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Tjale MA, Ombinda-Lemboumba S, Maphanga C, Mthunzi-Kufa P. TB diagnostic insights, progress made on point of care diagnostics and bioinformatics as an additional tool for improvement. Indian J Tuberc 2023; 70:468-474. [PMID: 37968053 DOI: 10.1016/j.ijtb.2023.03.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/19/2022] [Accepted: 03/31/2023] [Indexed: 11/17/2023]
Abstract
Despite major efforts made to control tuberculosis disease (TB), this disease continues to present a major global health challenge and drug resistance is continuously growing. TB is caused by Mycobacterium tuberculosis and spreads exclusively via human-to-human contact transmission. Therefore, early detection and diagnosis for proper treatment with active TB have a great impact on public health. Regardless, most people in developing countries with TB or TB-associated symptoms do not have access to an adequate initial diagnosis. Available bacteriologic-based techniques are either inefficient or may require a longer turnaround time from the laboratory. Contemporarily, non-bacteriologic based methods have both questionable sensitivity and specificity and while others cannot distinguish between active and latent TB. Thus, additional efforts have been made to find accurate diagnostic tests for TB. Herein, we review the available methods used for TB diagnosis, and in addition, we explore point of care (POC) diagnostics as an alternative way to develop TB diagnostic tests and further evaluate whether bioinformatics can be used as an additional screening tool for identification of possible TB biomarkers for the development of POC TB diagnostics, which is part of our research focus.
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Affiliation(s)
- Mabotse A Tjale
- Biophotonics, National Laser Centre, Council for Scientific and Industrial Research, P/O Box 395, Meiring Naudé Road Brummeria, Pretoria, South Africa.
| | - Saturnin Ombinda-Lemboumba
- Biophotonics, National Laser Centre, Council for Scientific and Industrial Research, P/O Box 395, Meiring Naudé Road Brummeria, Pretoria, South Africa
| | - Charles Maphanga
- Biophotonics, National Laser Centre, Council for Scientific and Industrial Research, P/O Box 395, Meiring Naudé Road Brummeria, Pretoria, South Africa; College of Agriculture, Engineering and Science, School of Chemistry and Physics, University of KwaZulu-Natal, Pietermaritzburg Campus, King Edward Avenue, Pietermaritzburg, South Africa
| | - Patience Mthunzi-Kufa
- Biophotonics, National Laser Centre, Council for Scientific and Industrial Research, P/O Box 395, Meiring Naudé Road Brummeria, Pretoria, South Africa; College of Agriculture, Engineering and Science, School of Chemistry and Physics, University of KwaZulu-Natal, Pietermaritzburg Campus, King Edward Avenue, Pietermaritzburg, South Africa
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2
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Mao Q, Ma S, Schrickel PL, Zhao P, Wang J, Zhang Y, Li S, Wang C. Review detection of Newcastle disease virus. Front Vet Sci 2022; 9:936251. [PMID: 35982920 PMCID: PMC9378970 DOI: 10.3389/fvets.2022.936251] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022] Open
Abstract
Newcastle disease (ND) is an acute and highly contagious disease caused by the Newcastle disease virus (NDV) infecting poultry, which has caused great harm to the poultry industry around the world. Rapid diagnosis of NDV is important to early treatment and early institution of control measures. In this review, we comprehensively summarize the most recent research into NDV, including historical overview, molecular structure, and infection mechanism. We then focus on detection strategies for NDV, including virus isolation, serological assays (such as hemagglutination and hemagglutination-inhibition tests, enzyme linked immunosorbent assay, reporter virus neutralization test, Immunofluorescence assay, and Immune colloidal gold technique), molecular assays (such as reverse transcription polymerase chain reaction, real-time quantitative PCR, and loop-mediated isothermal amplification) and other assays. The performance of the different serological and molecular biology assays currently available was also analyzed. To conclude, we examine the limitations of currently available strategies for the detection of NDV to lay the groundwork for new detection assays.
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Affiliation(s)
- Qian Mao
- College of Veterinary Medicine, Northwest Agriculture and Forestry University, Xianyang, China
| | - Shengming Ma
- Henan Joint International Research Laboratory of Veterinary Biologics Research and Application, Anyang Institute of Technology, Anyang, China
| | - Philip Luke Schrickel
- College of Veterinary Medicine, Northwest Agriculture and Forestry University, Xianyang, China
| | - Pengwei Zhao
- College of Veterinary Medicine, Northwest Agriculture and Forestry University, Xianyang, China
| | - Jingya Wang
- College of Veterinary Medicine, Northwest Agriculture and Forestry University, Xianyang, China
| | - Yuhua Zhang
- College of Veterinary Medicine, Northwest Agriculture and Forestry University, Xianyang, China
| | - Shuangyu Li
- College of Veterinary Medicine, Northwest Agriculture and Forestry University, Xianyang, China
| | - Chengbao Wang
- College of Veterinary Medicine, Northwest Agriculture and Forestry University, Xianyang, China
- *Correspondence: Chengbao Wang
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Jacobs R, Awoniyi DO, Baumann R, Stanley K, McAnda S, Kaempfer S, Malherbe ST, Singh M, Walzl G, Chegou NN. Concurrent evaluation of cytokines improves the accuracy of antibodies against Mycobacterium tuberculosis antigens in the diagnosis of active tuberculosis. Tuberculosis (Edinb) 2022; 133:102169. [PMID: 35121532 DOI: 10.1016/j.tube.2022.102169] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/12/2022] [Accepted: 01/16/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Antibodies against mycobacterial proteins are highly specific, but lack sensitivity, whereas cytokines have been shown to be sensitive but not very specific in the diagnosis of tuberculosis (TB). We assessed combinations between antibodies and cytokines for diagnosing TB. METHODS Immuoglubulin (Ig) A and IgM antibody titres against selected mycobacterial antigens including Apa, NarL, Rv3019c, PstS1, LAM, "Kit 1" (MTP64 and Tpx)", and "Kit 2" (MPT64, Tpx and 19 kDa) were evaluated by ELISA in plasma samples obtained from individuals under clinical suspicion for TB. Combinations between the antibody titres and previously published cytokine responses in the same participants were assessed for diagnosing active TB. RESULTS Antibody responses were more promising when used in combination (AUC of 0.80), when all seven antibodies were combined. When anti-"Kit 1"-IgA levels were combined with five host cytokine biomarkers, the AUC increased to 97% (92-100%) with a sensitivity of 95% (95% CI, 73-100%), and specificity of 88.5% (95% CI, 68.7-97%) achieved after leave-one-out cross validation. CONCLUSION When used in combination, IgA titres measured with ELISA against multiple Mycobacterium tuberculosis antigens may be useful in the diagnosis of TB. However, diagnostic accuracy may be improved if the antibodies are used in combination with cytokines.
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Affiliation(s)
- Ruschca Jacobs
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research; South African Medical Research Council Centre for Tuberculosis Research; Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Dolapo O Awoniyi
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research; South African Medical Research Council Centre for Tuberculosis Research; Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Ralf Baumann
- Lionex Diagnostics and Therapeutics, Braunschweig, Germany; Medical Faculty, Institute for Translational Medicine, Medical School Hamburg (MSH) - Medical University, Hamburg, Germany; Institute for Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Kim Stanley
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research; South African Medical Research Council Centre for Tuberculosis Research; Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Shirley McAnda
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research; South African Medical Research Council Centre for Tuberculosis Research; Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - Stephanus T Malherbe
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research; South African Medical Research Council Centre for Tuberculosis Research; Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Mahavir Singh
- Lionex Diagnostics and Therapeutics, Braunschweig, Germany
| | - Gerhard Walzl
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research; South African Medical Research Council Centre for Tuberculosis Research; Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Novel N Chegou
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research; South African Medical Research Council Centre for Tuberculosis Research; Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
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Abstract
Bacterial persisters are nongrowing cells highly tolerant to bactericidal antibiotics. However, this tolerance is reversible and not mediated by heritable genetic changes. Lon, an ATP-dependent protease, has repeatedly been shown to play a critical role in fluoroquinolone persistence in Escherichia coli. Although lon deletion (Δlon) is thought to eliminate persister cells via accumulation of the cell division inhibitor protein SulA, the exact mechanism underlying this phenomenon is not yet elucidated. Here, we show that Lon is an important regulatory protein for the resuscitation of the fluoroquinolone persisters in E. coli, and lon deletion impairs the ability of persister cells to form colonies during recovery through a sulA- and ftsZ-dependent mechanism. Notably, this observed "viable but nonculturable" state of antibiotic-tolerant Δlon cells is transient, as environmental conditions, such as starvation, can restore their culturability. Our data further indicate that starvation-induced SulA degradation or expression of Lon during recovery facilitates Z-ring formation in Δlon persisters, and Z-ring architecture is important for persister resuscitation in both wild-type and Δlon strains. Our in-depth image analysis clearly shows that the ratio of cell length to number of FtsZ rings for each intact ofloxacin-treated cell predicts the probability of resuscitation and, hence, can be used as a potential biomarker for persisters. IMPORTANCE The ATP-dependent Lon protease is one of the most studied bacterial proteases. Although deletion of lon has been frequently shown to reduce fluoroquinolone persistence, the proposed mechanisms underlying this phenomenon are highly controversial. Here, we have shown that lon deletion in Escherichia coli impairs the ability of persister cells to form colonies during recovery and that this reduction of persister levels in lon-deficient cells can be transient. We also found that altered Z-ring architecture is a key biomarker in both wild-type and lon-deficient persister cells transitioning to a normal cell state. Collectively, our findings highlight the importance of differentiating persister formation mechanisms from resuscitation mechanisms and underscore the critical role of the nonculturable cell state in antibiotic tolerance.
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Hessel M van Dijk J, van der Marel GA, Codée JDC. Developments in the Synthesis of Mycobacterial Phenolic Glycolipids. CHEM REC 2021; 21:3295-3312. [PMID: 34581501 DOI: 10.1002/tcr.202100200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 11/11/2022]
Abstract
The highly lipophilic outer barrier of mycobacteria, such as M. tuberculosis and M. leprae, is key to their virulence and intrinsic antibiotic resistance. Various components of this mycomembrane interact with the host immune system but many of these interactions remain ill-understood. This review covers several chemical syntheses of one of these components, mycobacterial phenolic glycolipids (PGLs), and outlines the interaction of these PGLs with the human immune system, as established using these well-defined pure compounds.
