.
Threshold determination: Positive results are typically defined as >600 IU/mL for IgM .
Correlation with bacterial index (BI): Higher antibody levels correlate with multibacillary (MB) disease (e.g., BI >2) .
PGL-1 IgM levels differ significantly between paucibacillary (PB) and multibacillary (MB) patients:
| Patient Type | Mean Baseline IgM (IU/mL) | Post-Treatment Reduction |
|---|---|---|
| MB (untreated) | 6.95–12.53 | 60–80% |
| PB (untreated) | 1.28 | <50% |
MB patients exhibit higher baseline levels due to greater bacterial loads .
Serum: Standard for clinical monitoring (88–96% sensitivity in MB) .
Saliva: Emerging non-invasive alternative with comparable sensitivity in endemic regions .
Limitations: PB patients show lower sensitivity (30–60%) due to localized immune responses .
Cohort stratification: MB vs. PB patients, household contacts (HHCs) .
Timepoints: Baseline, 6/12/24 months post-multidrug therapy (MDT) .
Statistical endpoints:
Prophylaxis success: Single-dose rifampicin (SDR) reduces IgM in HHCs, but 22.2% remain seropositive after 2 years .
Confounding factors: Age, BMI, and BCG vaccination status show no correlation (P >0.05) .
Limitation: Antibody persistence despite bacterial clearance suggests residual antigenic stimulation .
| Parameter | Native PGL-1 | Synthetic Analogs (ND-O-HSA/NT-P-HSA) |
|---|---|---|
| Sensitivity (MB) | 96% | 70–85% |
| Production cost | High | Moderate |
| Clinical utility | Limited | Widely adopted |
Synthetic analogs are less sensitive but critical for scalable diagnostics .
Internal controls: Use standardized reference sera with known IgM titers .
Cross-reactivity checks: Test against other glycolipids (e.g., lipoarabinomannan) .
Target identification: PGL-1’s trisaccharide moiety is immunodominant .
Adjunct biomarkers: Combine antibody levels with IFN-γ or TNF-α to assess cellular immunity .