Main activity: study of biomarkers of the humoral immune response in leprosy, pathogen-host interaction, prospecting for diagnostic tests, and immunopathogenesis studies.
Experience in applied immunology, translational research, immunoassays, cell and tissue culture, ex vivo model of human organotypic skin explant culture (hOSEC), in vivo experimentation, cytotoxicity tests, functional assays for screening biocompounds, clinical research, and clinical trials. Work in active search actions for leprosy and training of primary health care professionals of the Ministry of Health in partnership with the National Reference Center for Sanitary Dermatology and Leprosy of the department of clinical medicine/dermatology (CRNDSHansen) of the Hospital das Clínicas (HCFMRP - USP). Co-responsible for the undergraduate extension activity and for Achieving sustainable Development Goals.
EDUCATION
Biomedical scientist | Clinical pathologist | MSc in Human Pathology | PhD in Science | Postdoctoral Internal Medicine
RESEARCH, TEACHING, or OTHER INTERESTS
Immunology, Infectious Diseases, Dermatology, Public Health, Environmental and Occupational Health
Pure neural leprosy in a child: case report and diagnostic challenges Hortência Aparecida dos Reis Santana, Isabela Pedra Diamantino, Jean Carlos de Araújo Arruda, Pedro Alysson Mota da Silva, Gabrieli Souza dos Santos, et al. Revista Da Sociedade Brasileira De Medicina Tropical, 2026 Pure neural leprosy (PNL) is infrequent and manifests exclusively in the peripheral nerves without skin involvement, making the diagnosis more complex. We report the case of a 10-year-old child with muscle atrophy and sensory loss, diagnosed through clinical evaluation, grade 2 disability, and a positive anti-PGL-I test. The slit-skin smear (SSS) was negative for acid-fast bacilli. After 12 months of multidrug therapy, esthesiometric sensitivity improved; however, neurological deficits persisted, requiring anti-inflammatory treatment and physiotherapy. This case highlights the importance of early diagnosis and treatment for preventing disabilities. Tools, such as anti-PGL-I tests and imaging, are crucial, particularly in resource-limited settings.
Efficiency of the Sensory Mapping Score for Hansens’s disease diagnosis and follow-up: a functional cure criterion? Marco Andrey Cipriani Frade, Gustavo Sartori Albertino, João Vitor da Silva Sabino, Filipe Rocha Lima Frontiers in Medicine, 2025 Introduction Current operational criteria for Hansen’s disease (HD), which are primarily based on lesion count and fixed-duration multidrug therapy, tend to overlook the neurological spectrum of the disease and fail to define cure in terms of functional recovery. The objective was to develop and validate a Sensitive Mapping Score using Semmes-Weinstein Monofilaments to assess and monitor cutaneous sensory impairment in HD lesions during treatment with the RIMOXCLAMIN regimen. Methods A prospective cohort of 40 patients was followed over a 12-month period. Tactile sensitivity was evaluated in the hands, feet, and cutaneous lesions at 3-month intervals using a standardized SWM mapping system. Color-coded responses were converted into a numerical score reflecting the degree of sensory impairment. Clinical, neurological, and laboratory parameters were assessed in parallel. Results Although only 32.5% of patients met the multibacillary classification based on lesion count, 100% exhibited altered tactile sensation and 80% presented with nerve thickening. The SMS demonstrated early sensitivity to neurological improvement, with significant changes observed by the third month ( p = 0.0156). By 12 months, 74.3% of lesions had achieved complete sensory recovery. The progression of SMS scores paralleled reductions in pain levels, nerve palpation abnormalities, and physical disability grades. No linear correlation was found with standard hand and feet scores, reinforcing the SMS’s complementary value in capturing localized sensory recovery. Conclusion The SMS is a low-cost, accessible, and objective tool for neurological monitoring in HD. It quantifies functional recovery in cutaneous lesions, offering a clinically meaningful alternative to the concept of an “administrative cure.” Its adoption could guide individualized treatment durations, enhance therapeutic decision-making, and promote a shift toward function-based definitions of cure in HD management.
