M J Lefford

Wayne State University, Detroit, Michigan, United States

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Publications (6)10.89 Total impact

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    K A Near · M J Lefford
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    ABSTRACT: Active tuberculosis (TB) and leprosy are difficult to diagnose early because there are few organisms to detect and the specific immune response does not distinguish between active and inactive disease. We developed an immunoassay for lysozyme to see whether serum lysozyme levels could be used to identify individuals with clinical leprosy or TB. The immunoassay for lysozyme proved superior to standard enzyme assays that were less sensitive and reliable. The lysozyme assay was compared with assays for antibodies to Mycobacterium tuberculosis lipoarabinomannan (LAM) and M. leprae phenolic glycolipid-1. The sera tested were from Ethiopian leprosy (paucibacillary and multibacillary) and TB patients and from healthy Ethiopian and U.S. controls. The lysozyme assay was able to detect more of the individuals with TB (sensitivity, 100% for 19 patients) or leprosy (sensitivity, 86% for 36 patients) than either antibody assay. In particular, lysozyme levels were raised in a higher proportion of the paucibacillary leprosy patients (83% of 17), for whom the antibody assays were less sensitive; the LAM IgG and the phenolic glycolipid-1 IgM levels were raised in only 62 and 44% of 16 patients, respectively. The data suggest that lysozyme measurements may be useful in the diagnosis of mycobacterial infections and other chronic infectious granulomatoses.
    Preview · Article · Jun 1992 · Journal of Clinical Microbiology
  • M J Lefford · M Hunegnaw · E Siwik
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    ABSTRACT: An ELISA has been used to measure IgM antibodies to phenolic glycolipid-I (PGL-I) in previously undiagnosed patients who were suspected of leprosy on purely clinical grounds. The certainty of clinical diagnosis was classified as either "firm" or "indefinite." Leprosy was confirmed in 133 of 161 patients on the basis of positive slit-skin smears and/or skin and/or nerve histopathology. All 58 patients with multibacillary leprosy (BB, BL, or LL) were correctly diagnosed clinically, as were 50 of 54 patients (93%) with a firm diagnosis of BT or TT leprosy. The firm clinical diagnoses were more accurate than either the slit-skin smear or ELISA data. However, there were 44 patients (27% of total), designated "rule out leprosy" (RO), for whom the clinical diagnosis was indefinite. The clinical suspicion of leprosy (RO) was correct in only 24 (55%) of these patients who had BT leprosy. The slit-skin smears were positive in only 20% of these patients compared to 50% for the ELISA. It was concluded that the PGL-I IgM ELISA may have its greatest diagnostic confirmatory value in paucibacillary disease because paucibacillary leprosy comprises the major source of clinical diagnostic difficulty.
    No preview · Article · Oct 1991 · International Journal of Leprosy and Other Mycobacterial Diseases
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    ABSTRACT: Sera or plasmas from 129 leprosy patients were tested by immunoblotting for antibodies that bound to proteins in a Triton-insoluble fraction enriched in neural intermediate filaments (IF fraction) from human or bovine spinal cord. Sixty samples (47%) showed positive staining of proteins at 35 kDa, 42 kDa or both. The presence of these antibodies appeared to be evenly distributed across the spectrum of disease. The frequency of these antibodies in samples from 12 healthy Ethiopians was similar to that in the leprosy group. Similar antibodies were found in only three of 28 samples from U.S. patients with neurologic diseases and in seven of 35 normal U.S. sera. Sera from U.S. tuberculosis patients stained multiple bands in the 50-30 kDa region of the blots; 11 of 16 stained bands corresponding to the 35 kDa or 42 kDa bands along with a number of other bands in this region. The 35 kDa and 42 kDa antigens do not appear to be breakdown products of neural filaments or glial fibrillary acidic protein, since antibodies to these proteins do not react with the 35 kDa or 42 kDa antigen. Further, the staining pattern with the leprosy sera is unchanged following Ca2+-mediated proteolysis of the IF-enriched fraction. The two antigens differ from one another in isoelectric point: the pI of the 35 kDa antigen is 5.9, and the pI of the 42 kDa antigen is 4.8. Staining of the immunoblots with antibodies against a number of known neural antigens failed to identify the 35 kDa and 42 kDa antigens. The 42 kDa antigen appears to be a component of axolemma, since 42 kDa-positive leprosy sera stained a protein with identical migration in preparations of bovine peripheral nervous system and human central nervous system axolemma. In some sera, antibodies reacting with the 35 kDa antigen were adsorbed by D-O bovine serum albumin, a synthetic analogue of the terminal disaccharide portion of the phenolic glycolipid 1 of Mycobacterium leprae. Antibodies to the 42 kDa antigen were not removed by this treatment.
