Navegando por Palavras-chave "HLA Antigens"
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- ItemSomente MetadadadosMarcadores sorológicos e genéticos da hanseníase em uma comunidade indígena no estado do Acre(Universidade Federal de São Paulo (UNIFESP), 2019-06-27) Teles, Stefanie Ferreira [UNIFESP]; Gamba, Monica Antar [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Leprosy, although presenting a decrease in the number of new cases since the introduction of polychemotherapy (MDT), remains endemic in countries such as India, Brazil, Indonesia, among others, persisting as a public health problem. In the indigenous population of Brazil the coefficient of detection of leprosy is in a situation of high endemicity. Purpose: To analyze the anti-PGL-I and anti-LID-I antibody titers by the anti-PGL-I ELISA and the NDO-LID lateral flow rapid test and compare with HLA alleles identified in the study population. Method: A cross-sectional, clinical study carried out in two indigenous villages, Barão and Ipiranga, in the municipality of Mâncio Lima, Acre. 10 ml blood was collected by venipuncture of the brachial vein, packed in a tube with ethylenediaminetetraacetic acid (EDTA) for the determination of anti-PGL-I IgM antibodies by the ELISA method, the NDO-LID lateral flow test and typing of the HLA class alleles I (A *, B * and C * loci) and II (loci DRB1 * and DQB1 *) by LabType ™ (One-Lambda-USA) technique. The frequency of the alleles was obtained by direct counting. Bivariate analyzes were performed using Pearson's Chi-square test and Fisher's exact test. The adjustment was performed using the binary logistic regression technique and the threshold for statistical significance was set at the alpha level of 5% (p <0.05). The results were presented in Odds Ratio with 95% confidence interval (95% CI). The degree of agreement between the techniques was evaluated by the Cohen Kappa Index. Results: The study evaluated a sample of 285 individuals, most of whom lived in the Barão village (54%), Puyanawa ethnic group (79%), male (51%), less than nine years old schooling (44%), with a family income of less than a minimum salarie wage (56%), young adults (48%), residing in houses with a wooden structure and masonry (52%) with more than 4 rooms (85%) and more than 4 residents per household 58%). Seropositivity was identified by the NDO-LID rapid test in 70 individuals (24.56%) and the PGL-I ELISA test in 30 individuals (10.53%). The concordance between NDO-LID and ELISA-PGL-I results showed a Kappa (Cohen) index of 0.39 indicating a regular and significant agreement. There was a positive association with a chance of seropositivity to antibodies to PGL-I of almost 4 times more for residents in the Ipiranga village than in the Barão. The most common HLA alleles were A * 02: 01 (59.6%), B * 40: 02 (32.1%), C * 04: 01 (26.8%), DRB1 * 16: 02 (45.4%), DQA1 * 05:05 (48.8%) and DQB1 * 03: 01 (68.9%), respectively. In the Barão village, a significant association was found between the NDO-LID1 positive test with the HLA-A * 02 and HLA-B * 53 alleles. In the Ipiranga village there was a significant association of the HLA-B * 15 allele with negative result for the NDO-LID1 test. In the typing of the HLA alleles of the population of the two villages, the HLA-B * 40 allele and HLA-C * 03 were associated with a positive serological response to aPGL-I. Conclusion: Extensive potential for subclinical infection as well as continuous contact with M.leprae. Residing in the Ipiranga village showed the likelihood of presence of aPGL-I seropositivity indicating a nearly 4-fold higher chance of having positive anti-PGL-I ELISA (OR: 3.7). On the genetic analysis, a strong link was found with the Terena lineage and the influence of the HLA class I and II molecules on seroconversion to the NDO-LID1 leprosy and PGL-1 ELISA leprosy tests.