Serum anti-lipid antibodies in patients affected by leprosy in a high-burden municipality in Brazil: a cross-sectional study Humberto Baptista Costa, Filipe Rocha Lima, Igor Gabriel Meneses Lima, Sávio Breno Pires Brito, Julia Bitencourt, et al. Revista do Instituto De Medicina Tropical De Sao Paulo, 2025 Early diagnosis plays a pivotal role in breaking the epidemiological chain of Mycobacterium leprae transmission. Currently, diagnosis relies on clinical, dermato-neurological features, and histological/microbiological assessments. This prospective cross-sectional study investigated whether IgA, IgM, and IgG anti-lipid antibodies can be used to improve the diagnostic performance for leprosy-affected patients in a high-burden municipality in Brazil. Serum samples from 91 volunteers, including patients with leprosy (n=62), household contacts (n=21), and endemic controls (n=8) were screened by enzyme-linked immunosorbent assays (ELISA) for IgA, IgM, and total IgG against four lipids—namely, cardiolipin (CL), phosphatidylcholine (PTC), phosphatidylethanolamine (PE), and phosphatidylinositol (PI)—and a glycosphingolipid—sulfatide (SL)—found in the bacterial cell wall. Antibodies against all lipids were detected in the sera of patients with leprosy. Significantly higher levels of IgA anti-CL, anti-PE, and anti-PTC, IgM anti-CL, and total IgG anti-PTC were observed in these patients compared to household contacts and endemic controls (p < 0.0001). ROC curve analyses demonstrated high accuracy in discriminating patients with leprosy from the contacts, with moderate to high sensitivity and specificity, even in paucibacillary patients. Despite the small study population and the absence of patients with other dermatological lesions for differential diagnosis, these findings suggest the potential of anti-lipid antibodies as biomarkers for leprosy detection. This approach offers a promising method to improve early diagnosis in high-burden areas, such as the studied municipality in Brazil.
Serological testing for Hansen’s disease diagnosis: Clinical significance and performance of IgA, IgM, and IgG antibodies against Mce1A protein Filipe Rocha Lima, Mateus Mendonça Ramos Simões, Gabriel Martins da Costa Manso, Diana Mota Toro, Vanderson Mayron Granemann Antunes, et al. Frontiers in Medicine, 2023 Hansen’s disease (HD) is an infectious, treatable, and chronic disease. It is the main cause of infectious peripheral neuropathy. Due to the current limitations of laboratory tests for the diagnosis of HD, early identification of infected contacts is an important factor that would allow us to control the magnitude of this disease in terms of world public health. Thus, a cross-sectional study was conducted in the Brazilian southeast with the objective of evaluating humoral immunity and describing the accuracy of the immunoassay based on IgA, IgM, and IgG antibodies against surface protein Mce1A of Mycobacterium, the predictive potential of these molecules, the clinical significance of positivity, and the ability to segregate new HD cases (NC; n = 200), contacts (HHC; n = 105), and healthy endemic controls (HEC; n = 100) as compared to α-PGL-I serology. α-Mce1A levels for all tested antibodies were significantly higher in NC and HHC than in HEC (p &lt; 0.0001). The performance of the assay using IgA and IgM antibodies was rated as highly accurate (AUC &gt; 0.85) for screening HD patients. Among HD patients (NC), positivity was 77.5% for IgA α-Mce1A ELISA, 76.5% for IgM, and 61.5% for IgG, while α-PGL-I serology showed only 28.0% positivity. Multivariate PLS-DA showed two defined clusters for the HEC and NC groups [accuracy = 0.95 (SD = 0.008)] and the HEC and HHC groups [accuracy = 0.93 (SD = 0.011)]. IgA was the antibody most responsible for clustering HHC as compared to NC and HEC, evidencing its usefulness for host mucosal immunity and as an immunological marker in laboratory tests. IgM is the key antibody for the clustering of NC patients. Positive results with high antibody levels indicate priority for screening, new clinical and laboratory evaluations, and monitoring of contacts, mainly with antibody indexes ≥2.0. In light of recent developments, the incorporation of new diagnostic technologies permits to eliminate the main gaps in the laboratory diagnosis of HD, with the implementation of tools of greater sensitivity and accuracy while maintaining satisfactory specificity.
