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    1983, 41(3):1077.Infect. Immun.

    Gelber and P J BrennanS N Cho, D L Yanagihara, S W Hunter, R Hin serodiagnosis of leprosy.Mycobacterium leprae and use

    phenolic glycolipid I fromSerological specificity of

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    V o l . 4 1 , N o . 3N F E C T I O N AND I M M U N I T Y , S e p t . 1 9 8 3 , p . 1 0 7 7 - 1 0 8 30 0 1 9 - 9 5 6 7 / 8 3 / 0 9 1 0 7 7 - 0 7 $ 0 2 . 0 0 / 0C o p y r i g h t C 1 9 8 3 , A m e r i c a n S o c i e t y f o r M i c r o b i o l o g y

    S e r o l o g i c a l S p e c i f i c i t y o f P h e n o l i c G l y c o l i p i d I f r o mM y c o b a c t e r i u m l e p r a e a n d U s e i n S e r o d i a g n o s i s o f L e p r o s y

    SANG-NAE CHO,1 DONNA L . YANAGIHARA,1 SHIRLEY W. HUNTER,1 ROBERT H. GELBER,2 ANDPATRICK J . B R E N N A N ' *

    D e p a r t m e n t o f M i c r o b i o l o g y , C o l o r a d o S t a t e U n i v e r s i t y , F o r t C o l l i n s , C o l o r a d o 8 0 5 2 3 1 a n d U . S . P u b l i cH e a l t h S e r v i c e , H a n s e n ' s D i s e a s e P r o g r a m , S e t o n M e d i c a l C e n t e r , D a l y C i t y , C a l i f o r n i a 9 4 0 1 5 2R e c e i v e d 2 May 1 9 8 3 / A c c e p t e d 2 4 J u n e 1 9 8 3

    T h e s e r o l o g i c a l a c t i v i t i e s o f t h e s p e c i f i c p h e n o l i c g l y c o l i p i d I f r o m M y c o b a c t e -r i u m l e p r a e , i t s d i s s e c t e d p a r t s , a n d r e l a t e d g l y c o l i p i d s f r o m o t h e r m y c o b a c t e r i awere e x a m i n e d b y e n z y m e - l i n k e d i m m u n o s o r b e n t assay a g a i n s t h y p e r i m m u n ea n t i - M . leprae r a b b i t a n t i s e r u m a n d sera f r o m p a t i e n t s w i t h l e p r o s y a n d o t h e rm y c o b a c t e r i a l d i s e a s e s . H i g h a n t i - p h e n o l i c g l y c o l i p i d I i m m u n o g l o b u l i n M a n t i -b o d i e s were f o u n d i n 2 3 o f 2 4 ( 9 6 % ) o f l e p r o m a t o u s l e p r o s y p a t i e n t s on s h o r t t e r mc h e m o t h e r a p y a n d i n 8 o f 1 3 t u b e r c u l o i d l e p r o s y p a t i e n t s ( 6 2 % ) . S e r a f r o mp a t i e n t s w i t h t u b e r c u l o s i s or a t y p i c a l m y c o b a c t e r i a l i n f e c t i o n s were d e v o i d o fa n t i - p h e n o l i c g l y c o l i p i d I a c t i v i t y . T h e s t r u c t u r a l l y r e l a t e d p h e n o l i c g l y c o l i p i d sf r o m M y c o b a c t e r i u m k a n s a s i i a n d M y c o b a c t e r i u m b o v i s a n d t h e a g l y c o n e s e g -ments o f t h e M. leprae p r o d u c t s h o w e d n o s i g n i f i c a n t a c t i v i t y . T h u s , t h et r i s a c c h a r i d e d e t e r m i n a n t o f p h e n o l i c g l y c o l i p i d I i s s p e c i f i c i n i t s s t r u c t u r e ,s e r o l o g i c a l a c t i v i t y , a n d , t o a l e s s e r e x t e n t , t h e a n t i b o d y c l a s s i t e v o k e s .

    T h e r e c e n t i s o l a t i o n o f a n u m b e r o f u n i q u ep h t h i o c e r o l - c o n t a i n i n g l i p i d s f r o m t h e s u r f a c e o fM y c o b a c t e r i u m l e p r a e ( 9 , 1 0 ) a f f o r d s t h e u n -p r e c e d e n t e d o p p o r t u n i t y t o r e l a t e s p e c i f i c , f u l l yd e f i n e d , l e p r o s y b a c i l l a r y m o i e t i e s t o t h e i m m u -n o l o g i c a l r e s p o n s e s o f l e p r o s y p a t i e n t s . S i n c et h e s e l i p i d s c o m p r i s e t h e b u l k o f t h e c o p i o u so u t e r b a c i l l a r y e x t e n s i o n s ( 9 ) , t h e y may r e p r e -s e n t t h e p r i m a r y f u n c t i o n a l i n t e r f a c e b e t w e e nt h e o r g a n i s m a n d t h e h o s t ' s d e f e n s e . T h e p r i n c i -p a l l i p i d i s a d i a c y l p h t h i o c e r o l ( 9 ) , b u t t h e m o r ei n t e r e s t i n g a r e t h r e e t r i g l y c o s y l p h e n o l i c d i a -c y l p h t h i o c e r o l s , t w o o f w h i c h h a v e b e e n f u l l yc h a r a c t e r i z e d a n d s h o w n t o c o n t a i n t h e p r e v i -o u s l y u n r e c o g n i z e d t r i s a c c h a r i d e a p p e n d a g e s :3 , 6 - d i - 0 - m e t h y l - , - D - g l u c o p y r a n o s y l ( 1 - - 4 )2 , 3 - d i - 0 - m e t h y l - a - L - r h a m n o p y r a n o s y l ( 1 - - * 2 )3 - 0 - m e t h y l - a - L - r h a m n o p y r a n o s e ( i n p h e n o l i cg l y c o l i p i d I [ P h e n G L - I ] ) a n d 6 - O - m e t h y l - P - D -g l u c o p y r a n o s y l ( 1 - * 4 ) 2 , 3 - d i - 0 - m e t h y l - a - L - r h a m -n o p y r a n o s y l ( l - * 2 ) 3 - 0 - m e t h y l - a - L - r h a m n o p y r -a n o s e ( i n p h e n o l i c g l y c o l i p i d I I I ) ( 9 , 1 0 ) . S i n c et h e t r i s a c c h a r i d e s h o l d t h e p r o m i s e o f t h e l o n g -s o u g h t M. l e p r a e - s p e c i f i c a n t i g e n d e t e r m i n a n t s ,i m m e d i a t e i n t e r e s t c o n c e r n s t h e p o t e n t i a l o ft h e s e t r i s a c c h a r i d e s f o r t h e s p e c i f i c s e r o d i a g n o -s i s o f l e p r o s y . To t h i s e n d , t h e a c t i v i t i e s o f t h en a t i v e p h e n o l i c g l y c o l i p i d I a n d i t s d i s s e c t e dc o m p o n e n t s w e r e e x a m i n e d a g a i n s t a n t i - M . l e -p r a e r a b b i t a n t i s e r u m a n d s e r a f r o m l e p r o s yp a t i e n t s a c r o s s t h e c l i n i c o h i s t o p a t h o l o g i c a ls p e c t r u m o f t h e d i s e a s e . I n a d d i t i o n , t h e a c t i v i t y

    o f a c l o s e l y r e l a t e d t r i g l y c o s y l p h e n o l i c d i a -c y l p h t h i o c e r o l f r o m M y c o b a c t e r i u m k a n s a s i ia n d t h a t o f s e r a f r o m p a t i e n t s w i t h m y c o b a c t e -r i a l i n f e c t i o n s o t h e r t h a n l e p r o s y w e r e e x a m i n e dt o b e t t e r d e l i n e a t e t h e s p e c i f i c i t y o f t h e g l y c o l i p -i d a n t i g e n f o r s e r o l o g i c a l a s s e s s m e n t o f l e p r o s y .

