Leprosy Mailing List – November 11th, 2007
Ref.: New
Diagnostic Tools for Leprosy
From: Das P. K.,
Amsterdam, The Netherlands
Dear Salvatore,
I am pleased to read, with great interest,
the summary of Dr. Geluk (LML November 4th, 2007) and
about her excellent work. Naturally
I am tempted to make the following comments:
I totally agree up to a point that there is no question about the
novel aim of the group, comprised of the well known researchers who
had been pursuing the common methodical strategy in leprosy field for
over three decades with some deviation now and then, since the time of
WHO IMMLEP.
Indeed, despite the tremendous progress to
our knowledge about the patho-mechanism of leprosy, it still remains
unsolved to date, concerning the predictive identification of a risk
individual exposed to M leprae, who will or will not succumb to
this unfortunate debilitating disease.
As it is well recognised that
host immune response to a particular invading organism (irrespective
of exposure to other organisms), does shift in regards to antigen
specificities during the evolution of the infection and then disease. Since Leprosy is slowly
evolving infection before the disease is expressed it will be uphill
struggle to pinpoint some well defined post genomic antigen(s) for
developing simplistic diagnostics which can be used in the endemic
country.
Of course, there is no harm in trying for
success. Only reservation
is that one has to remember, as a rule of thumb, “host parasite
interaction” predicts that immune response to an invading organism
often leads to multi antigenic immune responses which often change at
certain time point during the evolution of infection and pathology.
Having expressed my reservation about the
euphoric enthusiasm, I must state clearly that in the next decade the
principal challenge in leprosy control is to come out with
comprehensive tool(s) for early predictive diagnosis of
individuals with the risk of developing disease and also for early
diagnosis of reactions and relapse.
Leprosy community will be watching the progress with great
interest in this direction which will be eventually translated
into a tailor made protocol “from bench to clinics”.
Pran
