Polimorfismo do gene MBL2 em pacientes e contatos intradomiciliares de hanseníase e sua associação com classe operacional, formas clínicas e Anti-PGL1 em áreas de risco no município do Recife-PE

Abstract

Despite the economic and social transformations, leprosy remains a public health problem. Pernambuco has 60 % of cases concentrated in the Recife metropolitan area and is responsible for 30% of the cases in the state, being considered a priority for leprosy control. The spatial distribution and identification of risk groups and the study of new technologies which may collaborate in the diagnosis and treatment of the cases is important to assist in the planning, implementation and monitoring of prevention and control measures of this disease. The use of serological and molecular markers appears as an option that can help to develop future strategies for contacting chemoprophylaxis, as measures of disease control. Genetic studies suggest that variations in the susceptibility of humans to leprosy involve complex characteristics of various polymorphic alleles, moreover the polymorphism of the mannose binding lectin (MBL2 ) gene have been associated with the protection against lepromatous leprosy .The present study aimed to investigate the association of polymorphism of MBL2 gene with operating class and clinical forms of leprosy and anti - PGL - 1 serology in household contacts in the highest risk areas in the city Recife in the period 2006-2013. The construction of the Social Need Indicator (ICS) was performed using data from the 2010 demographic census. For the detection of anti- PGL – 1 in the contacts, the ML Flow test was used. This test was developed in the Laboratory of Immunology of AIDS and Leprosy Institute of Tropical Pathology and Public Health (IPTSP) at the Federal University of Goiás (UFG). Genotyping of the promoting region was performed using Taqman fluorescent probes by PCR technology in real time. The comparison of the Social Need indicator with the detection rate of leprosy showed a direct relationship between them. The Spearman correlation coefficient was positive, but weak, probably due to the heterogeneous composition of the city. The seroprevalence of anti -PGL- 1 was 36.80 % being greater in female contacts, aged over 15, and in contacts of multibacillary patients MBL2 structural variantallele O andgenotype OO were associated to PB in univariate (p= 0.034 and 0.003) in manand cases olderthan 40 years; and in multivariate analysis the genotype OO also was independently associated to PB (p= 0.023). Interestingly, the O allele and HYO and LYO haplotype were associated to IgM anti-PGL-1 positive serology (p= 0.046 and 0.032). MBL2 polymorphism may influence leprosy development by anefficient modulation of anti-PGL-1 response and low complement activation.