Serodiagnosis of tuberculosis in perspective

[Relationship between serological diagnosis (ELISA) and severity of pulmonary tuberculosis in children]

Forty eight children from 0 to 13 years old were submitted to the enzyme-linked immunosorbent assay (ELISA) serological test with a view to detect anti PPD IgG antibodies, for diagnosis of pulmonary tuberculosis and to establish the relationship between immune response and radiological gravity of pulmonary tuberculosis (mild, moderate and severe). There were 29 children with pulmonary tuberculosis and 19 children without tuberculosis. The median ELISA optical density were: 0.098 in children with primary complex (mild); 0.092 in children with pneumonic pattern (moderate) and 0.134 in children with miliary tuberculosis (severe). These data show higher positive serological test results in severe forms of pulmonary tuberculosis (p = 0.0007).

Composition and immunoreactivity of the A60 complex and other cell fractions from Mycobacterium bovis BCG

Surface static cultures of Mycobacterium bovis BCG contained cells embedded in an extracellular matrix, whose mechanical removal yielded free cells that were pressure disrupted and fractionated into cytoplasm and walls. Cell envelopes were either mechanically disrupted or extracted with detergents. Intracellular and extracellular fractions were analysed for proteins, polysaccharides, and antigen 6O (A60), a major complex immunodominant in tuberculosis. A60 was present in extracellular matrix, cytoplasm and walls: it represented a substantial portion of the proteins and polysaccharides of these fractions. While the protein/polysaccharide ratio varied according to the origin of A60 preparations, the electrophoretic patterns of A60 proteins (which accounted for the immunogenicity of the complex) remained unchanged. Western blots pointed to the proteins present within the 29-45 kDa range as the A60 components endowed with the highest immunogenicity level. Since the most heavily stained protein bands in SDS-PAGE patterns were located outside the region best recognized by antisera, a striking discordance was found between concentration and immunogenicity patterns of A60 proteins. The electrophoretic patterns of A60- and non-A60-proteins from cytoplasm were also different. A60 complexes in dot blots and some electrophoresed A60 proteins reacted with monoclonal antibodies directed against lipoarabinomannan (LAM), a highly immunogenic polymer of cell envelope. This contaminating compound was removed from A60 with organic solvents and detergents. SDS-PAGE and Western blot patterns of proteins from delipidated A60 were similar to those of native A60 proteins.

Humoral immune response against antigen 60 in BCG-vaccinated infants

An ELISA assay based on the A-60 antigen complex from Mycobacterium bovis BCG cytoplasm was used to detect anti-mycobacterial antibodies of different classes in the sera of 63 BCG-vaccinated infants during the 6-month post-vaccination period. The mean IgM and IgA levels increased, whereas the mean IgG level decreased after BCG vaccination. However, in a minority of cases only Ig levels were above the cut-off line: this was true for IgM in 11/63 (17%) cases and for IgA in 14/63 (22%) of cases but none of the tested infants was anti-A60 IgG ELISA positive. Fifty-two infants (83%) were tuberculin-positive eight weeks after vaccination, and no significant difference in mean antibody levels of tuberculin-positive and negative cases was observed, except for IgG (p < 0.05).

Soluble Mycobacterium bovis protein antigens: studies on their purification and immunological evaluation

The eradication of bovine tuberculosis is an ultimate aim of the beef industry and the development of accurate diagnostic tests will expedite eradication. Characterization of Mycobacterium bovis antigens, and a detailed understanding of their immune reactivity will aid in the development of more specific and sensitive diagnostic tests. With this aim, studies were conducted which have resulted in the purification and immunological characterization of the major soluble M. bovis antigens. The purified antigens were found to contain cross-reactive epitopes and immunological responses to these proteins varied among individual animals. Thus if more specific diagnostic tests are to be formulated, they will have to be at the epitope level, using only species-specific epitopes and not whole proteins. Due to the genetic diversity of the response of infected cattle to individual epitopes, a large cocktail of such epitopes will be necessary for the development of a sensitive test.