Bacilloscopy and polymerase chain reaction of slit-skin smears and anti-phenolic glycolipid-I serology for Hansen’s disease diagnosis Filipe Rocha Lima, Natália Aparecida de Paula, Mateus Mendonça Ramos Simões, Gabriel Martins da Costa Manso, Gustavo Sartori Albertino, et al. Frontiers in Medicine, 2022 The bacilloscopy of the slit-skin smear (SSS) is the exclusive laboratory test associated with dermato-neurological evaluation for Hansen’s disease (HD) diagnosis; however, it is negative in the majority of PB or primary neural forms. Thus, a PCR technique involving different sequences and target genes has been performed with an aim to increase the sensitivity and specificity of M. leprae identification, especially in patients with low bacillary loads. Additionally, serological assays based on antibody response reflect infection levels and indicate that this could be a simpler, less invasive technique for estimating M. leprae exposure. Serological tests and PCR have been shown to be more sensitive and accurate than the SSS. Our study aimed to measure accuracy and performance among the SSS and PCR of dermal scrapings stored on filter paper and APGL-I serology for diagnosis in HD. A cross-sectional study analyzing the medical records (n = 345) of an HD outpatient-dermatology clinic from 2014 to 2021 was conducted. Accuracy performance parameters, correlation, and concordance were used to assess the value among the SSS, PCR, and APGL-I exams in HD. The SSS presented 24.5% sensitivity, 100% specificity, 37.4% accuracy, and the lowest negative predictive value (21.5%). The PCR assay had 41, 100, and 51% sensitivity, specificity, and accuracy, respectively. PCR and APGL-I serology increased the detection of HD cases by 16 and 20.6%, respectively. PCR was positive in 51.3% of patients when the SSS was negative. The SSS obtained moderate concordance with PCR [k-value: 0.43 (CI: 0.33–0.55)] and APGL-I [k-value: 0.41 (CI: 0.31–0.53)]. A moderate positive correlation was found between the APGL-I index and the bacillary index (r = 0.53; P &lt; 0.0001). Thus, the use of the SSS is a low sensitivity and accuracy method due to its low performance in HD detection. The use of PCR and serological tests allows for a more sensitive and accurate diagnosis of patients.
Evaluation of altered patterns of tactile sensation in the diagnosis and monitoring of leprosy using the Semmes-Weinstein monofilaments Marco Andrey Cipriani Frade, Fred Bernardes Filho, Claudia Maria Lincoln Silva, Glauber Voltan, Filipe Rocha Lima, et al. Plos One, 2022 Background Leprosy neuropathy is the most common peripheral neuropathy of infectious etiology worldwide; it is characterized as asymmetric and focal multiple mononeuropathy. Semmes-Weinstein monofilament (SWM) test is a simple method to assess sensory nerve function. Methods and findings In this prospective cohort study, a dermatologist carried out hands and feet tactile sensation test with SWM in 107 multibacillary leprosy patients at diagnosis and in 76 patients at the end of treatment from 2016 to 2019. At diagnosis, 81/107 (75.7%) patients had some degree of functional disability, and 46 (43%) of them had altered SWM-test in the hands and 94 (87.9%) of them in the feet. After one year of multibacillary multidrug therapy, the disability decreasing to 44/76 patients (57.9%) and decreasing of the percentual of patients with altered SWM-test to 18% for the hands, and to 28.7% for the feet. At the end of treatment, the number of SMW-test points presented improvement in the hands of 22 (28.9%) patients, and in the feet of 47 (61.8%). In the hands, by SWM-test, only the radial nerve point demonstrated a significant asymmetry, while in the feet, the difference between the sum of altered SWM-test points showed significant asymmetry between both sides, highlighting the tibial nerve for the establishment of asymmetric leprosy neuropathy. In Spearman’s correlation analysis, a positive correlation with statistical significance was observed between the number of hands and feet SWM altered points at diagnosis and the degree of disability at diagnosis (0.69) and at the end of the treatment (0.80). Conclusion The patterns of hands and feet tactile sensation at diagnosis and their consequent modifications with the anti-leprosy drugs define the bacterial etiology of neuropathy, an important tool for the clinical diagnosis and follow up of the disease, highlighting the tibial nerve findings, the most affected nerve among leprosy patients by SWM-test, with significant asymmetry and focality impairments.
