Isolation of Mycobacterium lepromatosis and Development of Molecular Diagnostic Assays to Distinguish Mycobacterium leprae and M. lepromatosis

Abstract Background Mycobacterium leprae was thought to be the exclusive causative agent of leprosy until Mycobacterium lepromatosis was identified in a rare form of leprosy known as diffuse lepromatous leprosy (DLL). Methods We isolated M. lepromatosis from a patient with DLL and propagated it in a...

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Published inClinical infectious diseases Vol. 71; no. 8; pp. e262 - e269
Main Authors Sharma, Rahul, Singh, Pushpendra, McCoy, Rajiv C, Lenz, Shannon M, Donovan, Kelly, Ochoa, Maria T, Estrada-Garcia, Iris, Silva-Miranda, Mayra, Jurado-Santa Cruz, Fermin, Balagon, Marivic F, Stryjewska, Barbara, Scollard, David M, Pena, Maria T, Lahiri, Ramanuj, Williams, Diana L, Truman, Richard W, Adams, Linda B
Format Journal Article
LanguageEnglish
Published US Oxford University Press 05.11.2020
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Abstract Abstract Background Mycobacterium leprae was thought to be the exclusive causative agent of leprosy until Mycobacterium lepromatosis was identified in a rare form of leprosy known as diffuse lepromatous leprosy (DLL). Methods We isolated M. lepromatosis from a patient with DLL and propagated it in athymic nude mouse footpads. Genomic analysis of this strain (NHDP-385) identified a unique repetitive element, RLPM, on which a specific real-time quantitative polymerase chain reaction assay was developed. The RLPM assay, and a previously developed RLEP quantitative polymerase chain reaction assay for M. leprae, were validated as clinical diagnostic assays according to Clinical Laboratory Improvement Amendments guidelines. We tested DNA from archived histological sections, patient specimens from the United States, Philippines, and Mexico, and US wild armadillos. Results The limit of detection for the RLEP and RLPM assays is 30 M. leprae per specimen (0.76 bacilli per reaction; coefficient of variation, 0.65%–2.44%) and 122 M. lepromatosis per specimen (3.05 bacilli per reaction; 0.84%–2.9%), respectively. In histological sections (n = 10), 1 lepromatous leprosy (LL), 1 DLL, and 3 Lucio reactions contained M. lepromatosis; 2 LL and 2 Lucio reactions contained M. leprae; and 1 LL reaction contained both species. M. lepromatosis was detected in 3 of 218 US biopsy specimens (1.38%). All Philippines specimens (n = 180) were M. lepromatosis negative and M. leprae positive. Conversely, 15 of 47 Mexican specimens (31.91%) were positive for M. lepromatosis, 19 of 47 (40.43%) were positive for M. leprae, and 2 of 47 (4.26%) contained both organisms. All armadillos were M. lepromatosis negative. Conclusions The RLPM and RLEP assays will aid healthcare providers in the clinical diagnosis and surveillance of leprosy. Mycobacterium lepromatosis was isolated and propagated in mouse footpads. We developed a real-time polymerase chain reaction (PCR) assay using a unique repetitive element, RLPM. We validated this and the RLEP PCR Mycobacterium leprae assay for the clinical diagnosis of leprosy.
AbstractList Abstract Background Mycobacterium leprae was thought to be the exclusive causative agent of leprosy until Mycobacterium lepromatosis was identified in a rare form of leprosy known as diffuse lepromatous leprosy (DLL). Methods We isolated M. lepromatosis from a patient with DLL and propagated it in athymic nude mouse footpads. Genomic analysis of this strain (NHDP-385) identified a unique repetitive element, RLPM, on which a specific real-time quantitative polymerase chain reaction assay was developed. The RLPM assay, and a previously developed RLEP quantitative polymerase chain reaction assay for M. leprae, were validated as clinical diagnostic assays according to Clinical Laboratory Improvement Amendments guidelines. We tested DNA from archived histological sections, patient specimens from the United States, Philippines, and Mexico, and US wild armadillos. Results The limit of detection for the RLEP and RLPM assays is 30 M. leprae per specimen (0.76 bacilli per reaction; coefficient of variation, 0.65%–2.44%) and 122 M. lepromatosis per specimen (3.05 bacilli per reaction; 0.84%–2.9%), respectively. In histological sections (n = 10), 1 lepromatous leprosy (LL), 1 DLL, and 3 Lucio reactions contained M. lepromatosis; 2 LL and 2 Lucio reactions contained M. leprae; and 1 LL reaction contained both species. M. lepromatosis was detected in 3 of 218 US biopsy specimens (1.38%). All Philippines specimens (n = 180) were M. lepromatosis negative and M. leprae positive. Conversely, 15 of 47 Mexican specimens (31.91%) were positive for M. lepromatosis, 19 of 47 (40.43%) were positive for M. leprae, and 2 of 47 (4.26%) contained both organisms. All armadillos were M. lepromatosis negative. Conclusions The RLPM and RLEP assays will aid healthcare providers in the clinical diagnosis and surveillance of leprosy. Mycobacterium lepromatosis was isolated and propagated in mouse footpads. We developed a real-time polymerase chain reaction (PCR) assay using a unique repetitive element, RLPM. We validated this and the RLEP PCR Mycobacterium leprae assay for the clinical diagnosis of leprosy.