    MATERIALS AND METHODSS o u r c e o f l i p i d s . L i p i d s w e r e o b t a i n e d b y e x t r a c t i o no f M . l e p r a e - i n f e c t e d ' a r m a d i l l o t i s s u e s a n d f r a c t i o n a t -e d o n s i l i c i c a c i d c o l u m n s ( 1 0 ) . D i m y c o c e r o s y l p h t h i o -c e r o l was e l u t e d w i t h C H C 1 3 a n d p u r i f i e d b y p r e p a r a -t i v e t h i n - l a y e r c h r o m a t o g r a p h y ( T L C ) i n C H C 1 3 ( 9 ) .P h t h i o c e r o l w a s d e r i v e d f r o m i t b y a l k a l i n o l y s i s a n df u l l y p u r i f i e d b y p r e p a r a t i v e TLC ( 9 ) . P h e n G L - I w a so b t a i n e d b y f u r t h e r i r r i g a t i o n o f s i l i c i c a c i d c o l u m n sw i t h 2% CH30H i n C H C 1 3 , f o l l o w e d b y p r e p a r a t i v eTLC i n e t h e r - a c e t o n e ( 8 : 2 ) ( 1 0 ) . D e a c y l a t e d P h e n G L - Ia n d i t s f a t t y a c i d s w e r e d e r i v e d f r o m t h e n a t i v eg l y c o l i p i d b y a l k a l i n o l y s i s f o l l o w e d b y s e p a r a t i o n o ft h e c o m p o n e n t p a r t s o n s i l i c i c a c i d ( 1 0 ) . T h e d e g l y c o -s y l a t e d p h e n o l i c p h t h i o c e r o l c o r e w a s d e r i v e d f r o mt h e d e a c y l a t e d P h e n G L - I b y m e t h a n o l y s i s ( 1 0 ) . P r e p a -r a t i o n a n d c h a r a c t e r i z a t i o n o f t h e t r i g l y c o s y l p h e n o l i cd i a c y l p h t h i o c e r o l ( m y c o s i d e A ) f r o m M. k a n s a s i i h a sb e e n d e s c r i b e d ( 8 ) . T h e m o n o g l y c o s y l p h e n o l i c d i a -c y l p h t h i o c e r o l ( m y c o s i d e B ) o f M. b o v i s w a s e x t r a c t e df r o m l y o p h i l i z e d BC G w i t h C H C 1 3 - C H 3 0 H ( 2 : 1 ) , a n d

    p a r t i a l l y p u r i f i e d b y e l u t i o n f r o m s i l i c i c a c i d c o l u m n sw i t h C H C l 3 - 1 % m e t h a n o l i n C H C l 3 . F i n a l p u r i f i c a t i o nw a s a c c o m p l i s h e d b y p r e p a r a t i v e TLC i n d i e t h y le t h e r - a c e t o n e ( 9 : 1 ) . T h e s t r u c t u r e w a s e x a m i n e d b yp r o c e d u r e s d e s c r i b e d p r e v i o u s l y ( 9 , 1 0 ) , a n d t h a tr e p o r t e d b y D e m a r t e a u - G i n s b u r g a n d L e d e r e r ( 5 ) w a s1 0 7 7