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Affiliation(s)
- J Hessel M van Dijk
- Leiden Institute of Chemistry, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands
| | - Gijs A van der Marel
- Leiden Institute of Chemistry, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands
| | - Jeroen D C Codée
- Leiden Institute of Chemistry, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands
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6
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Namuganga AR, Chegou NN, Mayanja-Kizza H. Past and Present Approaches to Diagnosis of Active Pulmonary Tuberculosis. Front Med (Lausanne) 2021; 8:709793. [PMID: 34631731 PMCID: PMC8495065 DOI: 10.3389/fmed.2021.709793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/17/2021] [Indexed: 12/15/2022] Open
Abstract
Tuberculosis disease continues to contribute to the mortality burden globally. Due to the several shortcomings of the available diagnostic methods, tuberculosis disease continues to spread. The difficulty to obtain sputum among the very ill patients and the children also affects the quick diagnosis of tuberculosis disease. These challenges warrant investigating different sample types that can provide results in a short time. Highlighted in this review are the approved pulmonary tuberculosis diagnostic methods and ongoing research to improve its diagnosis. We used the PRISMA guidelines for systematic reviews to search for studies that met the selection criteria for this review. In this review we found out that enormous biosignature research is ongoing to identify host biomarkers that can be used as predictors of active PTB disease. On top of this, more research was also being done to improve already existing diagnostic tests. Host markers required more optimization for use in different settings given their varying sensitivity and specificity in PTB endemic and non-endemic settings.
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Affiliation(s)
- Anna Ritah Namuganga
- Uganda–Case Western Research Collaboration-Mulago, Kampala, Uganda
- Joint Clinical Research Centre, Kampala, Uganda
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Novel N. Chegou
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Harriet Mayanja-Kizza
- Uganda–Case Western Research Collaboration-Mulago, Kampala, Uganda
- College of Health Sciences, Makerere University, Kampala, Uganda
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7
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Pathak A, Venugopal P, Nair BG, Suneesh PV, Satheesh Babu T. Facile pH-sensitive optical detection of pathogenic bacteria and cell imaging using multi-emissive nitrogen-doped carbon dots. Microchem J 2020. [DOI: 10.1016/j.microc.2020.105324] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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8
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Hao X, Bai J, Ding Y, Wang J, Liu Y, Yao L, Pan W. Characterization of antibody response against 16kD and 38kD of M. tuberculosis in the assisted diagnosis of active pulmonary tuberculosis. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:945. [PMID: 32953745 PMCID: PMC7475385 DOI: 10.21037/atm-20-5476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background In view of the inability of traditional etiological methods to diagnose pulmonary tuberculosis rapidly and effectively, the antibody responses against 38kD and 16kD-antigens of Mycobacterium tuberculosis (M. tuberculosis) were both detected in order to obtain a better serological detection method for M. tuberculosis. Methods M. tuberculosis-secreted protein 38kD and membrane protein 16kD were prokaryotically expressed and purified, and then used as detection antigens. A novel evolved immunoglobulin-binding molecule (NEIBM)-ELISA method was used to detect antibody levels against 38kD and 16kD in active tuberculosis patients (confirmed tuberculosis cases and clinically diagnosed cases), to explore the significance of these two antigens in serological detection of M. tuberculosis, and to study the diagnostic value of the combined detection of the two antigens in active pulmonary tuberculosis. Results The results showed that the positive detection rates of the 16kD antigen and 38kD antigen of M. tuberculosis were higher (about 44%) in the confirmed cases of tuberculosis, and there was no significant difference in the positive detection rates of the two antigens (P=0.786). The combined detection of these two antigens showed that the positive detection rate could be increased to 61.5%, which was significantly better than the detection effect of the two antigens alone. The positive detection rates of 16kD and 38kD antigens were 26–30% in clinically diagnosed tuberculosis cases, which were lower than those in confirmed tuberculosis cases, and there was no significant difference in the positive detection rates of the two antigens (P=0.242). The detection effect of the two combined antigens was better than that of the 16kD and 38kD antigens alone, but the detection rate was still lower than that of the confirmed tuberculosis cases. Conclusions This study found that the detection effect of 16kD and 38kD antigens was similar in confirmed cases and clinically diagnosed cases of pulmonary tuberculosis, and that the detection effect needs to be further improved. The combined detection of the two antigens showed a significantly better detection effect than the two antigens alone, suggesting that the combined detection of multiple antigens can be used for serological diagnosis of M. tuberculosis infection in clinic.
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Affiliation(s)
- Xiaohui Hao
- Department of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,Shanghai Clinical Research Center for Tuberculosis, Shanghai, China
| | - Jie Bai
- Department of Medical Microbiology and Parasitology, Navy Medical University, Shanghai, China
| | - Yingying Ding
- Department of Medical Microbiology and Parasitology, Navy Medical University, Shanghai, China
| | - Jinhong Wang
- Department of Medical Microbiology and Parasitology, Navy Medical University, Shanghai, China
| | - Yidian Liu
- Department of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,Shanghai Clinical Research Center for Tuberculosis, Shanghai, China
| | - Lan Yao
- Department of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.,Shanghai Clinical Research Center for Tuberculosis, Shanghai, China
| | - Wei Pan
- Department of Medical Microbiology and Parasitology, Navy Medical University, Shanghai, China
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9
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Xu S, Xue Y, Guo F, Xu M, Gopinath SCB, Mao X. Targeted DNA complementation on a 1,1'-carbonyldiimidazole-functionalized surface for identifying Mycobacterium tuberculosis. 3 Biotech 2020; 10:227. [PMID: 32373419 DOI: 10.1007/s13205-020-02216-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/18/2020] [Indexed: 10/24/2022] Open
Abstract
Herein, a rapid and sensitive current-volt measurement was developed for identifying the IS6110 DNA sequence to diagnose Mycobacterium tuberculosis (TB). An aminated capture probe was immobilized on a 1,1'-carbonyldiimidazole-functionalized interdigitated electrode (IDE) silica substrate, and the target sequence was detected by complementation. It was found that all tested concentrations displayed a higher response in current changes than the control, and the limit of detection was 10 fM. The sensitivity ranged from 1 to 10 fM. The control sequences with single-, triple-mismatch and noncomplementary sequences showed great discrimination. This rapid and easy DNA detection method helps to identify M. tuberculosis for early-stage diagnosis of TB.
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Affiliation(s)
- Shu Xu
- Department of Tuberculosis Complications, Xi'an Chest Hospital, East Section of Aerospace Avenue, Chang'an District, Xi'an, 710100 Shaanxi China
| | - Yu Xue
- Department of Tuberculosis Complications, Xi'an Chest Hospital, East Section of Aerospace Avenue, Chang'an District, Xi'an, 710100 Shaanxi China
| | - Fengyan Guo
- Department of Tuberculosis Complications, Xi'an Chest Hospital, East Section of Aerospace Avenue, Chang'an District, Xi'an, 710100 Shaanxi China
| | - Miaomiao Xu
- Department of Tuberculosis Complications, Xi'an Chest Hospital, East Section of Aerospace Avenue, Chang'an District, Xi'an, 710100 Shaanxi China
| | - Subash C B Gopinath
- 2School of Bioprocess Engineering, Universiti Malaysia Perlis, 02600 Arau, Malaysia.,3Institute of Nano Electronic Engineering, Universiti Malaysia Perlis, 01000 Kangar, Malaysia
| | - Xiaohui Mao
- Department of Tuberculosis Complications, Xi'an Chest Hospital, East Section of Aerospace Avenue, Chang'an District, Xi'an, 710100 Shaanxi China
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10
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Korolyova-Ushakova AG, Baranova EV, Ignatov SG, Soloviev PV, Kondakov NN, Mel’nikova TM, Abronina PI, Podval’nyi NM, Kononov LO, Biketov SF. Comparative Characteristics of the Diagnostic Potential of Mycobacterial Synthetic Antigens for the Seroriagnosis of Lepra and Tuberculosis. APPL BIOCHEM MICRO+ 2019. [DOI: 10.1134/s0003683819060097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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11
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Kitada S. Application of a commercial serodiagnostic kit that measures the serum anti-glycopeptidolipid core IgA antibody in Mycobacterium avium complex pulmonary disease. Respir Investig 2019; 57:410-414. [PMID: 31085120 DOI: 10.1016/j.resinv.2019.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 03/28/2019] [Accepted: 04/09/2019] [Indexed: 06/09/2023]
Abstract
The diagnosis of Mycobacterium avium complex (MAC) pulmonary disease is occasionally cumbersome and time-consuming because the MAC species is ubiquitous, and therefore its detection is not necessarily indicative of a definitive diagnosis. A serodiagnostic method specific for MAC pulmonary disease that measures the serum anti-glycopeptidolipid core antigen IgA has been developed and is commercially available. Meta-analysis revealed that the test showed a good diagnostic accuracy. The estimated sensitivity and specificity values were 69.6% (95% confidence interval 62.1-76.1) and 90.6% (95% confidence interval 83.6-95.1), respectively. As antibody levels may reflect the disease activity, their serial measurement can also be used in the management of MAC disease. To justify its routine use in clinical practice, further validation in various regions and studies addressing whether serodiagnosis combined with present diagnostic criteria facilitate more rapid accurate diagnosis of MAC pulmonary disease are necessary.
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Affiliation(s)
- Seigo Kitada
- Department of Respiratory Medicine, Yao Tokushukai General Hospital, 1-17 Wakakusa-cho Yao-city, Osaka, 581-0011, Japan.
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12
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Tu Phan LM, Tufa LT, Kim HJ, Lee J, Park TJ. Trends in Diagnosis for Active Tuberculosis Using Nanomaterials. Curr Med Chem 2019; 26:1946-1959. [DOI: 10.2174/0929867325666180912105617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 07/19/2018] [Accepted: 07/19/2018] [Indexed: 12/18/2022]
Abstract
Background:Tuberculosis (TB), one of the leading causes of death worldwide, is difficult to diagnose based only on signs and symptoms. Methods for TB detection are continuously being researched to design novel effective clinical tools for the diagnosis of TB.Objective:This article reviews the methods to diagnose TB at the latent and active stages and to recognize prospective TB diagnostic methods based on nanomaterials.Methods:The current methods for TB diagnosis were reviewed by evaluating their advantages and disadvantages. Furthermore, the trends in TB detection using nanomaterials were discussed regarding their performance capacity for clinical diagnostic applications.Results:Current methods such as microscopy, culture, and tuberculin skin test are still being employed to diagnose TB, however, a highly sensitive point of care tool without false results is still needed. The utilization of nanomaterials to detect the specific TB biomarkers with high sensitivity and specificity can provide a possible strategy to rapidly diagnose TB. Although it is challenging for nanodiagnostic platforms to be assessed in clinical trials, active TB diagnosis using nanomaterials is highly expected to achieve clinical significance for regular application. In addition, aspects and future directions in developing the high-efficiency tools to diagnose active TB using advanced nanomaterials are expounded.Conclusion:This review suggests that nanomaterials have high potential as rapid, costeffective tools to enhance the diagnostic sensitivity and specificity for the accurate diagnosis, treatment, and prevention of TB. Hence, portable nanobiosensors can be alternative effective tests to be exploited globally after clinical trial execution.
