@article{mbs:/content/journal/jmm/10.1099/jmm.0.016394-0, author = "Gupta, Nishma and Shankernarayan, Nallakandy P. and Dharmalingam, Kuppamuthu", title = "α1-Acid glycoprotein as a putative biomarkerfor monitoring the development of the type II reactional stage of leprosy", journal= "Journal of Medical Microbiology", year = "2010", volume = "59", number = "4", pages = "400-407", doi = "https://doi.org/10.1099/jmm.0.016394-0", url = "https://www.microbiologyresearch.org/content/journal/jmm/10.1099/jmm.0.016394-0", publisher = "Microbiology Society", issn = "1473-5644", type = "Journal Article", keywords = "TNF-α, tumour necrosis factor-α", keywords = "BB, mid-borderline", keywords = "RR, reversal reaction", keywords = "BT, borderline tuberculoid", keywords = "AGP, α1-acid glycoprotein", keywords = "2DE, two-dimensional electrophoresis", keywords = "MALDI-TOF, matrix-assisted laserdesorption/ionization-time of flight", keywords = "IPG, immobilized pH gradient", keywords = "sLex, sialyl Lewis x", keywords = "TT, tuberculoid leprosy", keywords = "ENL, erythema nodosum leprosum", keywords = "BL, borderline lepromatous", keywords = "MDT, multidrug therapy", keywords = "LL, lepromatous leprosy", abstract = "Leprosy, a spectral disease manifested on the basis of host immune responses,is complicated by its reactional stages, namely type I reversal reaction (RR)and type II erythema nodosum leprosum (ENL). These reactional stagesare characterized by uncontrolled and aberrant immune responses. Biomarkersfor reactional stages would aid in early diagnosis, efficient treatment, preventionof neurological complications and prediction of predisposition to reactionalstages. In this study, comparative analysis of the serum proteome of leprosypatients by two-dimensional electrophoresis (2DE) followed by massspectrometry showed differential expression of acute-phase protein α 1-acid glycoprotein (AGP; also known as orosomucoid).AGP levels in untreated ENL cases were significantly higher than in lepromatousleprosy (LL; a non-reactional disease stage) (P=0.0126),RR (P=0.0176) and healthy controls (P=0.0030).These data were confirmed using ELISA. The levels of AGP decreased to normallevels after treatment with multidrug therapy and thalidomide (P=0.0167). In a follow-up study, AGP levels, which were highin the untreated ENL stage, decreased significantly at 5 days (P=0.0084) and 21 days (P=0.0027)post-treatment. A stage-dependent increase in AGP in an LL patient who progressedinto the ENL stage was also shown. Glycosylation analysis by 2DE showed differentialexpression of acidic glycoforms of AGP in untreated ENL cases. Changes inAGP concentration and differential expression of isoforms correlated withthe inflammatory condition in ENL and also with the treatment regimen. Thus,initial validation of AGP as an ENL-specific biomarker and treatment indicatorwas shown in this study.", }