In vitro immunodiagnostic assays for bovine tuberculosis

The immune response to mycobacterial infections in cattle is predominantly cellular in nature and current diagnostic tests for M. bovis are based on the measurement of T cell responses. The low sensitivity of serological assays for tuberculosis is therefore not surprising and serological tests will at best be used to complement rather than replace cellular assays. The recently developed bovine interferon gamma (IFN-gamma) assay is a rapid (24 hour) and simple whole blood in vitro assay, which in Australian field trials was found to be significantly more sensitive than the intradermal tuberculin test for the diagnosis of bovine tuberculosis. The problem of false-positive reactions, due to the cross-reactive nature of the antigen preparations used, can largely be overcome by using a comparative assay in which an animal's IFN-gamma response to bovine PPD and avian PPD are compared. Although reasonably M. bovis specific proteins have been identified and characterised, their use in either serological or cellular diagnostic assays is likely to be restricted due to the genetic diversity of the bovine immune response to M. bovis infection.

Cellular and humoral immune responses of cattle to purified Mycobacterium bovis antigens

Cellular responses to several purified antigens of Mycobacterium bovis were examined in experimentally infected cattle over a period of 36 months, using in vitro cellular proliferation and interferon-gamma assays. These antigens (12, 19, 22a, b, 24, 25, 30, 32, 39, 65 and 70 kDa) included the majority of M. bovis protein antigens described to date and are highly homologous to those purified from M. tuberculosis. Cellular responses were examined at 3-month time intervals during the 36-month course of infection. All purified antigens induced cellular immune responses in the infected animals. The onset and magnitude of response to individual antigens varied among the animals. At any specific time during the period of infection one or more antigens appeared to be immunodominant but the immunodominance profile changed as the infection progressed. Humoral immune responses were low or absent in the first half of the infection period, but increased substantially for some of the antigens during the second half. Variation was observed among the different animals as to which antigens they recognized.

A field evaluation of serological and cellular diagnostic tests for bovine tuberculosis

This paper describes the field evaluation of a serological test and a new in vitro assay for cell-mediated reactivity for the diagnosis of bovine tuberculosis. The use of a Mycobacterium bovis-specific antigen (MPB-70) in an ELISA to test the serological response to tuberculosis infection resulted in a specificity of 96.4% and a sensitivity of 18.1%. The most favourable results were obtained with the interferon gamma (IFN-gamma) assay which had a sensitivity of 81.8% and a specificity of 99.1%. Respective figures for the single intradermal tuberculin test were 68.1% and 96.7%. The use of MPB-70 as the antigen in the IFN-gamma assay reduced the sensitivity of this assay, without producing any useful increase in specificity. The IFN-gamma assay was also demonstrated to be a practical diagnostic test for use with large groups of cattle.

Serological reactivity to Mycobacterium bovis protein antigens in cattle

The serological response to 12 purified Mycobacterium bovis antigens were examined in an ELISA assay. These antigens included the majority of M. bovis protein antigens described to date and in most cases they were very similar to the M. tuberculosis antigens of the same molecular mass. The purified antigens were tested against sera from M. bovis infected cattle, M. bovis culture-negative cattle from infected herds and animals infected with related microorganisms, mainly other mycobacterial species. All the antigens gave strong reactions with at least some sera from the M. bovis infected group and showed cross-reactivity with some of the sera from the other two groups. The antigen with the highest specificity reacted strongly with only 60% of the M. bovis infected sera. Antigens that reacted with most or all of the M. bovis infected sera also gave the highest cross-reactivity with sera from the other two groups. These results indicate that a serological test based on any one or a combination of these antigens, without removal of the cross-reacting epitopes, would be unsatisfactory.

A sandwich enzyme immunoassay for bovine interferon-gamma and its use for the detection of tuberculosis in cattle

An in vitro cellular assay for bovine tuberculosis has recently been developed. This assay detects gamma-interferon released in response to specific antigen in a whole blood culture system. The bio-assay previously described for the detection of bovine gamma-interferon (IFN-gamma) has now been replaced with a sandwich enzyme immunoassay (EIA) which utilises two monoclonal antibodies to bovine IFN-gamma. The EIA detects less than 25pg/ml of recombinant bovine IFN-gamma and is specific for biologically active bovine IFN-gamma; and does not detect bovine alpha or beta interferon. IFN-gamma from sheep, goat and buffalo, but not from pig, deer or man, are also recognised by the EIA. The bovine IFN-gamma EIA when used in conjunction with the whole blood culture system has resulted in a simple, rapid and sensitive in vitro assay for specific cell mediated immune responsiveness to M. bovis infection in cattle.