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Affiliation(s)
- Le Minh Tu Phan
- Department of Chemistry, Institute of Interdisciplinary Convergence Research, Research Institute of Halal Industrialization Technology, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
| | - Lemma Teshome Tufa
- Department of Nano Fusion and Cogno-Mechatronics Engineering, Pusan National University, 2 Busandaehak-ro 63beon-gil, Geumjeong-gu, Busan 46241, Korea
| | - Hwa-Jung Kim
- Department of Microbiology and Research Institute for Medical Science, College of Medicine, Chungnam National University, 266 Munhwa- ro, Jung-gu, Daejeon 35015, Korea
| | - Jaebeom Lee
- Department of Chemistry, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon 34134, Korea
| | - Tae Jung Park
- Department of Chemistry, Institute of Interdisciplinary Convergence Research, Research Institute of Halal Industrialization Technology, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea
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Wang Y, Wu Q, Zhang W, Zhang N. Tuberculosis and HIV Coinfection–the Challenge in the Prevention, Detection and Treatment of Tuberculosis. Curr Bioinform 2019. [DOI: 10.2174/1574893613666180621153734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Tuberculosis (TB) is still a major public health concern world-wide. The
increasing global burden of TB is linked to HIV infection. HIV-TB coinfection has also
conditioned clinical aspects of the TB. Since the HIV is beginning in the 1980s, the HIV infection
poses a significant challenge in global TB control.
Objective:
In this review we focused on the challenges of epidemiological and clinical feature of
tuberculosis presented by the HIV coinfection.
Method:
The article consists of a summary of the most important effects presented by the HIV
coinfection on epidemiological and clinical feature of tuberculosis. The article analyzes and
summary the causes for these challenges.
Results:
The major challenges to strategy of TB control and clinical feature of TB-HIV coinfection
are presented in this paper.
Conclusion:
HIV/TB co-infection is synergic, interactive and reciprocal with significant impact.
The infection of HIV and Mtb affect each other and the breakdown the immune function in
TB/HIV coinfected individual. HIV infection has changed the strategy of TB control, however
HIV increases global burden of TB, the reduction in the TB incidence rate is far from sufficient.
Atypically clinical manifestations in TB/HIV co-infected patients and increased MDR-TB and
XDR-TB contribute to the challenges in the diagnosis and treatment. Increased complexity of
managing patients requires expertise in the clinical m knowledge. The focused efforts to control
HIV-related TB are of great urgency. These findings will provide insight into the prevention,
detection and treatment of tuberculosis and will guide advances towards tuberculosis control.
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Affiliation(s)
- Yiyi Wang
- TCM Key Research Laboratory for Infectious Disease Prevention for State Administration of Traditional Chinese Medicine, China
| | - Qi Wu
- TCM Key Research Laboratory for Infectious Disease Prevention for State Administration of Traditional Chinese Medicine, China
| | - Wei Zhang
- Clinical and Research Center of Infectious Diseases Beijing Ditan Hospital, Capital Medical University, 100015, Peiking, China
| | - Ning Zhang
- Department of Biomedical Engineering, Tianjin Key Lab of Biomedical Engineering Measurement, Tianjin University, Tianjin, China
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Azzurri A, Kanaujia G, Sow O, Bah B, Diallo A, Prete GD, Gennaro M. Serological Markers of Pulmonary Tuberculosis and of Response to Anti-Tuberculosis Treatment in a Patient Population in Guinea. Int J Immunopathol Pharmacol 2018. [DOI: 10.1177/205873920601900120] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of the study was to evaluate serological correlates of active tuberculosis and of response to antituberculosis treatment in a cohort of HIV-negative patients with pulmonary tuberculosis studied at diagnosis and during treatment at the Service de Pneumo-Phtisiologie, Centre Hospitalier-Universitaire Ignace Deen, Conakry, Republic of Guinea. Two similar cohorts of HIV-negative healthy households of patients and healthy community controls were included in the study. Plasma samples were obtained from 168 untreated tuberculosis patients, 167 healthy household controls, and 168 healthy community controls. Serial plasma samples were also obtained from the tuberculosis patients at 2 and 8 months after initiation of chemotherapy. IgG antibody levels were measured by an enzyme-linked immunosorbent assay (ELISA) using ten purified M. tuberculosis antigens. ELISA results were analysed by comparing geometric means of data. Of the ten antigens tested, five (14kDa Ag, 19kDa Ag, AlaDH, MS, and MPT83) elicited similar antibody responses in untreated TB patients and controls. In contrast, levels of three antibodies (ESAT-6, LAM, and 38kDa Ag) were higher in untreated TB patients than in household or community controls (p < 0.0001). Levels were higher in untreated patients than in community controls also for the anti-Rv2626c antibody (p = 0.0001) and, at a lower significance level, for the anti-FdxA antibody (p < 0.025). Antibody levels against ESAT-6 and Rv2626c decreased during therapy, while antibody levels to the 38 kDa antigen and LAM increased during therapy; FdxA antibody levels did not vary with treatment. Neither severity of presentation nor chest X-ray patterns affected levels of these antibodies before treatment. In contrast, after the 8-month therapeutic course, patients who presented with moderate/severe disease had higher levels of anti-ESAT-6, anti-FdxA, and anti-38kDa antibodies than those of patients with mild disease onset. Patients with bilateral lung lesions had significantly higher anti-38kDa and anti-LAM levels, both at diagnosis and after 8-month treatment, than patients with lesions involving only one lung. Antibodies to alanine dehydrogenase and malate synthetase measured at initiation of treatment were higher in tuberculosis patients who subsequently failed therapy than in those who were cured. The main conclusions of the study are: a) plasma levels of antibodies to a number of M. tuberculosis represent serological correlates of active disease; b) these correlates are affected in an antigen-specific fashion by anti-tuberculosis treatment; c) particular serological markers may be predictive of treatment outcome.
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Affiliation(s)
- A. Azzurri
- Department of Internal Medicine, University of Florence, Italy
| | | | - O.Y. Sow
- Service de Pneumo-Phtisiologie, Centre Hospitalier-Universitaire Ignace Deen, Conakry, Republic of Guinea
| | - B. Bah
- Service de Pneumo-Phtisiologie, Centre Hospitalier-Universitaire Ignace Deen, Conakry, Republic of Guinea
| | - A. Diallo
- Service de Pneumo-Phtisiologie, Centre Hospitalier-Universitaire Ignace Deen, Conakry, Republic of Guinea
| | - G. Del Prete
- Department of Internal Medicine, University of Florence, Italy
| | - M.L. Gennaro
- Public Health Research Institute, Newark, NJ, USA
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Wayengera M, Kateete DP, Asiimwe B, Joloba ML. Mycobacterium tuberculosis thymidylate kinase antigen assays for designating incipient, high-risk latent M.tb infection. BMC Infect Dis 2018; 18:133. [PMID: 29548281 PMCID: PMC5857104 DOI: 10.1186/s12879-018-3007-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 02/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Precise designation of high risk forms of latent Mycobacterium tuberculosis-M.tb infections (LTBI) is impossible. Delineation of high-risk LTBI can, however, allow for chemoprophylaxis and curtail majority cases of active tuberculosis (ATB). There is epidemiological evidence to support the view that LTBI in context of HIV-1 co-infection is high-risk for progression to ATB relative to LTBI among HIV-ve persons. We recently showed that assays of M.tb thymidylate kinase (TMKmt) antigen and host specific IgG can differentiate ATB from LTBI and or no TB (NTB, or healthy controls). In this study, we aimed to expose the differential levels of TMKmt Ag among HIV+ve co-infected LTBI relative to HIV-ve LTBI as a strategy to advance these assays for designating incipient LTBI. METHODS TMKmt host specific IgM and IgG detection Enzyme Immuno-Assays (EIA) were conducted on 40 TB exposed house-hold contacts (22 LTBI vs. 18 no TB (NTB) by QunatiFERON-TB GOLD®); and TMKmt Ag detection EIA done on 82 LTBI (46 HIV+ve vs 36 HIV-ve) and 9 NTB (American donors). Purified recombinant TMKmt protein was used as positive control for the Ag assays. RESULTS IgM levels were found to be equally low across QuantiFERON-TB GOLD® prequalified NTB and TB exposed house-hold contacts. Higher TMKmt host specific IgG trends were found among TB house-hold contacts relative to NTB controls. TMKmt Ag levels among HIV+ve LTBI were 0.2676 ± 0.0197 (95% CI: 0.2279 to 0.3073) relative to 0.1069 ± 0.01628 (95% CI: 0.07385 to 0.14) for HIV-ve LTBI (supporting incipient nature of LTBI in context of HIV-1 co-infection). NTB had TMKmt Ag levels of 0.1013 ± 0.02505 (5% CI: 0.0421 to 0.1606) (intimating that some were indeed LTBI). CONCLUSIONS TMKmt Ag levels represent a novel surrogate biomarker for high-risk LTBI, while host-specific IgG can be used to designate NTB from LTBI.