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    1 0 7 8 CHO ET A L .c o n f i r m ed a n d a m p l i f i e d . I t i s a m i x t u r e o f 2 7 - [ p ( 2 -O - m e t h y l - a - L - r h a m n o p y r a n o s y l o x y ) p h e n y l ] - 9 , 1 1 - d i -m y c o c e r o s y l - 3 - m e t h o x y l - 4 - m e t h y l - h e p t a c o s a n e , a n d2 9 - [ p ( 2 - O - m e t h y l - a - L - r h a m n o p y r a n o s y l o x y p h e n y l ] - 9 ,1 1 - d i m y c o c e r o s y l - 3 - m e t h o x y l - 4 - m e t h y l - n o n a c o s an e( C . V . K n i s l e y a n d P . J . B r e n n a n , u n p u b l i s h e d d a t a ) .S e r a . H y p e r i m m u n e a n t i s e r u m w a s o b t a i n e d f r o mr a b b i t s i m m u n i z e d w i t h M . l e p r a e p u r i f i e d f r o m a r m a -d i l l o l i v e r a n d e m u l s i f i e d i n i n c o m p l e t e F r e u n d a d j u -v a n t . A n i m a l s w e r e i n o c u l a t e d i n t r a m u s c u l a r l y a n db l e d 7 w e e k s a f t e r t h e f i n a l b o o s t . Human s e r a w e r eo b t a i n e d f r o m i n d i v i d u a l l e p r o s y p a t i e n t s a t t e n d i n g t h ec l i n i c o f t h e U . S . P u b l i c H e a l t h S e r v i c e H a n s e n ' sD i se a s e P r o g r a m , S e t o n M e d i c a l C e n t e r , D a l e C i t y ,C a l i f . P a t i e n t s w e r e c l a s s i f i e d c l i n i c a l l y a n d p a t h o l o g i -c a l l y a c c o r d i n g t o t h e R i d l e y a n d J o p l i n g s c a l e ( 1 4 ) . Ap o o l o f s e r u m w a s o b t a i n e d b y m i x i n g e q u a l v o l u m e s o fs e r a f r o m s e v e r a l p a t i e n t s ( o f R . H . G e l b e r ) w i t hl e p r o m a t o u s l e p r o s y . S e r a w e r e a l s o o b t a i n e d f r o mp a t i e n t s w i t h m y c o b a c t e r i a l i n f e c t i o n s o t h e r t h a n M .I e p r a e a t t e n d i n g N a t i o n a l J e w i s h H o s p i t a l a n d R e -s e a r c h C e n t e r , D e n v e r , C o l . I n a l l c a s e s , c l i n i c a ls y m p t o m s o f d i s e a s e w e r e e v i d e n t , a c i d - f a s t b a c i l l iw e r e d e t e c t e d i n s p u t a o r o t h e r b o d y f l u i d s o r o r g a n s ,a n d m y c o b a c t e r i a h a d b e e n c u l t u r e d a n d , i n m o s tc a s e s , i d e n t i f i e d b y b i o c h e m i c a l m e a n s , s e r o l o g y , a n dTLC o f t h e s p e c i f i c l i p i d a n t i g e n s ( 4 ) . T h e a t y p i c a lm y c o b a c t e r i a i s o l a t e d w e r e M . k a n s a s i i , M . f o r t u i t u m ,o r o n e o f t h e v a r i o u s M. i n t r a c e l l u l a r e s e r o t y p e s .N o r m a l s e r a w e r e o b t a i n e d f r o m s t u d e n t s a n d g r a d u a t -i n g D o c t o r s o f V e t e r i n a r y M e d i c i n e a t C o l o r a d o S t a t eU n i v e r s i t y .E L I S A c o n d i t i o n s . F o r e n z y m e - l i n k e d i m m u n o s o r -b e n t a s s a y ( E L I S A ) a n a l y s i s o f h u m a n s e r a , l i p i d s ( 1 0 0. g / m l ) w e r e s u s p e n d e d i n c a r b o n a t e - b i c a r b o n a t e c o a t -i n g b u f f e r ( p H 9 . 6 ; r e f e r e n c e 1 6 ) b y d i r e c t s o n i c a t i o nf o r 2 0 t o 3 0 s w i t h a 3-mm p r o b e . T h e s u s p e n s i o n wasd i l u t e d t o t h e r e q u i r e d c o n c e n t r a t i o n w i t h t h e s a m eb u f f e r ; 5 0 , u l w a s a d d e d t o w e l l s o f p o l y s t y r e n e m i c r o -t i t e r p l a t e s w h i c h w e r e i n cu ba t ed a t 3 7 C f o r 1 4 t o 1 6 hi n a m o i s t c h a m b e r . W e l l s w e r e w a s h e d w i t h p h o s -p h a t e - b u f f e r e d s a l i n e ( P B S ) , b l o c k e d b y t h e a d d i t i o n o f1 0 0 , u l o f PBS c o n t a i n i n g 5% b o v i n e s e r u m a l b u m i n( B S A ) , a n d i n c u b a t e d a t 3 7 C f o r 1 h i n a m o i s tc h a m b e r . T h e c o n t e n t s w e r e a s p i r a t e d , a n d 5 0 , u l o fh u m a n s e r u m d i l u t e d w i t h PBS c o n t a i n i n g 2 0 % o n o r m a lg o a t s e r u m ( P B S - N G S ) w a s a d d e d . P l a t e s w e r e i n c u -b a t e d a t 3 7 C f o r 1 h , w a s h e d w i t h P B S , f o l l o w e db y t h e a d d i t i o n o f g o a t . a n t i - h u m a n i m m u n o g l o b u l i n M( I g M ) - o r i m m u n o g l o b u l i n G ( I g G ) - p e r o x i d a s e c o n j u -g a t e r e a g e n t ( C a p p e l L a b o r a t o r i e s , D o w n i n g t o n , P a . )d i l u t e d 1 / 1 , 0 0 0 i n P B S - N G S . A f t e r a 1 - h i n c u b a t i o na n d f i v e f u r t h e r w a s h i n g s , 5 0 , u l o f H 2 0 2 - O - p h e n y l e n e -d i a m i n e s u b s t r a t e - d y e r e a g e n t i n c i t r a t e p h o s p h a t eb u f f e r ( 1 6 ) w e r e a d d e d a n d i n c u b a t e d a t 3 7 C f o r 3 0m i n i n t h e c a s e o f t h e I g M c o n j u g a t e a n d 2 h f o r t h eI g G c o n j u g a t e . R e a c t i o n s w e r e t e r m i na t ed w i t h 2 . 5 NH 2 S O 4 a f t e r a 3 0 - m i n i n c u b a t i o n a n d t h e a b s o r b a n c ew a s r e a d a t 4 8 8 n m ( A 4 8 8 ) . ELISA w a s a l s o c o n d u c t e dw i t h w h o l e M. l e p r a e s u s p e n d e d i n c o a t i n g b u f f e r ( 5 0j i g / m l ) . ELISA o n h y p e r i m m u n e r a b b i t s e r u m wasc o n d u c t e d a s d e s c r i b e d ( 1 0 ) . To a b o l i s h I g M a c t i v i t y ,r e d u c t i o n w i t h 2 - m e r c a p t o e t h a n o l was p e r f o r m e d a sd e s c r i b e d b y M e l s o m a n d D u n c a n ( 1 2 ) . I g G wass e p a r a t e d f r o m I g M w i t h a c o m m e r c i a l I g M i s o l a t i o nk i t ( I s o l a b I n c . , A k r o n , O h i o ) b a s e d on t h e p r o c e d u r ed e s c r i b e d b y J o h n s o n a n d L i b b y ( 1 1 ) .

    S t a t i s t i c s . S t a t i s t i c a l a n a l y s i s w a s p e r f o r m e d b y u s -i n g t h e g r o u p c o m p a r i s o n S t u d e n t t t e s t .RESULTS