BACKGROUNDMycobacterium leprae was thought to be the exclusive causative agent of leprosy until Mycobacterium lepromatosis was identified in a rare form of leprosy known as diffuse lepromatous leprosy (DLL). METHODSWe isolated M. lepromatosis from a patient with DLL and propagated it in athymic nude mouse footpads. Genomic analysis of this strain (NHDP-385) identified a unique repetitive element, RLPM, on which a specific real-time quantitative polymerase chain reaction assay was developed. The RLPM assay, and a previously developed RLEP quantitative polymerase chain reaction assay for M. leprae, were validated as clinical diagnostic assays according to Clinical Laboratory Improvement Amendments guidelines. We tested DNA from archived histological sections, patient specimens from the United States, Philippines, and Mexico, and US wild armadillos. RESULTSThe limit of detection for the RLEP and RLPM assays is 30 M. leprae per specimen (0.76 bacilli per reaction; coefficient of variation, 0.65%-2.44%) and 122 M. lepromatosis per specimen (3.05 bacilli per reaction; 0.84%-2.9%), respectively. In histological sections (n = 10), 1 lepromatous leprosy (LL), 1 DLL, and 3 Lucio reactions contained M. lepromatosis; 2 LL and 2 Lucio reactions contained M. leprae; and 1 LL reaction contained both species. M. lepromatosis was detected in 3 of 218 US biopsy specimens (1.38%). All Philippines specimens (n = 180) were M. lepromatosis negative and M. leprae positive. Conversely, 15 of 47 Mexican specimens (31.91%) were positive for M. lepromatosis, 19 of 47 (40.43%) were positive for M. leprae, and 2 of 47 (4.26%) contained both organisms. All armadillos were M. lepromatosis negative. CONCLUSIONSThe RLPM and RLEP assays will aid healthcare providers in the clinical diagnosis and surveillance of leprosy.
Mycobacterium lepromatosis was isolated and propagated in mouse footpads. We developed a real-time polymerase chain reaction (PCR) assay using a unique repetitive element, RLPM. We validated this and the RLEP PCR Mycobacterium leprae assay for the clinical diagnosis of leprosy.
Mycobacterium leprae was thought to be the exclusive causative agent of leprosy until Mycobacterium lepromatosis was identified in a rare form of leprosy known as diffuse lepromatous leprosy (DLL). We isolated M. lepromatosis from a patient with DLL and propagated it in athymic nude mouse footpads. Genomic analysis of this strain (NHDP-385) identified a unique repetitive element, RLPM, on which a specific real-time quantitative polymerase chain reaction assay was developed. The RLPM assay, and a previously developed RLEP quantitative polymerase chain reaction assay for M. leprae, were validated as clinical diagnostic assays according to Clinical Laboratory Improvement Amendments guidelines. We tested DNA from archived histological sections, patient specimens from the United States, Philippines, and Mexico, and US wild armadillos. The limit of detection for the RLEP and RLPM assays is 30 M. leprae per specimen (0.76 bacilli per reaction; coefficient of variation, 0.65%-2.44%) and 122 M. lepromatosis per specimen (3.05 bacilli per reaction; 0.84%-2.9%), respectively. In histological sections (n = 10), 1 lepromatous leprosy (LL), 1 DLL, and 3 Lucio reactions contained M. lepromatosis; 2 LL and 2 Lucio reactions contained M. leprae; and 1 LL reaction contained both species. M. lepromatosis was detected in 3 of 218 US biopsy specimens (1.38%). All Philippines specimens (n = 180) were M. lepromatosis negative and M. leprae positive. Conversely, 15 of 47 Mexican specimens (31.91%) were positive for M. lepromatosis, 19 of 47 (40.43%) were positive for M. leprae, and 2 of 47 (4.26%) contained both organisms. All armadillos were M. lepromatosis negative. The RLPM and RLEP assays will aid healthcare providers in the clinical diagnosis and surveillance of leprosy.