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Affiliation(s)
- Misaki Wayengera
- Department of Pathology, Unit of Genetics & Genomics, School of Biomedical Sciences, Makerere University College of Health Sciences, P o Box 7072, Kampala, Uganda. .,Department of Immunology &Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, P o Box 7072, Kampala, Uganda.
| | - David P Kateete
- Department of Immunology &Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, P o Box 7072, Kampala, Uganda.,Department of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, P o Box 7072, Kampala, Uganda
| | - Benon Asiimwe
- Department of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, P o Box 7072, Kampala, Uganda
| | - Moses L Joloba
- Department of Immunology &Molecular Biology, School of Biomedical Sciences, Makerere University College of Health Sciences, P o Box 7072, Kampala, Uganda.,Department of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, P o Box 7072, Kampala, Uganda
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Wang S, Wu J, Chen J, Gao Y, Zhang S, Zhou Z, Huang H, Shao L, Jin J, Zhang Y, Zhang W. Evaluation of Mycobacterium tuberculosis-specific antibody responses for the discrimination of active and latent tuberculosis infection. Int J Infect Dis 2018; 70:1-9. [PMID: 29410147 DOI: 10.1016/j.ijid.2018.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 12/08/2017] [Accepted: 01/10/2018] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The serological antibody detection tests offer several advantages for the rapid diagnosis of tuberculosis (TB). The Mycobacterium tuberculosis-specific antibody responses associated with different stages of TB infection remain to be investigated. METHODS The Pathozyme-Myco IgG (Myco G), Pathozyme TB Complex Plus (TB Complex), IBL M. tuberculosis IgG ELISA (IBL), Anda Biologicals TB IgG (Anda-TB), and T-SPOT.TB (T-SPOT) tests were performed for 133 active TB patients (ATB group), 131 controls (CON group), and 95 subjects with latent TB infection (LTBI group). RESULTS The four serological tests all showed relatively low sensitivity in the ATB group but high specificity in the LTBI and CON groups. The antibody levels of the four serological tests were significantly higher in the ATB group than in the LTBI group. The same trend was observed between the LTBI and CON groups. The four serological tests demonstrated potential diagnostic value in discriminating ATB from LTBI. A combination of the Anda-TB and TB Complex tests exhibited the best diagnostic potential in discriminating ATB from LTBI, with a sensitivity of 89.4% and a specificity of 94.7%. Further, the diagnostic value of Anda-TB and TB Complex were validated in a prospective cohort including 106 patients with suspected ATB. Combined with the T-SPOT test, the tests showed a sensitivity of 87.2% and a specificity of 92.5% for discriminating ATB patients from all ATB suspected cases in the validation group. CONCLUSIONS The antibody responses of the serological tests all showed significant differences between the ATB and LTBI groups. A combination of Anda-TB and the TB Complex test demonstrated high diagnostic potential in discriminating ATB from LTBI and may be an additional diagnostic tool in the diagnosis of M. tuberculosis infection.
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Affiliation(s)
- Sen Wang
- Institute of Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jing Wu
- Institute of Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiazhen Chen
- Institute of Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan Gao
- Institute of Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Shu Zhang
- Institute of Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Zumo Zhou
- People's Hospital of Zhuji, Zhejiang Province, Zhuji, China
| | - Heqing Huang
- People's Hospital of Zhuji, Zhejiang Province, Zhuji, China
| | - Lingyun Shao
- Institute of Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jialin Jin
- Institute of Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Ying Zhang
- Institute of Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China; Institutes of Biomedical Sciences, Fudan University, Shanghai, China; MOH and MOE Key Laboratory of Medical Molecular Virology, Shanghai Medical College, Fudan University, Shanghai, China; Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Wenhong Zhang
- Institute of Infectious Diseases, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China; Institutes of Biomedical Sciences, Fudan University, Shanghai, China; MOH and MOE Key Laboratory of Medical Molecular Virology, Shanghai Medical College, Fudan University, Shanghai, China.
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Rufai SB, Singh A, Singh J, Kumar P, Sankar MM, Singh S. Diagnostic usefulness of Xpert MTB/RIF assay for detection of tuberculous meningitis using cerebrospinal fluid. J Infect 2017; 75:125-131. [PMID: 28501491 DOI: 10.1016/j.jinf.2017.04.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/01/2017] [Accepted: 04/05/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Tuberculous meningitis (TBM) is the most severe form of extra-pulmonary tuberculosis (TB) due to association of diseases with high rates of mortality and morbidity. Diagnosis continues to be a clinical challenge as microbiological confirmation is rare and time consuming resulting in delayed treatment. Xpert MTB/RIF assay is a rapid and simple test, which has been endorsed by World Health Organization as an initial diagnostic test for the diagnosis of TBM. However, evidence still lacks for its performance on cerebrospinal fluid (CSF) for the diagnosis of TBM especially from India. METHODS A total of 267 CSF samples from patients with high clinico-radiological suspicion of TBM were included in this study. Ziehl-Neelsen (ZN) staining, BACTEC Mycobacterial Growth Indicator Tube (MGIT-960) culture system, and Xpert MTB/RIF assay (using cartridge version G4) were tested on all samples. RESULTS Of total 267 samples, all were negative for smear AFB and 52 (19.5%) were culture positive by MGIT-960 culture system. However, out of 52 (19.5%) cultures detected positive by MGIT-960, 5 (9.6%) were detected as resistant to rifampicin. Xpert MTB/RIF assay was positive in 38 (14.2%) samples and negative in 223 (83.5%) samples. Cartridge error was detected in 6 (2.2%) samples, which could not be repeated due to insufficient sample volume. The sensitivity and specificity of Xpert MTB/RIF assay in comparison to MGIT-960 was 55.1% (95%, CI: 40.2-69.3) and 94.8% (95%, CI: 90.9-97.4) respectively. Overall, Xpert MTB/RIF assay detected 38 (14.2%) as positive for MTB of which 4 (10.5%), 31 (81.6%) and 3 (7.9%) were found to be rifampicin resistant, sensitive and indeterminate respectively. CONCLUSION Xpert MTB/RIF assay showed lower sensitivity as compared to MGIT 960 culture for the diagnosis of TBM from CSF samples.
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Affiliation(s)
- Syed Beenish Rufai
- Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Singh
- Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Jitendra Singh
- Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Parveen Kumar
- Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Manimuthu Mani Sankar
- Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sarman Singh
- Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India.
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- Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
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Ma G, Pan J, Han J, Gao L, Zhang S, Li R. Identification of M. tuberculosis antigens in the sera of tuberculosis patients using biomimetic affinity chromatography in conjunction with ESI-CID-MS/MS. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1061-1062:452-458. [PMID: 28820984 DOI: 10.1016/j.jchromb.2017.07.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/19/2017] [Accepted: 07/28/2017] [Indexed: 11/16/2022]
Abstract
The profiling of abnormally-expressed proteins in host cells using mass spectrometry (MS) analysis is a classical approach for screening disease-associated biomarkers in clinical diagnosis. However, few pathogen-specific antigens can currently be detected in serum using this proteomic approach, since these are very low-abundant proteins that are easily masked by host high-abundant proteins. Identification of pathogen-specific antigens in the sera of tuberculosis patients is crucial for the clinical diagnosis of this infectious disease, especially in immune-compromised patients. In the present study, two biomimetic affinity chromatography (BiAC) media, At-23 and A115-94, were selected from a library of BiAC media and used to selectively fractionate Albumin and Immunoglobulin from sera, respectively, prior to MS analyses. Each fraction was collected and screened against the proteomic database of M. tuberculosis complex. Three antigens, FbpA, FbpB and BfrB, were identified with two distinct peptides in BiAC-fractionated sera from tuberculosis patients, which were confirmed by Western blotting. Moreover, the identification of pathogen-specific antigens in sera by BiAC in conjunction with ESI-CID-MS/MS represents a promising strategy for the discovery of disease-associated biomarkers in other diseases.
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Affiliation(s)
- Guorong Ma
- State Key Laboratory of Microbial Metabolism and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jinting Pan
- State Key Laboratory of Microbial Metabolism and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jincheng Han
- State Key Laboratory of Microbial Metabolism and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Lina Gao
- Clinical Laboratory of the Second Affiliated Hospital, Lanzhou University, Lanzhou 730030, China
| | - Shulin Zhang
- Department of Immunology and Microbiology, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
| | - Rongxiu Li
- State Key Laboratory of Microbial Metabolism and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200240, China; Engineering Research Center of Cells & Therapeutic Antibodies, Ministry of Education, Shanghai, China.
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19
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Nanogapped impedimetric immunosensor for the detection of 16 kDa heat shock protein against Mycobacterium tuberculosis. Mikrochim Acta 2016. [DOI: 10.1007/s00604-016-1911-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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20
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Mohammad OI, Okab AA, El Behisy MM, Sudhom FGT. Value of CA-125 in diagnosis and assessment of severity of active pulmonary tuberculosis. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2016. [DOI: 10.1016/j.ejcdt.2015.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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21
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Tiwari D, Haque S, Tiwari RP, Jawed A, Govender T, Kruger HG. Fast and efficient detection of tuberculosis antigens using liposome encapsulated secretory proteins of Mycobacterium tuberculosis. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2015; 50:189-198. [PMID: 26231299 DOI: 10.1016/j.jmii.2015.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/19/2015] [Accepted: 05/28/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE A rapid and efficient diagnostic test was developed for the detection of Mycobacterium tuberculosis antigens in serum samples of active tuberculosis (TB) and extrapulmonary TB patients via a liposomal agglutination-based method. METHODS A rapid card test has been developed to facilitate the recognition of high-affinity binding rabbit raised purified culture filtrate protein antibodies coupled on the surface of activated liposomal preparation. In the presence of TB antigens, the polyclonal antibodies bound to the liposomal particles demonstrate a visible agglutination reaction. RESULTS The developed assay was simple, rapid, reliable, sensitive, and specific as a diagnostic test for the detection of antigens in serum samples of clinically confirmed cases of TB within 4-5 minutes' duration. The test was evaluated at different hospitals, medical colleges, and pathology centers, and involved 1483 participants. This investigation was conducted to detect the presence of these antigens during the period of active growth of the microorganism in serum samples for pulmonary TB and processed tissue biopsy for other extrapulmonary TB. Results obtained using this test were compared with acid-fast bacilli smear and culture results. CONCLUSION Our study demonstrated that the newly developed liposome tuberculosis antigen card test detected antigens in our study population with approximately 97.48% sensitivity and 95.79% specificity. This is the first study to report the liposomal encapsulation of culture filtrate proteins from M. tuberculosis for diagnostic application.
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Affiliation(s)
- Dileep Tiwari
- Catalysis and Peptide Research Unit, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; School of Environmental Biology and Centre for Biotechnology Studies, University of Awdhesh Pratap Singh, Rewa 486001, Madhya Pradesh, India.
| | - Shafiul Haque
- Department of Biosciences, Jamia Millia Islamia, New Delhi 110025, India; Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Ram P Tiwari
- Department of Biotechnology, Immunodiagnostic Division, Vanguard Diagnostic Pvt. Ltd., Delhi 110020, India
| | - Arshad Jawed
- Research and Scientific Studies Unit, College of Nursing and Allied Health Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Thavendran Govender
- Catalysis and Peptide Research Unit, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Hendrik G Kruger
- Catalysis and Peptide Research Unit, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Mohammad AA, Mohammad OE, Shoman AA. Comparative study between tuberculin skin test and serum albumin level in patients with active pulmonary tuberculosis. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2015. [DOI: 10.4103/1687-8426.158086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Shojaei TR, Mohd Salleh MA, Tabatabaei M, Ekrami A, Motallebi R, Rahmani-Cherati T, Hajalilou A, Jorfi R. Development of sandwich-form biosensor to detect Mycobacterium tuberculosis complex in clinical sputum specimens. Braz J Infect Dis 2014; 18:600-8. [PMID: 25181404 PMCID: PMC9425227 DOI: 10.1016/j.bjid.2014.05.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 05/06/2014] [Accepted: 05/19/2014] [Indexed: 10/29/2022] Open
Abstract
Mycobacterium tuberculosis, the causing agent of tuberculosis, comes second only after HIV on the list of infectious agents slaughtering many worldwide. Due to the limitations behind the conventional detection methods, it is therefore critical to develop new sensitive sensing systems capable of quick detection of the infectious agent. In the present study, the surface modified cadmium-telluride quantum dots and gold nanoparticles conjunct with two specific oligonucleotides against early secretory antigenic target 6 were used to develop a sandwich-form fluorescence resonance energy transfer-based biosensor to detect M. tuberculosis complex and differentiate M. tuberculosis and M. bovis Bacille Calmette-Guerin simultaneously. The sensitivity and specificity of the newly developed biosensor were 94.2% and 86.6%, respectively, while the sensitivity and specificity of polymerase chain reaction and nested polymerase chain reaction were considerably lower, 74.2%, 73.3% and 82.8%, 80%, respectively. The detection limits of the sandwich-form fluorescence resonance energy transfer-based biosensor were far lower (10 fg) than those of the polymerase chain reaction and nested polymerase chain reaction (100 fg). Although the cost of the developed nanobiosensor was slightly higher than those of the polymerase chain reaction-based techniques, its unique advantages in terms of turnaround time, higher sensitivity and specificity, as well as a 10-fold lower detection limit would clearly recommend this test as a more appropriate and cost-effective tool for large scale operations.