    D e v e l o p m e n t o f E L I S A . T h e ELISA c o n d i -t i o n s d e s c r i b e d p r e v i o u s l y u s i n g h y p e r i m m u n ea n t i - M . l e p r a e a n t i s e r u m w e r e s u i t a b l e f o r d e m -o n s t r a t i n g t h e i n h e r e n t s e r o l o g i c a l a c t i v i t y o fn a t i v e P h e n G L - I , b u t t h e f e w h u m a n s e r a t e s t e dw e r e m a r k e d b y a b n o r m a l l y h i g h b a c k g r o u n da b s o r b a n c e s ( 1 0 ) . I n a n o t h e r s e t o f c o n d i t i o n s , i nw h i c h e t h a n o l w a s e m p l o y e d a s t h e c o a t i n gm e d i u m a n d P B S - T w e e n w a s u s e d f o r n o n s p e -c i f i c b l o c k i n g a n d a s t h e d i l u e n t , i n t a c t P h e n G L -I r e a c t e d p o o r l y , a n d d e a c y l a t e d P h e n G L - I d i dn o t r e a c t a t a l l ; p r e s u m a b l y , i t d i d n o t a d s o r ba n d w a s l o s t a s t h e f l u i d p h a s e .V a r i a t i o n o f t h e c o n d i t i o n s b a s i c a l l y d e s i g n e df o r p r o t e i n a n t i g e n s ( 7 , 1 6 ) p r o v e d t o b e t h e m o s tr e p r o d u c i b l e f o r P h e n G L - I . T h e i m p o r t a n t f e a -t u r e s o f t h e p r o c e d u r e s e e m t o b e t h o r o u g hs o n i c a t i o n o f t h e g l y c o l i p i d i n t h e c o a t i n g b u f f e r ,d e l e t i o n o f d e t e r g e n t s f r o m a l l s u b s e q u e n t s t e p s ,u s e o f a d o u b l e b l o c k w i t h h e t e r o l o g o u s BS Aa n d h o m o l o g o u s N G S , a n d a l s o u s e o f t h e l a t t e ra s a d i l u e n t . F i g u r e 1 s h o w s t h e a c t i v i t y o b -s e r ve d w i t h t h e p o o l e d h u m a n l e p r o m a t o u s l e p -r o s y s e r a a n d a r a n g e o f g l y c o l i p i d c o n c e n t r a -t i o n s w i t h e i t h e r t h e I g M - o r I g G - c o n j u g a t e dr e a g e n t . I g M r e s p o n s e s w e r e u n i f o r m l y m u c hh i g h e r t h a n t h o s e o f I g G . When p o o l e d s e r a f r o ml e p r o m a t o u s l e p r o s y p a t i e n t s w e r e r e d u c e d w i t h2 - m e r c a p t o e t h a n o l a l l a n t i - P h e n G L - I I g M a c t i v -i t y w a s a b o l i s h e d , a n d o n l y t h e l o w r e s i d u a l I g Ga c t i v i t y r e m a i n e d . When t h e m a j o r i t y o f I g Gs u b c l a s s e s w e r e r e m o v e d f r o m I g M b y a m i n o -e t h y l - S e p h e d e x A - 5 0 i o n - e x c h a n g e c h r o m a t o g -r a p h y ( 1 1 ) , t h e r e w a s l i t t l e d i m i n u t i o n i n a c t i v i -t y ; t h e c o r r e l a t i o n c o e f f i c i e n t b e t w e e n t h e A 4 8 8v a l u e s f o r p u r i f i e d I g M a n d f o r w h o l e s e r u m IgMw a s 0 . 9 9 2 . T h u s , t h e r e a c t i v e i m m u n o g l o b u l i nc l a s s i s m o s t l y I g M . T h e l o w e r l i m i t o f a n t i g e nr e a c t i v i t y w a s a b o u t 2 5 0 n g / m l , i . e . , 1 2 . 5 n g o r 6p m o l p e r w e l l . A n t i b o d y t i t r a t i o n o f t h e p o o l e da c t i v e s e r a s h o w e d a n a p p r o x i m a t e l i n e a r r e l a -t i o n s h i p b e t w e e n a b s o r p t i o n a n d d i l u t i o n o f s e -rum p o o l i n t h e r a n g e 1 : 1 0 0 t o 1 : 6 , 4 0 0 . B a s e d o ns e v e r a l t r i a l e x p e r i m e n t s w i t h p o o l e d a c t i v e a n dn e g a t i v e s e r a , a d i l u t i o n o f 1 : 3 0 0 w a s c h o s e n ,a n d p l a t e s w e r e r o u t i n e l y c o a t e d w i t h 2 , u g o fP h e n G L - I p e r m l o f b u f f e r ( 1 0 0 n g p e r w e l l ) a t3 7 C f o r 1 4 t o 1 6 h . U n d e r t h e s e c o n d i t i o n s , a na b s o r b a n c e v a l u e o f 0 . 9 7 2 + 0 . 1 0 0 ( t r i p l i c a t e ) f o rt h e p o o l e d a c t i v e s e r a was o b t a i n e d c o m p a r e dw i t h a v a l u e o f 0 . 0 4 8 + 0 . 0 1 6 ( t r i p l i c a t e ) f o rp o o l e d s e r a f r o m h e a l t h y c o n t r o l s .S p e c i f i c i t y o f P h e n G L - I . To c o m p a r e t h es e r o l o g i c a l a c t i v i t y o f t h e n a t i v e g l y c o l i p i d w i t hi t s v a r i o u s e n t i t i e s , P h e n G L - I a n d t h e d i m y c o -c e r o s y l p h t h i o c e r o l s w e r e s u b j e c t e d t o a l k a l i n e

    I N F E C T . IMMUN.

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    SEROLOGY OF PHENOLIC GYLCOLIPID I

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    A n t i g e n ( S A g / m l )F I G . 1 . C o m p a r i s o n o f I g G a n d I g M a n t i b o d y a c t i v i t i e s a g a i n s t P h e n G L - I ( 2 , u g / m l ) i n p o o l e d s e r a f r o mh u m a n l e p r o m a t o u s l e p r o s y p a t i e n t s ( d i l u t e d 1 : 3 0 0 ) .

    a n d a c i d i c d e g r a d a t i o n s ( 9 , 1 0 ) ( F i g . 2 ) . R e m o v a lo f t h e f a t t y a c y l f u n c t i o n s f r o m P h e n G L - I d i dl i t t l e t o e n h a n c e a c t i v i t y ( F i g . 3 ) . L i t t l e s e r o l o g i -c a l a c t i v i t y w a s f o u n d i n t h e a g l y c o n e s e g m e n t so f t h e p h t h i o c e r o l - c o n t a i n i n g l i p i d s , s u c h a s t h ep h e n o l i c p h t h i o c e r o l c o r e , p h t h i o c e r o l i t s e l f , t h ed i m y c o c e r o s y l p h t h i o c e r o l o r t h e f r e e m y c o c e r o -s i c a c i d s . M o r e o v e r , t h e m o n o g l y c o s y l p h e n o l i cd i m y c o c e r o s y l p h t h i o c e r o l f r o m M . b o v i s a n dt h e t r i g l y c o s y l p h e n o l i c d i a c y l p h t h i o c e r o l f r o mM. k a n s a s i i w e r e d e v o i d o f s i g n i f i c a n t a c t i v i t y

    a g a i n s t t h e a n t i - M . l e p r a e r a b b i t a n t i b o d i e s o rt h o s e f r o m human l e p r o m a t o u s l e p r o s y p a t i e n t s .To f u r t h e r e x a m i n e t h e s e r o l o g i c a l s p e c i f i c i t yo f t h e t r i g l y c o s y l e n t i t y , a n t i - M . l e p r a e r a b b i ta n t i s e r u m w a s r e a c t e d a g a i n s t t h e f u l l r a n g e o f3 1 m y c o s i d e C g l y c o p e p t i d o l i p i d a n t i g e n s f r o mm e m b e r s o f t h e M . a v i u m - M . i n t r a c e l l u l a r e - M .s c r o f u l a c e u m s e r o c o m p l e x ( 2 , 4 ) . T h e s e g l y c o -l i p i d s a r e e n d o w e d w i t h s h o r t t y p e - s p e c i f i c t e t -r a - o r t r i s a c c h a r i d e a n t i g e n d e t e r m i n a n t s , a r ea l s o r i c h i n O - m e t h y l - 6 - d e o x y h e x o s e s a n d 0 -

    P h e n o l i c G l y c o i p i d - IOCH3

    3 . 6 - c - - M e - G c p ( I - 4 ) 2 , 3 - d - O - M e - R h a p ( 1 2 ) 3 - 0 - M e - R h a p 1 S - C H , - ( C H , ) , , - C H - C H , - C H - ( C H , ) 4 - C H - - H - C H , - C R ,I I II OR OR O H 3

    R = M y c o c e r o s i c A c i d sM y c o c e r o s i c A c i d s

    O C H 33 , 6 - d - O - M e - G l c p 1 0 4 ) 2 , 3-b-O-Me-Rp ( 1 S 2 ) 3-O;Me-FCiapI CC H , - ( C H , ) , , - C H - C H , - - C H - - ( C H ) , - C H - C H - - C H , - C H ,

    I IIOH OH CH,

    H + D e a c y l a t e d P h e n o l i c G l y c o l i p i d - IO C H ,

    HO-@-CH,HCH,),,-CH--CH,- , H - ( C H 2 ) . - C H - C H - C H , - C H ,OH OH C H ,

    P h e n o l i c P h t h i o c e r o l C o r eF I G . 2 . F r a c t i o n a t i o n o f t h e P h e n G L - I m o l e c u l e w i t h a l k a l i an d a c i d .