Author Adams, Linda B
Truman, Richard W
Pena, Maria T
Lahiri, Ramanuj
Lenz, Shannon M
Donovan, Kelly
Balagon, Marivic F
Scollard, David M
Singh, Pushpendra
Jurado-Santa Cruz, Fermin
Sharma, Rahul
McCoy, Rajiv C
Williams, Diana L
Ochoa, Maria T
Estrada-Garcia, Iris
Silva-Miranda, Mayra
Stryjewska, Barbara
AuthorAffiliation 3 Department of Biology, Johns Hopkins University, Baltimore, Maryland, USA
1 US Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, National Hansen’s Disease Program , Baton Rouge, Louisiana, USA
8 Centro Dermatológico Dr. Ladislao de la Pascua, Secretaria de Salud de la Ciudad de México , Mexico City, Mexico
9 Leonard Wood Memorial, Center for Leprosy Research , Cebu, Philippines
7 Consejo Nacional de Ciencia y Tecnologia (National Council of Science and Technology)–Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México , Mexico City, Mexico
4 IHRC, Inc., Atlanta, Georgia, USA
5 Department of Dermatology, University of Southern California, Los Angeles, California, USA
6 Departamento Immunologia, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional , Mexico City, Mexico
2 National Institute of Research in Tribal Health, Jabalpur, MP India
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Keywords leprosy diagnostic assay
real-time PCR
Mycobacterium leprae
Mycobacterium lepromatosis
Language English
License This work is written by (a) US Government employee(s) and is in the public domain in the US.
Published by Oxford University Press for the Infectious Diseases Society of America 2019.
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D. L. W. R. W. T. and D. M. S. are retired.
Present affiliation: Cofactor Genomics, St Louis, Missouri, USA.
R. S. and P. S. contributed equally to this work.
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Kato (2021060919582787700_CIT0012) 1986; 57
Bezalel (2021060919582787700_CIT0028) 2019; 94
Burd (2021060919582787700_CIT0010) 2010; 23
Lahiri (2021060919582787700_CIT0013) 2005; 54
Koressaar (2021060919582787700_CIT0014) 2007; 23
Han (2021060919582787700_CIT0005) 2008; 130
Han (2021060919582787700_CIT0022) 2014; 142
de Wit (2021060919582787700_CIT0006) 1994; 140
Singh (2021060919582787700_CIT0016) 2015; 112
Scollard (2021060919582787700_CIT0004) 2016
Han (2021060919582787700_CIT0007) 2009; 191
Truman (2021060919582787700_CIT0009) 2008; 2
Han (2021060919582787700_CIT0023) 2012; 11
Virk (2021060919582787700_CIT0029) 2017; 23
Westgard (2021060919582787700_CIT0019) 2016
Gurung (2021060919582787700_CIT0025) 2019; 25
Truman (2021060919582787700_CIT0020) 2011; 364
Braet (2021060919582787700_CIT0017) 2018; 56
Rea (2021060919582787700_CIT0003) 2005; 73
2021060919582787700_CIT0001
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Han (2021060919582787700_CIT0008) 2012; 51
Jessamine (2021060919582787700_CIT0021) 2012; 11
Cheng (2021060919582787700_CIT0026) 2019; 13
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Snippet Abstract Background Mycobacterium leprae was thought to be the exclusive causative agent of leprosy until Mycobacterium lepromatosis was identified in a rare...
Mycobacterium leprae was thought to be the exclusive causative agent of leprosy until Mycobacterium lepromatosis was identified in a rare form of leprosy known...
BACKGROUNDMycobacterium leprae was thought to be the exclusive causative agent of leprosy until Mycobacterium lepromatosis was identified in a rare form of...
Mycobacterium lepromatosis was isolated and propagated in mouse footpads. We developed a real-time polymerase chain reaction (PCR) assay using a unique...
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SubjectTerms Animals
Humans
Mexico
Mice
Mycobacterium
Mycobacterium leprae - genetics
Online Only
Pathology, Molecular
Title Isolation of Mycobacterium lepromatosis and Development of Molecular Diagnostic Assays to Distinguish Mycobacterium leprae and M. lepromatosis
URI https://www.ncbi.nlm.nih.gov/pubmed/31732729
https://search.proquest.com/docview/2315104421
https://pubmed.ncbi.nlm.nih.gov/PMC8189713
Volume 71
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