    No preview · Article · Mar 1989 · Journal of Neuroimmunology
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    ABSTRACT: Two methods for detecting the phenolic glycolipid, PGL-1, a Mycobacterium leprae-specific molecule, in the urine of leprosy patients are described. Both methods rely on the 100-fold preconcentration of the urine, which can be accomplished by a single-step ultrafiltration procedure. The equivalent of approximately 2.5 micrograms of PGL-1/ml was detected in the urine of LL patients with an inhibition ELISA. The second method, a direct dot-blot assay on nitrocellulose paper, was much simpler and more sensitive. As little as 3 ng of antigen was detected by the dot-blot technique. PGL-1 was detected in the urine of LL patients.
    No preview · Article · Feb 1987 · Scandinavian Journal of Immunology
  • Elizabeth P. Eustis-Turf · Joyce A. Benjamins · Maurice J. Lefford
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    ABSTRACT: Sera from 43 leprosy patients were tested for antibodies that bound to normal human nerve. Thirty-eight percent showed positive staining as demonstrated by indirect immunofluorescence. Only 1 out of 30 control sera tested displayed similar staining. Western blots of myelin and neural intermediate filament (IF) proteins were tested with patient sera. Two of the anti-neural antibody (ANeAb)-positive leprosy sera bound to the P0 protein of PNS myelin. All 17 ANeAb-positive leprosy sera displayed 2 or more bands in the molecular weight range of Mr 45 000-55 000, when tested against IF proteins. One explanation for these findings is that leprosy patients produce antibodies to intermediate filament (IF) proteins released subsequent to the bacterial invasion of the peripheral nerves. The importance of these autoantibodies in the pathogenesis of leprosy is discussed.
    No preview · Article · Mar 1986 · Journal of Neuroimmunology
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    ABSTRACT: Active tuberculosis (TB)andleprosy aredifficult todiagnose early because there arefeworganisms todetect andthespecific immuneresponsedoesnotdistinguish between active andinactive disease. We developed an immunoassay forlysozymetoseewhether serum lysozyme levels couldbeusedtoidentify individuals with clinical leprosy orTB.Theimmunoassay forlysozymeproved superior tostandard enzyme assaysthat were less sensitive andreliable. Thelysozyme assaywas compared withassaysforantibodies toMycobacterium tuberculosis lipoarabinomannan (LAM)andM. lepraephenolic glycolipid-1. Thesera tested were from Ethiopian leprosy (paucibacillary andmultibacillary) andTB patients andfromhealthy Ethiopian andU.S. controls. Thelysozymeassaywas abletodetect more oftheindividuals withTB (sensitivity, 100%Nfor19 patients) orleprosy (sensitivity, 86%for36patients) thaneither antibody assay.Inparticular, lysozymelevels were raised ina higher proportion ofthepaucibacillary leprosy patients (83%of17), forwhomtheantibody assayswereless sensitive; theLAM IgGandthephenolic glycolipid-1 IgMlevels were raised inonly62and44% of16patients, respectively. Thedatasuggest that lysozymemeasurements may beuseful inthediagnosis of mycobacterial infections andother chronic infectious granulomatoses. Thediagnosis offlorid leprosy andtuberculosis (TB) presents fewdifficulties (6,16).Multibacillary leprosy (MB-L)canbediagnosed clinically in>90%ofcases(16), andextensive pulmonary TB canbeeasily confirmed by radiological methods, bythedetection ofacid-fast bacilli in thesputum, andbyculture. Thediagnosis ofpaucibacillary leprosy (PB-L), minimal pulmonary TB,andextrapulmo- naryTB isappreciably moredifficult. Theclinical features may beambiguous, andbacteriologic investigations are oftennegative. Although a biopsy examination may be definitive, facilities forhistopathologic studies maynotbe available indeveloping countries, inwhichleprosy andTB aremostprevalent. Oneapproach tothisproblemisto develop increasingly sensitive methods (24, 27)todetect the causative bacilli ortheir products (19). Another approach, whichwehaveadopted, istousetheresponse ofthehostto infer thepresence ofdisease. Ideally, thehostwoulddevelop anexquisitely sensitive response toanantigen thatisspecific fortheinfectious agent. Suchanideal hasbeenpartly realized inthediagnosis ofleprosy, inwhichantibody responses tothephenolic glycolipid-1 (PGL-1) antigen arehighly specific (2). How- ever,departure fromtheideal ismanifested bya low sensitivity inresponse topaucibacillary disease. Similarly, theantibody response tothecommonmycobacterial antigen lipoarabinomannan (LAM)isdetected less often inpatients withpaucibacillary disease (31, 32). Thesedataindicate that theantigen loaddrives theantibody response andthatthe detection ofpaucibacillary disease requires another typeof hostresponse marker, onethatislessdependent on the antigen load. BothPB-LandTB arecharacterized byhypersensitivity granulomas, thepredominant components ofwhichare macrophages. We therefore decided tomeasurea macro- phage secretory product, lysozyme, asanindicator ofgran-
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