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    FIG. 3. (A) R a b b i t I g G a n t i b o d y activity a g a i n s tPhen G L - 1 , dimycocerosyl pht h i o cero l, and variousdegradation produ c ts. The c o n c e n t r a t i o n of the l i p i d swas5 p g / m l of c o a t i n g b u f f e r . Anti-M. leprae rabbitantiserum was diluted 1:90 i n PBS-Tween (10). (B)Human 1gM a n t i b o d y activity a g a i n s t the variousl i p i d s . The concentration of lipids was 10 p g / m l ofc o a t i n g buffer and pooled sera from human leproma-tous patients wasdiluted 1:100 in PBS.

    methylglucoses ( 2 ) , and are h i g h l y reactive i nELISA a g a i n s t hyperimmune rabbit antiseraraised a ga in s t the homologous strains ( D . L.Y a n a g i h a r a , V. L. Barr, and P. J. Brennan, un-p u b l i s he d data). De s p i t e aplethora of 31 poten-t i a l l y reactive o ligo s a cchar ides, there weresur-prisingly few casesof cros s -rea ct ion ; o n l y theg l y c o p e p t i d o l i p i d s from serovars 5, 12, 18, 20,

    2 3 , 2 4 , a n d 2 8 s h o w e d s i g n i f i c a n t a c t i v i t y( > 0 . 1 0 ) w i t h a b s o r b a n c e s o f 0 . 5 7 0 . 4 , 0 . 1 10 . 0 7 , 0 . 2 5 0 . 1 7 , 0 . 3 1 0 . 2 2 , 0 . 2 9 0 . 2 1 ,2 . 5 3 1 . 7 9 , a n d 0 . 3 8 0 . 2 7 , r e s p e c t i v e l y ,c o m p a r e d w i t h an a b s o r b a n c e o f 1 . 3 3 0 . 9 4 f o rt h e P h e n G L - I a n t i - M . leprae a n t i s e r u m c o m b i -n a t i o n ( o n e s e t o f v a l u e s f r o m t h r e e s u c h e x p e r i -m e n t s , a l l q u a l i t a t i v e l y s i m i l a r ) . O f t h e s e , t h eg l y c o p e p t i d o l i p i d f r o m serovar 2 4 was t h e mostr e a c t i v e . H o w e v e r , w h e n t h e reverse r e a c t i o n swere c o n d u c t e d ( i . e . , P h e n G L - I a g a i n s t e a c h o ft h e h y p e r i m m u n e r a b b i t a n t i s e r a t o t h e i n d i v i d -u a l s e r o v a r s ) , t h e r e was n o t o n e i n c i d e n c e o f ap o s i t i v e r e a c t i o n . M o r e o v e r , w h e n t h e i n d i v i d -u a l g l y c o p e p t i d o l i p i d s were r e a c t e d w i t h p o o l e dsera f r o m l e p r o m a t o u s l e p r o s y p a t i e n t s t h e r ewas no c r o s s - r e a c t i v i t y .

    A n a l y s i s o f human s e r a . S e r a f r o m i n d i v i d u a ll e p r o s y p a t i e n t s , p a t i e n t s w i t h o t h e r m y c o b a c t e -r i a l i n f e c t i o n s , a n d h e a l t h y i n d i v i d u a l s were ana-l y z e d u s i n g b o t h t h e I g M - a n d I g G - c o n j u g a t e dr e a g e n t s ( T a b l e 1 ) . W i t h t h e I g M c o n j u g a t e , t h esera o f 2 9 o f 3 3 l e p r o m a t o u s p a t i e n t s ( 8 8 % )d e m o n s t r a t e d a n t i - g l y c o l i p i d a n t i b Q d i e s , a n d t h emean v a l u e ( A 4 8 8 , 0 . 5 8 0 + 0 . 5 1 4 ) was s i g n i f i -c a n t l y h i g h e r ( P < 0 . 0 1 ; S t u d e n t t t e s t ) t h a n t h a to f h e a l t h y s u b j e c t s . T r e a t m e n t o f l e p r o m a t o u sl e p r o s y p a t i e n t s f o r two or more years r e s u l t e di n s i g n i f i c a n t l y l o w e r I g M v a l u e s ( P < 0 . 0 1 ) . O ft h o s e t r e a t e d f o r l e s s t h a n two years, 2 3 o f 2 4( 9 6 % ) were j u d g e d p o s i t i v e ( m e a n A 4 8 8 , 0 . 7 3 7 0 . 5 1 9 ) , w h e r e a s f o r t h o s e t r e a t e d f o r more t h a ntwo y e a r s , 6 o f 9 ( 6 7 % ) were p o s i t i v e ( m e a nA 4 8 8 , 0 . 1 6 2 0 . 1 0 7 ) ( T a b l e 1 an d F i g . 4 ) . Eveni n t h i s l a t t e r group t h e mean A 4 8 8 v a l u e wass i g n i f i c a n t l y h i g h e r ( P < 0 . 0 1 ) t h a n i n t h eh e a l t h y s u b j e c t s .On e o f t h e two b o r d e r l i n e p a t i e n t s s t u d i e d h a de l e v a t e d I g M a n t i b o d i e s ( A 4 8 8 , 0 . 3 1 5 ) , b u t t h eo t h e r d i d n o t ( A 4 8 8 , 0 . 0 6 5 ) ( T a b l e 1 a n d F i g . 5 ) .Of t h e 1 3 t u b e r c u l o i d p a t i e n t s s t u d i e d , 8 ( 6 2 % )h a d s i g n i f i c a n t e l e v a t i o n s o f I g M a n t i b o d y t oP h e n G L - I ( m e a n A 4 8 8 , 0 . 1 8 6 0 . 2 5 1 ) ; t h e meanv a l u e f o r t u b e r c u l o i d p a t i e n t s was s i g n i f i c a n t l y

    TABLE 1 . Human I g M s e r o r e a c t i v i t y t o p h e n o l i c g l y c o l i p i d IN o . M e a n r e s p o n s e ( A 4 8 g ) SD f o r I gM gGI n f e c t i o n p o s i t i v e a / I g M / I g Gn e g a t i v e I g M I g G r a t i o

    H e a l t h y c o n t r o l s 0 / 2 3 0 . 0 4 8 0 . 0 1 6 0 . 0 4 6 0 . 0 1 6T u b e r c u l o s i s 0 / 1 2 0 . 0 5 9 0 . 0 2 2 0 . 0 6 9 0 . 0 2 2A t y p i c a l m y c o b a c t e r i a l i n f e c t i o n s 0 / 1 5 0 . 0 3 8 0 . 0 1 6 0 . 0 4 8 0 . 0 2 0T u b e r c u l o i d l e p r o s y ( T T , B T ) b 8 / 5 0 . 1 8 6 0 . 2 5 1 0 . 0 4 8 0 . 1 4 0 3 . 9L e p r o m a t o u s l e p r o s y ( L L P , L L S , B L ) c 2 9 / 4 0 . 5 8 0 0 . 5 1 4 0 . 0 8 4 0 . 0 6 8 6 . 9W i t h a < 2 - y r t h e r a p y 2 3 / 1 0 . 7 3 7 0 . 5 1 9 0 . 0 9 8 0 . 0 7 5 7 . 5W i t h a > 2 - y r t h e r a p y 6 / 3 0 . 1 6 2 0 . 1 0 7 0 . 0 4 5 0 . 0 2 1 3 . 6a P o s i t i v e , >3 S D f r o m t h e mean o f h e a l t h y c o n t r o l s .b T T , T u b e r c u l o i d ; B T , b o r d e r l i n e t u b e r c u l o i d .c L L P , P o l a r l e p r o m a t o u s ; L L , , s u b p o l a r l e p r o m a t o u s ; B L , b o r d e r l i n e l e p r o m a t o u s .

