Research Agenda

In order to identify critical gaps in knowledge related to transmission and to set priorities, R2STOP founder effect:hope commissioned an independent literature review entitled “Systematic Literature Review on Current Knowledge Regarding the Transmission of Leprosy” and convened a scientific meeting of partners, including infectious disease researchers, clinicians, public health experts, and social scientists to discuss gaps in our understanding of M. leprae transmission. The outcome of both activities has informed a research agenda addressing critical areas related to increasing our understanding of M. leprae transmission with the heightened potential of improving strategies for blocking transmission.

The initial priority funding areas of R2STOP will include:

Human-to-human transmission
(human reservoirs)

Areas of interest include:

  1. The discovery of biomarkers for all clinical and sub-clinical cases of leprosy as well as biomarkers for asymptomatic carriers
  2. Assessing the role of colonization and route of entry of M. leprae into the human host
  3. Investigating potential roles of co-infections on the entry/exit of M. leprae from the human host
  4. Studying the stages of pathogenicity of M. leprae to understand the migration (port of entry to the site of initial lesion to point of exit) of M. leprae inside the human host
Non-human Reservoirs

Areas of interest include:

  1. Distribution of M. leprae infection in armadillos in the Americas and potential zoonoses
  2. Investigate the role of other animals in M. leprae transmission
  3. Investigate the biological relationship between M. leprae and amoeba
  4. Investigate the presence of M. leprae in the environment in different endemic settings
  5. Use genotyping to understand the role of M. leprae found in the environment and those M. leprae strains found in the population
  6. Demonstrate viability of M. leprae in the environment
Host-Pathogen Interactions

Areas of interest include:

  1. Defining relationships between M. leprae genetic characteristic and virulence, growth kinetics, drug resistance, tropisms for nerves and the tendency to cause reactions
  2. Defining the role of host genetic risk factors in susceptibility and resistance to M. leprae infection, clinical progression of leprosy and reactions
  3. Understanding how the immune response affects the various manifestations of leprosy to include: establishing infection, progression of disease, nasal carriage and reactions
  4. Increasing our understanding of the similarities/differences between M. leprae and M. lepromatosis
Transmission Networks

Areas of interest include:

  1. Increased collection of genome sequenced M. leprae strains with isolates from various origins (e.g., worldwide, paucibacillary cases) complemented with detailed epidemiological data
  2. Investigation of genetic diversity of M. leprae from different sources (e.g., patients, nasal carriers, zoonotic and environmental) and various settings (e.g., high and low endemic regions) to understand the transmission ecology at the community level