At the end of 1999, LEPRA Health in Action opened a state-of-the-art research centre for infectious diseases in Cherlapally, Hyderabad, funded from £3 million collected through an appeal organised by the UK children’s programme Blue Peter.

It functions in close collaboration with national and international research laboratories as well as other components of LEPRA India to pursue research in clinical, operational, field and basic research studies.

Dr Subbanna has been Director of the BPHRC since January, 2010 and kindly agreed to share some of his thoughts about the BPHRC and leprosy research specifically. 

- What leprosy mysteries have to be resolved if we are to rid the world of leprosy?

• The early diagnosis of leprosy nerve damage and its consequences
• The identification of human and extra-human (any intermediate hosts/vectors etc) sources of transmission
• The successful culture of M. leprae in vitro 
• Prevention by vaccination 
• Early detection of the infection and drug resistance

- Which of the current research projects into leprosy do you consider may yield findings that will have a bearing on leprosy control strategy worldwide?

• To control transmission 
• Early diagnosis

- Of the ongoing research being conducted through the BPHRC – lower touch sensibility in the extremities of healthy Indians: further deterioration with age: clinical profile of leprosy in urban and semi-rural field areas; retrospective study of neuritis cases from 2000 to 2006; pattern of relapse in leprosy in an out-patient clinic in Hyderabad; thalidomide; ultrasonography of peripheral nerves in leprosy patients; study of viability of M. leprae in clinical samples and possibility of its presence in the environment using nucleic acid amplification techniques; study of T regulatory cells in human leprosy; role of genetic factors relevant to cytokines and immune responses in leprosy – which interests you the most and why?

• The study of viability in the environment interests me the most as this would help us understand the transmission dynamics and thus help in leprosy control strategy
• Immunological factors rendering a contact susceptible to leprosy

- What rapid molecular tools have been developed by the BPHRC to facilitate study of how leprosy is transmitted?

• Strain typing to study short chains of transmission
• Single-nucleotide polymorphism to study the global distribution of leprosy

- Have there been any recent advances in diagnosing drug resistance in patients?

• We have screened patients for primary and acquired drug resistance using molecular tools. Thus molecular diagnosis of rifampicin, dapsone and oflaxacin has been standardised

- What do you think of the findings published in the New England Journal of Medicine in December 2009 by scientists in Singapore and China that seem to indicate that there are variants to seven genes that appear to increase a person’s susceptibility to leprosy?  

• The function of the identified genes have to be elucidated 

- Is there any one scientific discovery about leprosy that stands out for you? 

The complete genome sequencing of M.leprae has paved the way for researchers to understand the pathogenesis and identify tools for early diagnosis and transmission.

- Of findings made at the BPHRC which, in your opinion, has had the greatest impact and influence?

• Analysis of strain typing results indicated that these tools could identify common source of infection in a family by showing identical Variable Number of Tandem Repeat (VNTR) pattern
• A study on secondary infections in plantar ulcers in leprosy patients has been conducted (during 2005-06), at BPHRC in collaboration with Sivananda Rehabilitation Home (German Leprosy and Tuberculosis Relief Association). The study facilitated the tertiary care referral centre to adapt an appropriate antibiotic regimen and cost effective management of infected plantar ulcers

- Can you comment on how collaborating internationally has opened up possibilities to work with the best minds, organisations and research facilities…

• Collaboration with Colorado State University (CSU) helped us with the training of our staff and also with outsourcing the modern molecular techniques for strain typing initially

 - What new partnerships are you thinking of building in the near future? 

• National: Central Leprosy Division of the Government of India & the South-East Asia Regional Office (SEARO) of the World Health Organization and The Leprosy Mission
• International: Institute for Tropical Medicine, Tubingen, Germany; London School of Hygiene and Tropical Medicine, London

- What other key features are in the BPHRC current strategy?

• Molecular epidemiology of M. leprae by linking lab and field projects
• Immunological factors of human host relevant to cytokines and T cells
• Genetic susceptibility factors of human host 
• Direct laboratory services for diagnosing multi drug resistant TB in collaboration with AP State Govt and basic and operational research in relevant areas is in place at BPHRC. Similar strategy is planned for leprosy drug resistance in collaboration with the WHO SEARO and the Central Leprosy Division of the Government of India

Blue Peter Public Health & Research Centre: http://www.leprasociety.org/bprcback.htm        

Categories: India, Technical information