    I N F E C T . IMMUN.

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    SEROLOGY OF PHENOLIC GYLCOLIPID I 1 0 8 1h i g h e r ( P < 0 . 0 5 ) t h a n t h a t o f t h e h e a l t h yc o n t r o l s , a n d s i g n i f i c a n t l y l o w e r ( P < 0 . 0 1 ) t h a nt h a t o f t h e l e p r o m a t o u s p a t i e n t s . F i v e o f t h el e p r o s y p a t i e n t s who h a d i n i t i a l l y d e m o n s t r a t e dp o s i t i v e s e r a w e r e r e s t u d i e d 1 m o n t h t o 1 y e a rl a t e r ; a l l r e m a i n e d p o s i t i v e , a n t i b o d y l e v e l s e i -t h e r s t a y i n g e s s e n t i a l l y t h e s a m e ( t w o p a t i e n t s )o r d e c r e a s i n g ( t h r e e p a t i e n t s ) . F o r a l l p a t i e n t st h r o u g h o u t t h e d i s e a s e s p e c t r u m , t h e I g M - t o -I g G r a t i o w a s v a r i a b l e , i n t h e r a n g e o f 3 . 6 t o 7 . 5 ,a g a i n i n d i c a t i n g t h a t a n t i - g l y c o l i p i d I g G a c t i v i t yi s o f q u e s t i o n a b l e s i g n i f i c a n c e . H o w e v e r , a ni n v e r s e r e l a t i o n s h i p o f I g M t o I g G a p p l i e d t oa n t i - w h o l e M. l e p r a e a n t i b o d i e s ; w h e n w h o l es u s p e n d e d M. l e p r a e w a s t h e c o a t i n g a n t i g e n ,t h e r a t i o w a s a b o u t 0 . 5 . No p a t i e n t s w i t h t u b e r -c u l o s i s ( n = 1 2 ; mean A 4 8 8 , 0 . 0 5 9 0 . 0 2 2 ) o rp a t i e n t s w i t h v a r i o u s a t y p i c a l m y c o b a c t e r i a l i n -f e c t i o n s ( n = 1 5 ; mean A 4 8 8 , 0 . 0 3 8 0 . 0 1 6 )d e m o n s t r a t e d I g G o r I g M s e r o r e a c t i v i t y t o P h e nG L - I . N e v e r t h e l e s s , a l l o f t h e s e s e r a s h o w e d ah i g h I g G r e s p o n s e i n ELISA t o w h o l e M. l e p r a ec o a t i n g a n t i g e n , i n d i c a t i n g t h a t t h e s e r a h a da n t i b o d i e s t o t h e c o m m o n m y c o b a c t e r i a l a n t i -g e n s .

    DISCUSSIONS i n c e t h e i r i s o l a t i o n a n d r e c o g n i t i o n o f t h e i rs t r u c t u r a l u n i q u e n e s s , t h e t r i s a c c h a r i d e a p p e n -

    d a g e s o f t h e p h e n o l i c g l y c o l i p i d s h a d p r o m i s e dt o b e s p e c i f i c M. l e p r a e h a p t e n s , e s p e c i a l l yw h e n c o n s i d e r e d i n l i g h t o f t h e m y c o s i d e Cp o l a r g l y c o p e p t i d o l i p i d s ( 2 , 4 ) a n d t h e t r e h a l o s e -c o n t a i n i n g l i p o o l i g o s a c c h a r i d e s ( S . W. H u n t e r ,R . C . M u r p h y , K . C l a y , M . B . G o r e n , a n d P . J .B r e n n a n , J . B i o l . C h e m . , i n p r e s s ) , a l l h i g h l ya n t i g e n i c a n d e n d o w e d w i t h s h o r t o l i g o s a c c h a -r i d e s o f e x q u i s i t e s p e c i f i c i t y . H o w e v e r , u n l i k et h e s e o t h e r s , t h e p h e n o l i c g l y c o l i p i d s a r e h i g h l ya p o l a r a n d n o t r e a d i l y a m e n a b l e t o s e r o l o g i c a lm a n i p u l a t i o n s . N e v e r t h e l e s s , t h e i r p o t e n t i a l a st o o l s f o r t h e s e r o d i a g n o s i s o f l e p r o s y w a s i n -f e r r e d f r o m i n i t i a l r e c o g n i t i o n o f t h e m a s t h el i k e l y s e r o l o g i c a l l y a c t i v e c o m p o n e n t s i n c r u d eb a c i l l a r y e x t r a c t s ( 3 ) , a n d , s u b s e q u e n t l y , P a y n ee t a l . ( 1 3 ) i n c o r p o r a t e d p u r e P h e n G L - I i n t ol i p o s o m e s a n d d e m o n s t r a t e d r e a c t i v i t y w i t h s e r af r o m l e p r o m a t o u s l e p r o s y p a t i e n t s b y g e l d i f f u -s i o n . P r e v i o u s l y , u s i n g h y p e r i m m u n e a n t i - M .l e p r a e a n t i s e r u m , we r e c o g n i z e d t h e f e l i c i t y o fELISA a n d a s s u m e d t h a t t h e o r i e n t a t i o n o f t h el i p i d o n t h e p o l y s t y r e n e s u b s t r a t u m w a s s u c h a st o r e n d e r t h e d i a c y l p h t h i o c e r o l c r y p t i c a n d p r e f -e r e n t i a l l y e x p o s e t h e t r i s a c c h a r i d e m o i e t y ( 1 0 ) .A s d e s c r i b e d h e r e , ELISA c o m b i n e d w i t h t h es i m p l e p l o y o f t h o r o u g h s o n i c a t i o n o f t h e g l y -c o l i p i d i n a n a q u e o u s medium a l l o w s r e a d yr e a c t i o n b e t w e e n g l y c o l i p i d a n d a n t i b o d i e s i ns e r a f r o m l e p r o s y p a t i e n t s . T h e m o s t g r a t i f y i n ga s p e c t o f t h e p r e s e n t s t u d y i s t h e a b s e n c e o f

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    0 New O l dL e p r o m a t o u s P a t i e n t sF I G . 4 . A n t i - P h e n G L - I a c t i v i t y i n l e p r o m a t o u sp a t i e n t s t r e a t e d w i t h d a p s o n e f o r l e s s t h a n two years( n e w p a t i e n t s ) a n d more t h a n two years ( o l d p a t i e n t s ) .