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Affiliation(s)
- Taha Roodbar Shojaei
- Institute of Advanced Technology (ITMA), Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Mohamad Amran Mohd Salleh
- Institute of Advanced Technology (ITMA), Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Meisam Tabatabaei
- Nanosystems Research Team (NRTeam), Microbial Biotechnology and Biosafety Department, Agricultural Biotechnology Research Institute of Iran (ABRII), Karaj, Iran
| | - Alireza Ekrami
- Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Roya Motallebi
- Department of Plant Breeding and Biotechnology, College of Agriculture, Shahrekord University, P.O. Box 115, Shahrekord, Iran
| | | | - Abdollah Hajalilou
- Institute of Advanced Technology (ITMA), Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Raheleh Jorfi
- Institute of Advanced Technology (ITMA), Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
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Lyra JMAD, Maruza M, Verza M, Carneiro MM, Albuquerque MDFMD, Rossetti ML, Ximenes R, Braga MC, Lucena-Silva N. Evaluation of four molecular methods for the diagnosis of tuberculosis in pulmonary and blood samples from immunocompromised patients. Mem Inst Oswaldo Cruz 2014; 109:805-13. [PMID: 25317709 PMCID: PMC4238774 DOI: 10.1590/0074-0276130542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 06/20/2014] [Indexed: 11/21/2022] Open
Abstract
The present study analysed the concordance among four different molecular diagnostic
methods for tuberculosis (TB) in pulmonary and blood samples from immunocompromised
patients. A total of 165 blood and 194 sputum samples were collected from 181 human
immunodeficiency virus (HIV)-infected patients with upper respiratory complaints,
regardless of suspicious for TB. The samples were submitted for smear microscopy,
culture and molecular tests: a laboratory-developed conventional polymerase chain
reaction (PCR) and real-time quantitative PCR (qPCR) and the Gen-Probe and Detect-TB
Ampligenix kits. The samples were handled blindly by all the technicians involved,
from sample processing to results analysis. For sputum, the sensitivity and
specificity were 100% and 96.7% for qPCR, 81.8% and 94.5% for Gen-Probe and 100% and
66.3% for Detect-TB, respectively. qPCR presented the best concordance with sputum
culture [kappa (k) = 0.864)], followed by Gen-Probe (k = 0.682). For blood samples,
qPCR showed 100% sensitivity and 92.3% specificity, with a substantial correlation
with sputum culture (k = 0.754) and with the qPCR results obtained from sputum of the
corresponding patient (k = 0.630). Conventional PCR demonstrated the worst results
for sputa and blood, with a sensitivity of 100% vs. 88.9% and a specificity of 46.3%
vs. 32%, respectively. Commercial or laboratory-developed molecular assays can
overcome the difficulties in the diagnosis of TB in paucibacillary patients using
conventional methods available in most laboratories.
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Affiliation(s)
| | - Magda Maruza
- Hospital Correia Picanço, Secretaria do Estado de Pernambuco, Recife, PE, Brasil
| | - Mirela Verza
- Fundação Estadual de Produção e Pesquisa em Saúde, Porto Alegre, RS, Brasil
| | | | | | | | - Ricardo Ximenes
- Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - Maria Cynthia Braga
- Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães-Fiocruz, Recife, PE, Brasil
| | - Norma Lucena-Silva
- Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães-Fiocruz, Recife, PE, Brasil
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A multicenter clinical evaluation of Mycobacterium tuberculosis IgG/IgM antibody detection using the colloidal gold method. Eur J Clin Microbiol Infect Dis 2014; 33:1989-94. [PMID: 24913311 PMCID: PMC4555362 DOI: 10.1007/s10096-014-2150-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 04/30/2014] [Indexed: 11/03/2022]
Abstract
A specific immunoassay method with the colloidal gold labeling technique has been developed more and more for tuberculosis (TB) diagnosis. The aim of this multicenter clinical evaluation was to evaluate the performance of a new serological diagnostic kit (the Trustline TB IgG/IgM Rapid Test kit) for the detection of Mycobacterium tuberculosis infection in China, with the Aupu TB Ab (IgG) Colloidal Gold Test kit being used as a control. A total of 1,009 specimens were collected from three TB hospitals, including 628 patients with TB, and 219 non-TB and 162 healthy patients as negative controls. According to the clinical diagnostic results, the sensitivities of the Trustline kit and the Aupu kit were 61.3 % and 53.7 %, respectively. Using the bacteriological test results as the "gold standard" to compare the results of the two kits, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Youden index (YI) were 77.60 %, 79.8 %, 73.31 %, 81.50 %, and 0.574 by the Trustline kit, and 67.86 %, 88.9 %, 83.27 %, 77.40 %, and 0.568 by the Aupu kit, respectively. Further, the sensitivity of the Trustline kit and the Aupu kit for the smear staining and the bacterial culture being positive was 75.6 %, 76.6 % and 65.6 %, 66.5 %, and for the negative result, it was 53.8 %, 50.9 % and 47.5 %, 45.0 %, respectively. Additionally, 35 specimens were IgM-positive by the Trustline kit; of these, 30 (4.8 %) were from patients with TB and 5 (1.3 %) were from individuals without TB. The results showed that the experimental test had a much higher sensitivity than the other commercial test and exhibited a good detection rate for M. tuberculosis infection. Therefore, this kit can be used in the supplementary diagnosis and screening of TB.
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Dynamic evolution and immunoreactivity of aptamers binding to polyclonal antibodies against MPT64 antigen of Mycobacterium tuberculosis. Eur J Clin Microbiol Infect Dis 2014; 33:1199-209. [PMID: 24500599 DOI: 10.1007/s10096-014-2056-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 01/07/2014] [Indexed: 02/07/2023]
Abstract
Antibody responses can be useful markers of tuberculosis infection. However, the established immunoassay diagnostic method is limited by antigenic variability. Replacing the recombinant proteins with aptamers may overcome these antigenic challenges. In this study, we systematically monitored the selection process of aptamers against anti-MPT64 antibodies of Mycobacterium tuberculosis to obtain more aptamers for developing a multisite system to increase the sensitivity of TB serological diagnosis. Twelve high-affinity aptamers with distinctive secondary structures were obtained by analyzing the dynamic evolution of aptamers against anti-MPT64 antibodies in the process of system evolution of ligands by exponential enrichment (SELEX). Pocket and stem-loops were found to be the basis of these aptamers binding to antibodies. Point mutations of highly conserved nucleotides in the pocket and stem-loop structures resulted in decreased affinity of aptamers to targets. To test the potential of these aptamers for future use in a serological diagnostic tool, three high-affinity aptamers with different epitope specificities were applied as capture aptamer in an enzyme-linked immunosorbent assay (ELISA) with sera of TB patients. The results showed that three aptamers all effectively bound anti-MPT64 antibodies from TB patients and had high specificity and sensitivity. These aptamers with high immunoreactivity in human sera may represent an efficient and promising analogue of MPT64 and have potential to substitute MPT64 as a nucleic acid antigen in the serological diagnosis of TB. Moreover, these aptamers with different epitope specificities may facilitate the development of a sandwich assay platform or a multisite system to effectively capture more targets in sera.
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Lagrange PH, Thangaraj SK, Dayal R, Deshpande A, Ganguly NK, Girardi E, Joshi B, Katoch K, Katoch VM, Kumar M, Lakshmi V, Leportier M, Longuet C, Malladi SVS, Mukerjee D, Nair D, Raja A, Raman B, Rodrigues C, Sharma P, Singh A, Singh S, Sodha A, Kabeer BSA, Vernet G, Goletti D. A toolbox for tuberculosis (TB) diagnosis: an Indian multi-centric study (2006-2008); evaluation of serological assays based on PGL-Tb1 and ESAT-6/CFP10 antigens for TB diagnosis. PLoS One 2014; 9:e96367. [PMID: 24797271 PMCID: PMC4010510 DOI: 10.1371/journal.pone.0096367] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 04/07/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The aim of this multi-centric prospective study in India was to assess the accuracy of a serological test as an additional tool for diagnosing active tuberculosis (ATB). In particular, an assay based on ELISA using a phenolic glycolipid (PGL-Tb1) or a fusion protein (ESAT-6/CFP10) was compared to the tuberculin skin test (TST) and the microbiological results according to HIV status. METHODS Individuals with and without ATB and HIV infection were enrolled. Serology and TST results were analyzed per se and in combination with the microbiological data. RESULTS Among the 778 ATB patients, 102 were HIV-infected, 316 HIV-uninfected and 360 had an HIV-unknown status. Of the 945 non-ATB subjects, 559 were at low risk (community adults) and 386 at high risk of M. tuberculosis exposure. Among those with ATB, the sensitivity of ELISA-PGL-Tb1 for ATB was higher than that of ELISA-ESAT-6/CFP10, both in HIV-infected (72.3% versus 63.7%, p = 0.29) and HIV-uninfected/HIV-unknown groups (40.5% versus 28.6%; p<0.0001), whereas the specificity was around 91% for both tests. Sensitivity for ATB increased when the results of the two ELISA were combined, reaching 75.5% in the HIV-infected and 50.9% in the group of HIV-uninfected/HIV-unknown ATB, with a significant decrease of the global specificity (83.9%). Analyzing the ELISA results with the microbiological results, we observed that the sensitivity of both serology tests was independent of the ATB patients' smear microscopy (SM) status and grade. Combining the results of SM with both ELISA, the detection of ATB patients significantly increased (p<0.0001), particularly in those with extrapulmonary TB (up to 45.1%) or HIV infection (up to 83.3%). No significant association was observed between TST and serology results. CONCLUSIONS In this prospective multi-centric study, the combination of two rapid tests, such as SM and serology, might be useful in detecting ATB, especially in HIV-infected patients.
