(LML) Nerve impairment, sensory testing and M.leprae immune status

Leprosy Mailing List – August 18,  2013 

Ref.:    (LML) Nerve impairment, sensory testing and M.leprae immune status  

From:  Pranab K Das, Univ. Birmingham, UK

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Dear Pieter

As you are aware that I am an attentive follower of the LML based discussion forum . I was following the correspondences regarding the use of different techniques (ranging from SW filaments, ball point, pin pricks, cotton wool /birds' feather touch etc) for evaluating the loss of sensation as a measure of nerve impairment in leprosy. Since all these techniques seem to be useful in field use with varying degree, I am not sure whether such diagnostics had been studied in conjunction with patients' M. leprae specific immune/non(innate) immune status. In Bauru, I am contemplating to undertake a study (both longitudinal/retrospective) using multipronged approach which will include, para-medical , sonography/MRI/doppler, electro-physiology(as the main back bone), immune status, as well as immunopathological study for determining the most valid paramedical sets, to diagnose the nerve impairment in the field, with confidence.

In our study, should we rely on the data obtained by the use of SW filaments (as Dr Barreto, correspondence is also suggestive), as the most representative?

We are still in the planning stage to undertake this project with the initiative of Dr. Garbino, Dr Jason Barreto and Dr Marcos Virmond . Our main aim will be to have cohort double blind study, to establish the robustness of the data for diagnostic and prognostic purposes, which( i.e. double blind study) are mostly lacking in the field of leprosy.

I must admit after being 35 years in the field of leprosy although as a part timer, every day I am learning some useful tip, even in my old age.

BW.

Pranab K Das

Honorary Sr. Research Associate

Division Pathology(Neuropathology Unit),

Academin Medical Center-Univ.Amsterdam, NL;

Honorary Sr. Research Fellow, Div Infection and Immunity

(Clinical Immunology Unit), Colleges of Medical/Dental Sciences,

Univ. Birmingham, UK; and Chair Immunodeficiency/Inflammation,

Institute of Pediatrics, Univ Brescia, Italy.

emails: p.k.das@amc.uva.nl; p.k.das@bham.ac.uk; pran.k.das@gmail.com

 

 

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder  editorlml@gmail.com