{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:18:12Z","timestamp":1790925492026,"version":"4.1.0"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"publisher","award":["APQ-1 E-26\/111.196\/2014"],"award-info":[{"award-number":["APQ-1 E-26\/111.196\/2014"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Leprosy is a chronic infectious disease caused by the bacillus <jats:italic>Mycobacterium leprae<\/jats:italic>. The disease may evolve for inflammatory reactions, reversal reaction (RR) and erythema nodosum leprosum (ENL), the major cause of irreversible neuropathy in leprosy, which occur in 1 in 3 people with leprosy, even with effective treatment of <jats:italic>M<\/jats:italic>. <jats:italic>leprae<\/jats:italic>. Leprosy remains persistently endemic in our region where it predominantly affects lowest socioeconomic conditions people, as <jats:italic>Toxoplasma gondii<\/jats:italic> infection in the municipality studied. Previously, we have shown <jats:italic>T<\/jats:italic>. <jats:italic>gondii<\/jats:italic> coinfection as a risk marker for leprosy, mainly in its severe form. This present study assessed whether <jats:italic>T<\/jats:italic>. <jats:italic>gondii<\/jats:italic> infection is also a risk factor for leprosy reactions and the predictive value of immunoglobulin production prior to development of leprosy reactions. Patients with leprosy (n = 180), co-infected or not with <jats:italic>T<\/jats:italic>. <jats:italic>gondii<\/jats:italic>, had their serum investigated for levels of IgA, IgE, IgG1, IgG2, IgG3 and IgG4 anti-PGL-1 by ELISA prior to development of leprosy reactions. The serologic prevalence for <jats:italic>T<\/jats:italic>. <jats:italic>gondii<\/jats:italic> infection was 87.7% in leprosy reaction patients reaching 90.9% in those with ENL. The leprosy reaction risk increased in <jats:italic>T<\/jats:italic>. <jats:italic>gondii<\/jats:italic> seropositive individuals was two-fold ([OR] = 2.366; 95% confidence interval [CI 95%]: 1.024\u20135.469) higher than those seronegative, and considering the risk of ENL, this increase was even more evident (OR = 6.753; 95% CI: 1.050\u201372.85) in coinfected individuals. When evaluated the prediction of anti-PGL-1 immunoglobulin levels for development of leprosy reactions in patients coinfected or not with <jats:italic>T<\/jats:italic>. <jats:italic>gondii<\/jats:italic>, only the increase IgE levels were associated to occurrence of reactional episodes of leprosy, specifically ENL type, in patients coinfected with <jats:italic>T<\/jats:italic>. <jats:italic>gondii<\/jats:italic>, compared to those not coinfected or no reaction. Thus, the immunomodulation in co-parasitism <jats:italic>T<\/jats:italic>. <jats:italic>gondii<\/jats:italic>\u2013<jats:italic>M<\/jats:italic>. <jats:italic>leprae<\/jats:italic> suggest increased levels of IgE as a biomarker for early detection of these acute inflammatory episodes and thereby help prevent permanent neuropathy and disability in leprosy patients.<\/jats:p>","DOI":"10.1371\/journal.pone.0300704","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T17:42:05Z","timestamp":1718214125000},"page":"e0300704","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Toxoplasma gondii infection and high levels of IgE are associated to erythema nodosum leprosy (ENL)"],"prefix":"10.1371","volume":"19","author":[{"given":"Leticia Silva","family":"Nascimento","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri Scheidegger","family":"de Castro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessany de Aquino","family":"Figueira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5559-2934","authenticated-orcid":true,"given":"Rebeka da Concei\u00e7\u00e3o","family":"Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Azevedo","family":"da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edilbert Pellegrini","family":"Nahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6172-166X","authenticated-orcid":true,"given":"Alba Luc\u00ednia","family":"Peixoto-Rangel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"issue":"4","key":"pone.0300704.ref001","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.1007\/s13311-021-01153-z","article-title":"Treatment and Evaluation Advances in Leprosy Neuropathy","volume":"18","author":"GJ Ebenezer","year":"2021","journal-title":"Neurotherapeutics"},{"issue":"11","key":"pone.0300704.ref002","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1111\/j.1348-0421.2001.tb01308.x","article-title":"Mycobacterium leprae and leprosy: a compendium","volume":"45","author":"S Sasaki","year":"2001","journal-title":"Microbiol Immunol"},{"issue":"1","key":"pone.0300704.ref003","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.clindermatol.2014.07.005","article-title":"Immunology of leprosy and diagnostic challenges","volume":"33","author":"I Nath","year":"2015","journal-title":"Clin Dermatol"},{"issue":"3","key":"pone.0300704.ref004","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1590\/S0037-86822010000300015","article-title":"Caracter\u00edsticas epidemiol\u00f3gicas e cl\u00ednicas das rea\u00e7\u00f5es hans\u00eanicas em indiv\u00edduos paucibacilares e multibacilares, atendidos em dois centros de refer\u00eancia para hansen\u00edase, na Cidade de Recife, Estado de Pernambuco","volume":"43","author":"M. 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