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Affiliation(s)
| | | | | | - Alaka Deshpande
- Sir J.J. Group of Govt Hosp. & Grant Medical College, Mumbai, India
| | | | - Enrico Girardi
- Department of Epidemiology and Preclinical Research, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Beenu Joshi
- National JALMA Institute of Leprosy & Other Mycrobacterial Diseases, Agra, India
| | - Kiran Katoch
- National JALMA Institute of Leprosy & Other Mycrobacterial Diseases, Agra, India
| | - Vishwa M. Katoch
- National JALMA Institute of Leprosy & Other Mycrobacterial Diseases, Agra, India
| | - Manoj Kumar
- All India Institute of Medical Sciences, New Delhi, India
| | - Vemu Lakshmi
- Nizam's Institute of Medical Sciences, Hyderabad, India
| | | | | | | | | | | | - Alamelu Raja
- National Institute for Research in Tuberculosis (formerly Tuberculosis Research Center), Chetput, Chennai, India
| | - Balambal Raman
- National Institute for Research in Tuberculosis (formerly Tuberculosis Research Center), Chetput, Chennai, India
| | - Camilla Rodrigues
- Microbiology Section, P D Hinduja Hospital & Medical Research Centre, Veer Savarkar Marg Mahim, Mumbai, India
| | | | | | - Sarman Singh
- All India Institute of Medical Sciences, New Delhi, India
| | - Archana Sodha
- Microbiology Section, P D Hinduja Hospital & Medical Research Centre, Veer Savarkar Marg Mahim, Mumbai, India
| | | | | | - Delia Goletti
- Department of Epidemiology and Preclinical Research, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
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Farazi A, Moharamkhani A, Sofian M. Validity of serum adenosine deaminase in diagnosis of tuberculosis. Pan Afr Med J 2013; 15:133. [PMID: 24319523 PMCID: PMC3852508 DOI: 10.11604/pamj.2013.15.133.2100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 07/06/2013] [Indexed: 11/23/2022] Open
Abstract
Introduction Tuberculosis is one of the most important infectious causes of death worldwide. Ziehl-Neelsen staining of sputum has high specificity in tuberculosis endemic countries, but modest sensitivity which varies among laboratories. This study was set up to investigate the diagnostic value of serum Adenosine deaminase in diagnosis of tuberculosis. Methods In a cross sectional and prospective study Serums of 200 patients of positive sputum smear, negative sputum smear, extra-pulmonary tuberculosis and bacterial community acquired pneumonia collected from March 2011 to May 2012 were evaluated. The data were analyzed using SPSS software and P-value of <0.05 was considered significant. Results A total of 200 subjects were included in the study designed in four groups. In cut-off value of ≥24 U/l for ADA in smear positive patients defined the sensitivity, specificity and positive predictive value 12%, 98% and 86% respectively. In smear negative patients defined the 6%, 98% and 75%, and in extra-pulmonary tuberculosis patients defined the sensitivity 14%, 98% and 88% respectively. Conclusion This study indicated that measurement of serum ADA level do not have enough sensitivity to assist in the diagnoses of tuberculosis patients from other respiratory diseases and not evaluated perform well enough to replace sputum smear microscopy. Thus, this tests have little role in the diagnosis of pulmonary tuberculosis.
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Affiliation(s)
- Aliasghar Farazi
- Department of Infectious Diseases, School of Medicine, Arak University of Medical Sciences, Arak, Iran
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Ren K, Banaei N, Zare RN. Sorting inactivated cells using cell-imprinted polymer thin films. ACS NANO 2013; 7:6031-6. [PMID: 23725546 PMCID: PMC3722270 DOI: 10.1021/nn401768s] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Previous work showed that cell imprinting in a poly(dimethylsiloxane) film produced artificial receptors to cells by template-assisted rearrangement of functional groups on the surface of the polymer thin film which facilitated cell capture in the polymer surface indentations by size, shape, and, most importantly, chemical recognition. We report here that inactivation of cells by treatment with formaldehyde (4%), glutaraldehyde (2%), or a combination of the two leads to markedly improved capture selectivity (a factor of 3) when cells to be analyzed are inactivated in the same manner. The enhanced capture efficiency compared to living cells results from two factors: (1) rigidification of the cell surface through cross-linking of amine groups by the aldehyde; and (2) elimination of chemicals excreted from living cells which interfere with the fidelity of the cell-imprinting process. Moreover, cell inactivation has the advantage of removing biohazard risks associated with working with virulent bacteria. These results are demonstrated using different strains of Mycobacterium tuberculosis.
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Affiliation(s)
- Kangning Ren
- Department of Chemistry, Stanford University, Stanford, California 94305-5080, USA
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Said AF, Mohamed BI, El-Sharkawy E, Al-Sherif M. Role of cancer antigen 125 in active pulmonary tuberculosis. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2013. [DOI: 10.1016/j.ejcdt.2013.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Srivastava SK, Ruigrok VJB, Thompson NJ, Trilling AK, Heck AJR, van Rijn C, Beekwilder J, Jongsma MA. 16 kDa heat shock protein from heat-inactivated Mycobacterium tuberculosis is a homodimer - suitability for diagnostic applications with specific llama VHH monoclonals. PLoS One 2013; 8:e64040. [PMID: 23737964 PMCID: PMC3667823 DOI: 10.1371/journal.pone.0064040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 04/10/2013] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The 16 kDa heat shock protein (HSP) is an immuno-dominant antigen, used in diagnosis of infectious Mycobacterium tuberculosis (M.tb.) causing tuberculosis (TB). Its use in serum-based diagnostics is limited, but for the direct identification of M.tb. bacteria in sputum or cultures it may represent a useful tool. Recently, a broad set of twelve 16 kDa specific heavy chain llama antibodies (VHH) has been isolated, and their utility for diagnostic applications was explored. METHODOLOGY/PRINCIPAL FINDINGS To identify the epitopes recognized by the nine (randomly selected from a set of twelve 16 kDa specific VHH antibodies) distinct VHH antibodies, 14 overlapping linear epitopes (each 20 amino acid long) were characterized using direct and sandwich ELISA techniques. Seven out of 14 epitopes were recognized by 8 out of 9 VHH antibodies. The two highest affinity binders B-F10 and A-23 were found to bind distinct epitopes. Sandwich ELISA and SPR experiments showed that only B-F10 was suitable as secondary antibody with both B-F10 and A-23 as anchoring antibodies. To explain this behavior, the epitopes were matched to the putative 3D structure model. Electrospray ionization time-of-flight mass spectrometry and size exclusion chromatography were used to determine the higher order conformation. A homodimer model best explained the differential immunological reactivity of A-23 and B-F10 against heat-treated M.tb. lysates. CONCLUSIONS/SIGNIFICANCE The concentrations of secreted antigens of M.tb. in sputum are too low for immunological detection and existing kits are only used for identifying M.tb. in cultures. Here we describe how specific combinations of VHH domains could be used to detect the intracellular HSP antigen. Linked to methods of pre-concentrating M.tb. cells prior to lysis, HSP detection may enable the development of protein-based diagnostics of sputum samples and earlier diagnosis of diseases.
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Affiliation(s)
- Saurabh K. Srivastava
- Plant Research International, Wageningen, The Netherlands
- Laboratory of Organic Chemistry, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Vincent J. B. Ruigrok
- Laboratory of Microbiology, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Natalie J. Thompson
- Biomolecular Mass Spectrometry and Proteomics, Bijvoet Center for Biomolecular Research and Utrecht Institute for Phamaceutical Sciences, Utrecht University, Utrecht, The Netherlands
- Netherlands Proteomics Centre, Utrecht, The Netherlands
| | - Anke K. Trilling
- Plant Research International, Wageningen, The Netherlands
- Laboratory of Organic Chemistry, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Albert J. R. Heck
- Biomolecular Mass Spectrometry and Proteomics, Bijvoet Center for Biomolecular Research and Utrecht Institute for Phamaceutical Sciences, Utrecht University, Utrecht, The Netherlands
- Netherlands Proteomics Centre, Utrecht, The Netherlands
| | - Cees van Rijn
- Laboratory of Organic Chemistry, Wageningen University and Research Centre, Wageningen, The Netherlands
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Antibody response to Mycobacterium tuberculosis p27-PPE36 antigen in sera of pulmonary tuberculosis patients. Tuberculosis (Edinb) 2013; 93:189-91. [DOI: 10.1016/j.tube.2012.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 10/11/2012] [Accepted: 10/13/2012] [Indexed: 11/23/2022]
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Franzeck FC, Ngwale R, Msongole B, Hamisi M, Abdul O, Henning L, Letang E, Mwaigomole G, Battegay M, Hatz C, Tanner M. Viral hepatitis and rapid diagnostic test based screening for HBsAg in HIV-infected patients in rural Tanzania. PLoS One 2013; 8:e58468. [PMID: 23469281 PMCID: PMC3585939 DOI: 10.1371/journal.pone.0058468] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 02/05/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Co-infection with hepatitis B virus (HBV) is highly prevalent in people living with HIV in Sub-Saharan Africa. Screening for HBV surface antigen (HBsAg) before initiation of combination antiretroviral therapy (cART) is recommended. However, it is not part of diagnostic routines in HIV programs in many resource-limited countries although patients could benefit from optimized antiretroviral therapy covering both infections. Screening could be facilitated by rapid diagnostic tests for HBsAg. Operating experience with these point of care devices in HIV-positive patients in Sub-Saharan Africa is largely lacking. We determined the prevalence of HBV and Hepatitis C virus (HCV) infection as well as the diagnostic accuracy of the rapid test device Determine HBsAg in an HIV cohort in rural Tanzania. METHODS Prospectively collected blood samples from adult, HIV-1 positive and antiretroviral treatment-naïve patients in the Kilombero and Ulanga antiretroviral cohort (KIULARCO) in rural Tanzania were analyzed at the point of care with Determine HBsAg, a reference HBsAg EIA and an anti-HCV EIA. RESULTS Samples of 272 patients were included. Median age was 38 years (interquartile range [IQR] 32-47), 169/272 (63%) subjects were females and median CD4+ count was 250 cells/µL (IQR 97-439). HBsAg was detected in 25/272 (9.2%, 95% confidence interval [CI] 6.2-13.0%) subjects. Of these, 7/25 (28%) were positive for HBeAg. Sensitivity of Determine HBsAg was rated at 96% (95% CI 82.8-99.6%) and specificity at 100% (95% CI, 98.9-100%). Antibodies to HCV (anti-HCV) were found in 10/272 (3.7%, 95% CI 2.0-6.4%) of patients. CONCLUSION This study reports a high prevalence of HBV in HIV-positive patients in a rural Tanzanian setting. The rapid diagnostic test Determine HBsAg is an accurate assay for screening for HBsAg in HIV-1 infected patients at the point of care and may further help to guide cART in Sub-Saharan Africa.
