| Objectives:Through detecting the levels of ACA-IgG,ANA,ENA-Ab,ASO,dsDNA,RF and LACC1 in peripheral blood of leprosy cured and healthy people,collecting and sorting out the relevant data of leprosy patients,analysis the epidemiological characteristics of leprosy,the expression of autoantibodies and LACC1 in leprosy cured patiens and the differences among different leprosy types,to explore the immune status and possible influencing factors of leprosy cured and distribution of autoantibodies and LACC1 among healthy people.Methods:The experimental group included 198 patients diagnosed with leprosy and cured in Wenshan Prefecture,Yunnan Province.According to the types of leprosy when diagnosed,they were divided into BT group,BL group,LL group,BB group,and TT group,with 43 cases,59 cases,35 cases,19 cases and 42 cases respectively.Healthy control group is from the physical examination center of YUN DA Hospital in December 2019,which has 101 cases in total.All group members were took 4ml venous blood to detect the expression of ACA-IgG,ANA,ENA-Ab,ASO,dsDNA,RF and LACC1 in peripheral blood by ELISA.The results were analyzed with IBM spss22.0 software package.Results:1.Epidemiological characteristics:A total of 198 cases were treated in the leprosy group,43 in the BT group,59 in the BL group,35 in the LL group,19 in the BB group and 42 in the TT group.The youngest is 16 years old and the oldest is 98 years old.The median age is 58(47,65)years old.There were 135 man and 63 women with a man to women ratio of 2.1:1.There were 101 healthy controls,with a minimum age of 18 years old and a maximum of 80 years old,with a median age of 57(48,66)years old,69 man and 32 women,with a man to women ratio of 2.2:1.All of them came from Wenshan Prefecture,Yunnan Province,except for those with incomplete information,95.2%were married,their mainly occupations were farmers,and most of the cultural levels are primary schools and below.The minimum age of onset was 5 years,the maximum age of onset was 75 years,and the median age of onset was 25(17,33)years.Most cases occurred in youth or adolescence,The mainly methods of leprosy detection the proportions are 58.6%and 26.8%respectively.The mainly age of diagnosis was young,accounting for 61.1%of the total.The interval between the onset of leprosy and the diagnosis:the shortest was treated in the same month and the longest was 18 years.Most are interval two years or less,accounting for 68.7%(136/198)of the total,with an average interval time of 26.2 months.The mainly methods of leprosy detection are dermatology visits,mutual report findings,general investigation findings,clue investigation findings,contact examination findings and self-reports,the proportions are 12.1%,14.1%,12.1%,12.1%,12.1%,and 11.6%,respectively.Apart from those who lacked information,33.7%of leprosy infection source came from within the family,26.1%came from outside the family and 38.3%had an unknown source of infection.The statistical results of the number of leprosy patients in the family showed that there were no other leprosy patients in 8 families,1 other leprosy patient in 27 families,2 other leprosy patients in 5 families,3 other leprosy patients in 8 families,4 other leprosy patients in 2 families,5 other leprosy patients in 6 families,6 other leprosy patients in 4 families,and 7 other leprosy patients in 1 family with unknown source of infection.Removal of unknown drugs,36.9%were treated with dapsone,including 11 cases in the BL group,15 cases in the BT group,4 cases in the BB group,22 cases in the LL group and 21 cases in the TT group;16.2%used dual therapy,including 1 case in BL group,11 cases in BT group and 20 cases in TT group;45.5%received triple therapy,including 45 cases in BL group,17 cases in BT group,14 cases in BB group,13 cases in LL group and 1 case in TT group.Removal persons with missing disability information,57.4%had no disability,4.0%had class I disability,37.6%had class II disability,1.0%had class III disability,and the disability rate was 42.6%.The proportions among BL type,BT type and TT are 27.9%,30.2%and 20.9%respectively.2.ACA-IgG,ANA,ENA-Ab,ASO,dsDNA,RF and LACC1 ELISA test results:In healthy controls,ACA-IgG,ANA,ENA-Ab,ASO,dsDNA,RF,and LACC1 were skewed.The median concentration of ACA-IgG was 5.97(3.02,14.64)ng/ml.The median concentration of ANA was 61.02(6.49,31.55)ng/ml;ENA-Ab median concentration is 34.34(29.65,49.49)ng/ml;ASO median concentration is 61.33(32.267,113.94)U/L;dsDNA median concentration is 6.92(5.03,8.94)IU/ML;RF median concentration is 0.47(0.20,0.98)ng/ml;LACC1 median concentration is 1.66(1.07,1.93)ng/ml.The concentration of ACA-IgG in man was higher than in women(P<0.05),the difference was statistically significant.ACA-IgG,ANA,ENA-Ab,ASO,dsDNA,RF,and LACC1 concentration levels had no statistically difference among the 40-year-old and below group,the 41-year-old to 70-year-old group and the over 71-year-old group(P>0.05).LACC1,ACA-IgG,ANA,ENA-Ab,ASO,dsDNA,and RF were positively correlated.The levels of ACA-IgG,ANA,ENA-Ab,ASO,dsDNA,RF and LACC1 in the leprosy-cured group were skewed.The median concentration of ACA-IgG was 41.45(22.00,67.26)ng/ml;the median concentration of ANA was 61.02(34.06,91.31)ng/ml;ENA-Ab median concentration was 43.50(33.13,59.68)ng/ml;ASO median concentration was 254,61(152.79,407.87)U/L;dsDNA median concentration was 7.11(5.31,10.24)IU/ML;RF median concentration was 2.79(1.60,4.24)ng/ml;LACC1 median concentration was 1.48(1.05,2.17)ng/ml.The concentration of LACC1 in the group of 71 years old was higher than that in the group of 40 years old and below and the group of over 41 years old to 70 years old,the difference was statistically significant(P=0.016,0.024 respectively).The differences in ACA-IgG concentration,ANA concentration,ENA-Ab concentration,ASO concentration,dsDNA concentration and RF concentration between different age groups were not statistically significant.LACC1,ACA-IgG,ANA,ENA-Ab,ASO,dsDNA,and RF were positively correlated(P<0.05).The concentration levels of ACA-IgG,ANA,ENA-Ab,ASO,dsDNA,RF and LACC1 in the dapsone treatment group,the dual treatment group and the triple treatment group were not statistically different(P>0.05).There was no statistically significant difference of the concentrations of LACC1,ACA-IgG,ENA-Ab,ASO and RF among different leprosy types.The concentration levels of dsDNA and ANA in the BT group were higher than those in the BB group(P=0.027 and 0.043,respectively).There was no statistical difference between the detection indexes of the disabled and the non-disabled.The concentrations of ACA-IgG,ENA-Ab,ASO,ANA and RF in the leprosy cured group were higher than those in the healthy control group(P<0.05),the difference was statistically significant.The positive rates of ACA-IgG,ANA,ENA-Ab,ASO,dsDNA,RF and LACC1ACA-IgG in the leprosy cured group were higher than those in the healthy control group(P<0.05),the difference was statistically significant.Conclusion(s):The autoantibody status of leprosy patients after cure is still different from that of healthy people,and there may be immune enhancement,regardless of gender,age,leprosy severity,and treatment regimen.There is a certain link between LACC1 and the situation of leprosy autoantibodies,and the specific mechanism of action needs to be further studied. |
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