    s i g n i f i c a n t b i n d i n g b e t w e e n t h e s o - c a l l e d m y c o -s i d e A o f M. k a n s a s i i a n d a n t i - P h e n G L - I a n t i -b o d i e s . P r e v i o u s l y , we h a d u s e d m y c o s i d e A asa n a i d t o e s t a b l i s h i n g t h e t r i g l y c o s y l a t e d n a t u r eo f t h e p r o d u c t f r o m M. leprae ( 8 ) . A l t h o u g h t h esugar c o m p o s i t i o n o f m y c o s i d e A i s known ( 5 ) ,t h e sequence h a s n o t b e e n f u l l y e s t a b l i s h e d .N e v e r t h e l e s s , t h e r e are s t r i k i n g s i m i l a r i t i e s i nt h e two p r o d u c t s ; b o t h c o n t a i n t r i s a c c h a r i d e s ,t h e n o n r e d u c i n g t e r m i n u s o f b o t h i s d i - O - m e t h -y l a t e d , t h e r e i s a p r e p o n d e r a n c e o f 0 - m e t h y l -6 - d e o x y h e x o s e s , a n d t h e r e are s i m i l a r i t i e s i nt h e c o n f i g u r a t i o n s o f t h e a n o m e r i c p r o t o n s .A c c o r d i n g l y , f u t u r e e m p h a s i s must b e on t h e[ 3 , 6 - d i - 0 - m e t h y l - - D - g l uc o p y r a n o sy l ( 1 - - 4 ) 2 ,3 -d i -0m e t h y l - a- L - r h a m n o p y r a n o s y l ( 1 - - 2 ) 3 - 0-m e t h y l - a t - L - r h a m n o p y r a n o s y l ] a n t i g e n d e t e r m i -n a n t , on i t s c h e m i c a l s y n t h e s i s , i t s c o n j u g a t i o n

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    1 0 8 2 C HO ET A L .

    TT BT BB BL L L S L L p TT BT BB BL L L S L L pF I G . 5 . I g G a n d I g M a n t i b o d y a c t i v i t i e s a g a i n s t P h e n G L - I ( 2 , u g I m l ) i n sera ( d i l u t e d 1 : 3 0 0 ) from h u m a nl e p r o s y p a t i e n t s across t h e d i s e a s e spectrum. Each p o i n t represents one i n d i v i d u a l . A l l p o i n t s above t h e dashedl i n e are c o n s i d e r e d p o s i t i v e ( s e r u m d i l u t i o n 1 : 3 0 0 ) . The s o l i d l i n e s represent median v a l u e s . TT, T u b e r c u l o i d ;B T , b o r d e r l i n e t u b e r c u l o i d ; BB, b o r d e r l i n e ; BL, b o r d e r l i n e l e p r o m a t o u s ; L L s , s u b p o l a r l e p r o m a t o u s ; L L p , p o l a rl e p r o m a t o u s .

    t o p e p t i d e c a r r i e r s , a n d i t s use as a t o o l f o rs e r o d i a g n o s i s a n d as a m o d u l a t o r o f c e l l m e d i a t -e d i m m u n i t y .A n t i - w h o l e M. leprae I g G a n d I g M h a v e b e e na m p l y d e m o n s t r a t e d i n l e p r o m a t o u s l e p r o s y pa-t i e n t s , a n d t h e a n t i - M . l e p r a e I g G was a b o u tt w i c e as h i g h as I g M ( 1 2 , 1 5 ) . T h u s , t h e a n t i - M .leprae IgM a n t i b o d i e s may b e m o s t l y i n r e -sponse t o t h e s p e c i f i c p h e n o l i c g l y c o l i p i d s ,w h e r e a s I g G may b e d i r e c t e d p r i m a r i l y a g a i n s tt h e more common m y c o b a c t e r i a l c e l l w a l l a n t i -gens, s u c h as t h e a r a b i n o g a l a c t a n - p e p t i d o g l y c a nc o m p l e x ( 1 ) . I n d e e d , sera f r o m p a t i e n t s w i t ho t h e r m y c o b a c t e r i a l i n f e c t i o n s , a l t h o u g h d e v o i do f a n t i - P h e n G L - I a n t i b o d i e s , s h o w e d h i g h a n t i -w h o l e M. leprae I g G . A n t i - M . l e p r a e I g M h a sb e e n a t t r i b u t e d t o p e r s i s t e n t i n f e c t i o n ( 1 5 ) .H o w e v e r , i t i s a l s o p o s s i b l e t h a t IgM m i g h t b e ab y s t a n d e r response t o t h e g l y c o l i p i d , d r i v e n b yn o n s p e c i f i c a l l y a c t i n g l y m p h o k i n e s p r o d u c e d b ya s p e c i f i c a l l y a c t i v a t e d T c e l l ( 6 ) . T h u s , t h ea b s e n c e o f a d i r e c t c e l l - t o - c e l l s i g n a l d e l i v e r e db y t h e T c e l l t o t h e r e s p o n d i n g B c e l l c o u l d b et h e reason f o r t h e l a c k o f a s u b s t a n t i a l I g M - t oI g G s w i t c h .C h e m o t h e r a p y o f l e p r o s y h a s b e e n a s s o c i a t e dw i t h d e c r e a s i n g a n t i b o d y t i t e r s , w h e r e a s r e -l a p s e d t u b e r c u l o i d p a t i e n t s g e n e r a t e h i g h e r a n t i -

    b o d y l e v e l s ( 1 7 ) . Touw e t a l . h a v e i n d i c a t e d t h a ta t t h e t u b e r c u l o i d e n d o f t h e s p e c t r u m , s o l i d -p h a s e a n t i b o d i e s t o w h o l e M. leprae c o r r e l a t e dw i t h s e v e r i t y o f d i s e a s e ( 1 5 ) . A s p e c i f i c assay f o rI g M a c t i v i t y t o t h e s p e c i f i c M. leprae g l y c o l i p i d ,p a r t i c u l a r l y i n t h e p r e c l i n i c a l s t a t e o f t h e l e p r o -matous f o r m o f t h e d i s e a s e , may e n a b l e e a r l i e rc h e m o t h e r a p y a n d t h e r e b y p r e v e n t d e f o r m i t ya n d e l i m i n a t e t h e i n f e c t i o u s r e s e r v o i r .

    ACKNOWLEDGMENTST h i s work wa s s u p p o r t e d b y P u b l i c H e a l t h S e r v i c e c o n t r a c tNO1 A I - 2 2 6 8 2 f r o m t h e N a t i o n a l I n s t i t u t e o f A l l e r g y an dI n f e c t i o u s D i s e a s e s .