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Yang H, Chen H, Liu Z, Ma H, Qin L, Jin R, Zheng R, Feng Y, Cui Z, Wang J, Liu J, Hu Z. A novel B-cell epitope identified within Mycobacterium tuberculosis CFP10/ESAT-6 protein. PLoS One 2013; 8:e52848. [PMID: 23308124 PMCID: PMC3538682 DOI: 10.1371/journal.pone.0052848] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 11/21/2012] [Indexed: 11/29/2022] Open
Abstract
Background The 10-kDa culture filtrate protein (CFP10) and 6-kDa early-secreted target antigen (ESAT-6) play important roles in mycobacterial virulence and pathogenesis through a 1∶1 complex formation (CFP10/ESAT-6 protein, CE protein), which have been used in discriminating TB patients from BCG-vaccinated individuals. The B-cell epitopes of CFP10 and ESAT-6 separately have been analyzed before, however, the epitopes of the CE protein are unclear and the precise epitope in the positions 40 to 62 of ESAT-6 is still unknown. Methods In the present study, we searched for the B-cell epitopes of CE protein by using phage-display library biopanning with the anti-CE polyclonal antibodies. The epitopes were identified by sequence alignment, binding affinity and specificity detection, generation of polyclonal mouse sera and detection of TB patient sera. Results One linear B-cell epitope (KWDAT) consistent with the 162nd–166th sequence of CE and the 57th–61st sequence of ESAT-6 protein was selected and identified. Significantly higher titers of E5 peptide-binding antibodies were found in the sera of TB patients compared with those of healthy individuals. Conclusion There was a B-cell epitope for CE and ESAT-6 protein in the position 40 to 62 of ESAT-6. E5 peptide may be useful in the serodiagnosis of tuberculosis, which need to be further confirmed by more sera samples.
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Affiliation(s)
- Hua Yang
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Haizhen Chen
- Clinical Laboratory Diagnostics, Shanxi Medical University, Taiyuan, China
| | - Zhonghua Liu
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hui Ma
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lianhua Qin
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ruiliang Jin
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ruijuan Zheng
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yonghong Feng
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhenling Cui
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jie Wang
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jinming Liu
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
- * E-mail: (JL); (ZH)
| | - Zhongyi Hu
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
- * E-mail: (JL); (ZH)
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Tasci C, Tapan S, Ozkaya S, Demirer E, Deniz O, Balkan A, Ozkan M, Inan I, Kurt I, Bilgic H. Efficacy of serum chitotriosidase activity in early treatment of patients with active tuberculosis and a negative sputum smear. Ther Clin Risk Manag 2012; 8:369-72. [PMID: 22956876 PMCID: PMC3431959 DOI: 10.2147/tcrm.s31752] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The results of sputum culture for Mycobacterium tuberculosis must be awaited in most cases, which delays the start of treatment in patients with sputum smear-negative pulmonary tuberculosis. We investigated whether plasma chitotriosidase activity is a strong marker for early diagnosis of tuberculosis in patients for whom a bacillus smear is negative and tuberculosis culture is positive. Methods Clinical, radiological, and laboratory features were evaluated in 75 patients, 17 of whom were diagnosed as having active tuberculosis by negative acid-fast bacillus smear and positive culture, 38 as having sequel tuberculosis which was radiologically and microbiologically negative, and 20 who served as healthy controls. Serum chitotriosidase activity levels were measured in both cases and controls. Results The mean age of the cases with active pulmonary tuberculosis, cases with sequel lesions, and controls was 23 ± 2.4 years, 22 ± 1.7 years, and 24 ± 2.1 years, respectively. Serum chitotriosidase levels were 68.05 ± 72.61 nmol/hour/mL in smear-negative, culture-positive pulmonary tuberculosis cases (Group A) and 29.73 ± 20.55 nmol/hour/mL in smear-negative, culture-negative sequel pulmonary tuberculosis cases (Group B). Serum chitotriosidase levels from patients in Group A were significantly higher than in Group B and Group C. There was no statistically significant difference in serum chitotriosidase levels between cases with sequel pulmonary tuberculosis (Group B, smear-negative, culture-negative) and healthy controls (Group C). Conclusion In patients with active tuberculosis and a negative sputum smear for acid-fast bacillus, plasma chitotriosidase activity seems to be a strong marker for diagnosis of active disease which can be used while awaiting culture results.
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Affiliation(s)
- Canturk Tasci
- Department of Pulmonary Diseases, Gulhane Medical Faculty, Ankara
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Ashenafi S, Aderaye G, Zewdie M, Raqib R, Bekele A, Magalhaes I, Lema B, Habtamu M, Rekha RS, Aseffa G, Maeurer M, Aseffa A, Svensson M, Andersson J, Brighenti S. BCG-specific IgG-secreting peripheral plasmablasts as a potential biomarker of active tuberculosis in HIV negative and HIV positive patients. Thorax 2012; 68:269-76. [PMID: 22923457 PMCID: PMC3585487 DOI: 10.1136/thoraxjnl-2012-201817] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Diagnosis of active tuberculosis (TB) among sputum-negative cases, patients with HIV infection and extra-pulmonary TB is difficult. In this study, assessment of BCG-specific IgG-secreting peripheral plasmablasts, was used to identify active TB in these high-risk groups. Methods Peripheral blood mononuclear cells were isolated from patients with TB and controls and cultured in vitro using an assay called Antibodies in Lymphocyte Supernatant, which measures spontaneous IgG antibody release from migratory plasmablasts. A BCG-specific ELISA and flow cytometry were used to quantify in vivo activated plasmablasts in blood samples from Ethiopian subjects who were HIV negative or HIV positive. Patients diagnosed with different clinical forms of sputum-negative active TB or other diseases (n=96) were compared with asymptomatic individuals including latent TB and non-TB controls (n=85). Immunodiagnosis of TB also included the tuberculin skin test and the interferon (IFN)-γ release assay, QuantiFERON. Results This study demonstrated that circulating IgG+ plasmablasts and spontaneous secretion of BCG-specific IgG antibodies were significantly higher in patients with active TB compared with latent TB cases and non-TB controls. BCG-specific IgG titres were particularly high among patients coinfected with TB and HIV with CD4 T-cell counts <200 cells/ml who produced low levels of Mycobacterium tuberculosis-specific IFNγ in vitro. Conclusions These results suggest that BCG-specific IgG-secreting peripheral plasmablasts could be successfully used as a host-specific biomarker to improve diagnosis of active TB, particularly in people who are HIV positive, and facilitate administration of effective treatment to patients. Elevated IgG responses were associated with impaired peripheral T-cell responses, including reduced T-cell numbers and low M tuberculosis-specific IFNγ production.
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Affiliation(s)
- Senait Ashenafi
- Department of Medicine, Center for Infectious Medicine (CIM), Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
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Opportunities for improved serodiagnosis of human tuberculosis, bovine tuberculosis, and paratuberculosis. Vet Med Int 2012; 2012:674238. [PMID: 22720192 PMCID: PMC3375143 DOI: 10.1155/2012/674238] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Accepted: 04/02/2012] [Indexed: 11/21/2022] Open
Abstract
Mycobacterial infections—tuberculosis (TB), bovine tuberculosis (bTB), and Johne's disease (JD)—are major infectious diseases of both human and animals. Methods presently in use for diagnosis of mycobacterial infections include bacterial culture, nucleic acid amplification, tuberculin skin test, interferon-γ assay, and serology. Serological tests have several advantages over other methods, including short turn-around time, relatively simple procedures, and low cost. However, current serodiagnostic methods for TB, bTB and JD exhibit low sensitivity and/or specificity. Recent studies that have aimed to develop improved serodiagnostic tests have mostly focused on identifying useful species-specific protein antigens. A review of recent attempts to improve diagnostic test performance indicates that the use of multiple antigens can improve the accuracy of serodiagnosis of these mycobacterial diseases. Mycobacteria also produce a variety of species-specific nonprotein molecules; however, only a few such molecules (e.g., cord factor and lipoarabinomannan) have so far been evaluated for their effectiveness as diagnostic antigens. For TB and bTB, there has been recent progress in developing laboratory-free diagnostic methods. New technologies such as microfluidics and “Lab-on-Chip” are examples of promising new technologies that can underpin development of laboratory-free diagnostic devices for these mycobacterial infections.
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Zhao S, Shi J, Zhang C, Zhao Y, Mao F, Yang W, Bai B, Zhang H, Shi C, Xu Z. Monoclonal antibodies against a Mycobacterium tuberculosis Ag85B-Hsp16.3 fusion protein. Hybridoma (Larchmt) 2012; 30:427-32. [PMID: 22008069 DOI: 10.1089/hyb.2011.0047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The secreted Mycobacterium tuberculosis (MTB) proteins, Ag85B and Hsp16.3, have been the focus of intensive research in recent years. These proteins have high sensitivity in bacterium-negative tuberculosis (TB) patients, and are valuable for the rapid diagnosis of bacterium-negative TB. Fusion proteins including multiple antigens such as Ag85B and Hsp16.3 provide improved sensitivity and specificity for serological diagnosis of active TB compared with a single antigen. Many studies have shown that the production of MAbs recognizing a specific repertoire of M. tuberculosis antigens and the tests based on monoclonal antibodies have been found to be valuable in positive detection of TB, particularly for smear-positive pulmonary TB. A number of MAbs are currently used for serodiagnosis of TB. Therefore, an Ag85B-Hsp16.3 fusion protein was expressed and purified using an E. coli system in this study. Three Ag85B-Hsp16.3 fusion protein-specific MAbs were generated by routine murine hybridoma techniques. The titer, specificity, and relative affinity of all three MAbs were determined by ELISA and the serological responses were analyzed. The levels of antigens in a proportion of TB patients were shown to be significantly higher than those in healthy controls. The sensitivity and specificity of the currently available detection systems is likely to be improved by the employment of a combination of these MAbs with others that are already in use.
