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The stable incidence of new leprosy cases suggests that transmission of infection continues despite worldwide implementation of MDT. Thus, specific tools are needed to diagnose early stage  Mycobacterium leprae  infection, the likely sources of transmission.  M. leprae  antigens that induce T-cell responses in  M. leprae  exposed and/or infected individuals thus are major targets for new diagnostic tools. Previously, we showed that ML1601c was immunogenic in patients and healthy household contacts (HHC). However, some endemic controls (EC) also recognized this protein. To improve the diagnostic potential, IFN-  γ   responses to ML1601c peptides were assessed using PBMC from Brazilian leprosy patients and EC. Five ML1601c peptides only induced IFN-  γ   in patients and HHC. Moreover, 24-hour whole-blood assay (WBA), two ML1601c peptides could assess the level of  M. leprae  exposure in Ethiopian EC. Beside IFN-  γ  , also IP-10, IL-6, IL-1  β  , TNF-  α  , and MCP-1 were increased in EC from areas with high leprosy prevalence in response to these ML1601c peptides. Thus, ML1601c peptides may be useful for differentiating  M. leprae  exposed or infected individuals and can also be used to indicate the magnitude of  M. leprae  transmission even in the context of various HLA alleles as present in these different genetic backgrounds.

Peptides Derived fromMycobacterium lepraeML1601c Discriminate between Leprosy Patients and Healthy Endemic Controls