    LITERATURE CITED1 . B a r k s d a l e , L . , a n d K . S . K i m . 1 9 7 7 . M y c o b a c t e r i u m .B a c t e r i o l . R e v . 4 1 : 2 1 7 - 3 7 2 .2 . B r e n n a n , P . J . , G . 0. A s p i n a l i , a n d J . E . N am S h i n . 1 9 8 1 .S t r u c t u r e o f t h e s p e c i f i c o l i g o s a c c h a r i d e s f r o m t h e g l y c o -p e p t i d o l i p i d a n t i g e n s o f serovars i n t h e M y c o b a c t e r i u ma v i u m - M y c o b a c t e r i u m i n t r a c e l l u l a r e - M y c o b a c t e r i u ms c r o f u l a c e u m c o m p l e x . J . B i o l . Chem. 2 5 6 : 6 8 1 7 - 6 8 2 2 .3 . B r e n n a n , P . J . , a n d W. W. B a r r o w . 1 9 8 0 . E v i d e n c e f o rs p e c i e s - s p e c i f i c l i p i d a n t i g e n s i n M y c o b a c t e r i u m l e p r a e .I n t . J . L e p r . 4 8 : 3 8 2 - 3 8 7 .4 . B r e n n a n , P . J . , H . M a y e r , G . 0. A s p i n a l l , a n d J . E . NamS h i n . 1 9 8 1 . S t r u c t u r e s o f t h e g l y c o p e p t i d o l i p i d a n t i g e n sf r o m serovars i n t h e M y c o b a c t e r i u m a v i u m / M y c o b a c t e r -

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    SEROLOGY OF PHENOLIC GYLCOLIPID Ii u m i n t r a c e l l u l a r e l M y c o b a c t e r i u m s c r o f u l a c e u m sero-c o m p l e x . E u r . J . B i o c h e m . 1 1 5 : 7 - 1 5 .5 . D e m a r t e a u - G i n s b u r g , H . , a n d E . L ed e r e r . 1 9 6 3 . S u r l as t r u c t u r e c h e m i q u e d u m y c o s i d e B . B i o c h i m . B i o p h y s .A c t a 7 0 : 4 4 2 - 4 5 1 .6 . E n d e r s , R . O . , E . K u s h n i r , J . W. K a p p l e r , P . M a r r a c k ,a n d S . C . K i n s k y . 1 9 8 3 . A r e q u i r e m e n t f o r n o n s p e c i f i c Tc e l l f a c t o r s i n a n t i b o d y responses t o " T - c e l l i n d e p e n d e n t "a n t i g e n s . J . I m m u n o l . 1 3 0 : 7 8 1 - 7 8 4 .7 . G i l i s , T . P . , a n d T . M. B u c h a n a n . 1 9 8 2 . P r o d u c t i o n a n dp a r t i a l c h a r a c t e r i z a t i o n o f m o n o c l o n a l a n t i b o d i e s t o My-c o b a c t e r i u m l e p r a e . I n f e c t . Immun. 3 7 : 1 7 2 - 1 7 8 .8 . H u n t e r , S . W . , a n d P . J . B r e n n a n . 1 9 8 1 . A n o v e l p h e n o l i cg l y c o l i p i d f r o m M y c o b a c t e r i u m l e p r a e p o s s i b l y i n v o l v e di n i m m u n o g e n i c i t y a n d p a t h o g e n i c i t y . J . B a c t e r i o l .1 4 7 : 7 2 8 - 7 3 5 .9 . H u n t e r , S . W . , a n d P . J . B r e n n a n . 1 9 8 3 . F u r t h e r s p e c i f i cp h e n o l i c g l y c o l i p i d a n t i g e n s a n d a r e l a t e d d i a c y l p h t h i o -c e r o l f r o m M y c o b a c t e r i u m l e p r a e . J . B i o l . Chem.2 5 8 : 7 5 5 6 - 7 5 6 2 .1 0 . H u n t e r , S . W . , T . F u j i w a r a , a n d P . J . B r e n n a n . 1 9 8 2 .S t r u c t u r e a n d a n t i g e n i c i t y o f t h e m a j o r s p e c i f i c g l y c o l i p i da n t i g e n o f M y c o b a c t e r i u m l e p r a e . J . B i o l . Chem.2 5 7 : 1 5 0 7 2 - 1 5 0 7 8 .1 1 . J o h n s o n , R . B . , a n d R . L i b b y . 1 9 8 0 . S e p a r a t i o n o f IgMe s s e n t i a l l y f r e e o f I g G f r o m serum f o r use i n systemsr e q u i r i n g assay o f I g M - t y p e a n t i b o d i e s w i t h o u t i n t e r f e r -

    ence f r o m r h e u m a t o i d f a c t o r . J . C l i n . M i c r n h i o l . 1 2 : 4 5 1 -4 5 4 .1 2 . M e l s o n , R . , a n d M. E . D u n c a n . 1 9 8 0 . D e m o n s t r a t i o n o fa n t i b o d i e s a g a i n s t M y c o b a c t e r i u m l e p r a e b o t h i ni m m u n o g l o b u l i n G a n d M i n sera f r o m p r e g n a n t a n d non-p r e g n a n t l e p r o m a t o u s l e p r o s y p a t i e n t s . L e p r . Rev.5 1 : 1 2 5 r 1 3 5 .1 3 . P a y n e , S . N . , P . D r a p e r , a n d R . J . W. R e e s . 1 9 8 2 . S e r o l o -g i c a l a c t i v i t y o f p u r i f i e d g l y c o l i p i d f r o m M y c o b a c t e r i u ml e p r a e . I n t . J . L e p r . 5 0 : 2 2 0 - 2 2 1 .1 4 . R i d l e y , D . S . , a n d W. H . J o p l i n g . 1 9 6 6 . C l a s s i f i c a t i o n o fl e p r o s y a c c o r d i n g t o i m m u n i t y . A f i v e - g r o u p s y s t e m . I n t .J . L e p r . 3 4 : 2 5 5 - 2 7 3 .1 5 . T o u w , J . , E . M. J . L a n g e n d i j k , G . L . S t o n e r , an d A .B e l e h u . 1 9 8 2 . H u m o r a l i m m u n i t y i n l e p r o s y : i m m u n o g l o b -u l i n G a n d M a n t i b o d y response t o M y c o b a c t e r i u m l e p r a ei n r e l a t i o n t o v a r i o u s d i s e a s e p a t t e r n s . I n f e c t . I m m un.3 6 : 8 8 5 - 8 9 2 .1 6 . V o l l e r , A . , D . E . B i d w e l l , a n d A . B a r t l e t t . 1 9 7 9 . P r o c e -d u r e s , p . 2 3 - 1 2 5 . I n Th e enzyme l i n k e d immunosorbentassay ( E L I S A ) , D y n a t e c h L a b o r a t o r i e s , I n c . , A l e x a n d r i a ,V a .1 7 . Y o d e r , L . , B . N a a f s , M. H a r b o e , an d G . B j u n e . 1 9 7 9 .A n t i b o d y a c t i v i t y a g a i n s t M y c o b a c t e r i u m l e p r a e a n t i g en 7i n l e p r o s y : s t u d i e s o n v a r i a t i o n i n a n t i b o d y c o n t e n tt h r o u g h o u t t h e s p e c t r u m a n d o n t h e e f f e c t o f DDS t r e a t -ment a n d r e l a p s e i n BT l e p r o s y . L e p r . R e v . 5 0 : 1 1 3 - 1 2 1 .

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