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Affiliation(s)
- Shanmin Zhao
- Division of Infection and Immunology, Laboratory Animals Center, Fourth Military Medical University, Xi'an, Shaanxi Province, China
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Hsieh SC, Chang CC, Lu CC, Wei CF, Lin CS, Lai HC, Lin CW. Rapid identification of Mycobacterium tuberculosis infection by a new array format-based surface plasmon resonance method. NANOSCALE RESEARCH LETTERS 2012; 7:180. [PMID: 22401500 PMCID: PMC3317816 DOI: 10.1186/1556-276x-7-180] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 03/08/2012] [Indexed: 05/31/2023]
Abstract
Tubercle bacillus [TB] is one of the most important chronic infectious diseases that cause millions of deaths annually. While conventional smear microscopy and culture methods are widely used for diagnosis of TB, the former is insensitive, and the latter takes up to 6 to 8 weeks to provide a result, limiting the value of these methods in aiding diagnosis and intermediate decisions on treatment. Therefore, a rapid detection method is essential for the diagnosis, prognosis assessment, and recurrence monitoring. A new surface plasmon resonance [SPR] biosensor based on an array format, which allowed immobilizing nine TB antigens onto the sensor chip, was constructed. Simultaneous determination of multiple TB antibodies in serum had been accomplished with this array-based SPR system. The results were compared with enzyme-linked immunosorbent assay, a conventional immunological method. Array-based SPR showed more advantages in providing label-free and real-time detection. Additionally, the high sensitivity and specificity for the detection of TB infection showed its potential for future development of biosensor arrays for TB diagnosis.
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Affiliation(s)
- Shang-Chen Hsieh
- Graduate Institute of Medical Biotechnology and Laboratory Science, and Research Center for Pathogenic Bacteria, Chang Gung University, No. 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 333, Taiwan
| | - Chia-Chen Chang
- Institute of Biomedical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan
| | - Chia-Chen Lu
- Department of Respiratory Therapy, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Road, Xinzhung District, New Taipei City, 24205, Taiwan
| | - Chia-Fong Wei
- Graduate Institute of Medical Biotechnology and Laboratory Science, and Research Center for Pathogenic Bacteria, Chang Gung University, No. 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 333, Taiwan
| | - Chuan-Sheng Lin
- Graduate Institute of Medical Biotechnology and Laboratory Science, and Research Center for Pathogenic Bacteria, Chang Gung University, No. 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 333, Taiwan
| | - Hsin-Chih Lai
- Graduate Institute of Medical Biotechnology and Laboratory Science, and Research Center for Pathogenic Bacteria, Chang Gung University, No. 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, 333, Taiwan
| | - Chii-Wann Lin
- Institute of Biomedical Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan
- Center for Emerging Material and Advanced Devices, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan
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Singh S, Singh J, Kumar S, Gopinath K, Balooni V, Singh N, Mani K. Poor performance of serological tests in the diagnosis of pulmonary tuberculosis: evidence from a contact tracing field study. PLoS One 2012; 7:e40213. [PMID: 22808119 PMCID: PMC3393741 DOI: 10.1371/journal.pone.0040213] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 06/02/2012] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Delayed or missed diagnosis of TB continues to fuel the global TB epidemic, especially in resource limited settings. Use of serology for the diagnosis of tuberculosis, commonly used in India, is another factor. In the present study a commercially available serodiagnostic assay was assessed for its diagnostic value in combination with smear, culture and clinical manifestations. METHODOLOGY/PRINCIPAL FINDINGS A total of 2300 subjects were recruited for the study, but 1041 subjects were excluded for various reasons. Thus 1259 subjects were included in the study of which 470 were pulmonary tuberculosis cases (440 of 470 were culture-positive) and 789 were their asymptomatic contacts. A house-to-house survey method was used. Blood samples were tested for IgM, IgA, and IgG antibodies using the Pathozyme Myco M (IgM), Myco A (IgA) and Myco G (IgG) enzyme immunoassay (EIA). Out of 470 PTB cases, BCG scar was positive in 82.34%. The Mantoux test and smear positivity rates in PTB cases were 94.3% (430/456), and 65.32% (307/470), respectively. Among the asymptomatic contacts, BCG scar was positive in 95.3% and Mantoux test was positive in 80.66% (442/548) contacts. No contact was found falsely smear positive. The sensitivity of IgM, IgA, and IgG EIA tests was 48.7%, 25.7% and 24.4%, respectively, while the specificity was 71.5%, 80.5%, 76.6%, respectively. Performance of EIAs was not affected by the previous BCG vaccination. However, prior BCG vaccination was statistically significantly (p = 0.005) associated with Mantoux test positivity in PTB cases but not in contacts (p = 0.127). The agreement between serology and Mantoux test was not significant. CONCLUSION The commercial serological test evaluated showed poor sensitivity and specificity and suggests no utility for detection of pulmonary tuberculosis.
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Affiliation(s)
- Sarman Singh
- Clinical Microbiology Division, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India.
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Tuberculous meningitis: diagnosis and treatment overview. Tuberc Res Treat 2011; 2011:798764. [PMID: 22567269 PMCID: PMC3335590 DOI: 10.1155/2011/798764] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Revised: 11/16/2011] [Accepted: 11/18/2011] [Indexed: 01/01/2023] Open
Abstract
Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis (TB) and has very high morbidity and mortality. TBM is typically a subacute disease with symptoms that may persist for weeks before diagnosis. Characteristic cerebrospinal fluid (CSF) findings of TBM include a lymphocytic-predominant pleiocytosis, elevated protein, and low glucose. CSF acid-fast smear and culture have relatively low sensitivity but yield is increased with multiple, large volume samples. Nucleic acid amplification of the CSF by PCR is highly specific but suboptimal sensitivity precludes ruling out TBM with a negative test. Treatment for TBM should be initiated as soon as clinical suspicion is supported by initial CSF studies. Empiric treatment should include at least four first-line drugs, preferably isoniazid, rifampin, pyrazinamide, and streptomycin or ethambutol; the role of fluoroquinolones remains to be determined. Adjunctive treatment with corticosteroids has been shown to improve mortality with TBM. In HIV-positive individuals with TBM, important treatment considerations include drug interactions, development of immune reconstitution inflammatory syndrome, unclear benefit of adjunctive corticosteroids, and higher rates of drug-resistant TB. Testing the efficacy of second-line and new anti-TB drugs in animal models of experimental TBM is needed to help determine the optimal regimen for drug-resistant TB.
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Padmapriyadarsini C, Narendran G, Swaminathan S. Diagnosis & treatment of tuberculosis in HIV co-infected patients. Indian J Med Res 2011; 134:850-65. [PMID: 22310818 PMCID: PMC3284094 DOI: 10.4103/0971-5916.92630] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Indexed: 11/06/2022] Open
Abstract
Human immunodeficiency virus (HIV) associated tuberculosis (TB) remains a major global public health challenge, with an estimated 1.4 million patients worldwide. Co-infection with HIV leads to challenges in both the diagnosis and treatment of tuberculosis. Further, there has been an increase in rates of drug resistant tuberculosis, including multi-drug (MDR-TB) and extensively drug resistant TB (XDRTB), which are difficult to treat and contribute to increased mortality. Because of the poor performance of sputum smear microscopy in HIV-infected patients, newer diagnostic tests are urgently required that are not only sensitive and specific but easy to use in remote and resource-constrained settings. The treatment of co-infected patients requires antituberculosis and antiretroviral drugs to be administered concomitantly; challenges include pill burden and patient compliance, drug interactions, overlapping toxic effects, and immune reconstitution inflammatory syndrome. Also important questions about the duration and schedule of anti-TB drug regimens and timing of antiretroviral therapy remain unanswered. From a programmatic point of view, screening of all HIV-infected persons for TB and vice-versa requires good co-ordination and communication between the TB and AIDS control programmes. Linkage of co-infected patients to antiretroviral treatment centres is critical if early mortality is to be prevented. We present here an overview of existing diagnostic strategies, new tests in the pipeline and recommendations for treatment of patients with HIV-TB dual infection.
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Affiliation(s)
- C. Padmapriyadarsini
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
| | - G. Narendran
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
| | - Soumya Swaminathan
- National Institute for Research in Tuberculosis (Indian Council of Medical Research), Chennai, India
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Monoclonal Antibody Against a Mycobacterium tuberculosis Ag85B-Hsp16.3 Fusion Protein. Hybridoma (Larchmt) 2011. [DOI: 10.1089/hyb.2011.0068.mab] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Liu S, Han W, Sun C, Lei L, Feng X, Yan S, Diao Y, Gao Y, Zhao H, Liu Q, Yao C, Li M. Subtractive screening with the Mycobacterium tuberculosis surface protein phage display library. Tuberculosis (Edinb) 2011; 91:579-86. [PMID: 21900047 DOI: 10.1016/j.tube.2011.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2011] [Revised: 07/22/2011] [Accepted: 07/25/2011] [Indexed: 11/20/2022]
Abstract
Surface proteins consist of secreted and membrane proteins and play a central role in the interaction of the pathogen with its environment, especially in the pathogenicity of Mycobacterium tuberculosis (MTB). Research on surface proteins in MTB has focused on 2D electrophoresis of culture filtrate proteins (CFP), extraction of transmembrane proteins with detergent and predicting their properties with a range of available algorithms. However, functional analysis of these secretomes is possible only if many proteins are expressed and purified individually, which limits a large number of studies to the function of the proteome. Here, we utilized a phage display system to construct a whole genomic surface protein phage display library of MTB, which can complete direct selection, identification, expression, purification and functional research of surface proteins of MTB. With this system we made a new serological approach involving iterative subtraction screening. Cross-reactivity of antibodies was reduced by preadsorption of the surface protein phage display library with the sera of healthy BCG-vaccinated individuals prior to studying their reactivity against the sera of tuberculosis (TB) patients. As a result six antigens were identified, three of which have not previously been reported as diagnosis antigens. The surface protein phage display library shows great promise in the study of MTB.
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Affiliation(s)
- Shanshan Liu
- College of Animal Science and Veterinary Medicine, Jilin University, Xi'an Road 5333#, Changchun 130062, China
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Wu L, Zhang M, Sun M, Jia B, Wang X. Humoural Immune Responses to a Recombinant 16-kDa–38-kDa—ESAT-6 Mycobacterial Antigen in Tuberculosis. J Int Med Res 2011; 39:514-21. [PMID: 21672355 DOI: 10.1177/147323001103900219] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The present study investigated the diagnostic value of a recombinant 38-kDa–16-kDa—early secreted antigenic target of 6 kDa (ESAT-6) Mycobacterium tuberculosis (MTB) fusion antigen in 105 patients with tuberculosis (TB), 25 non-TB pulmonary disease patients and 20 healthy individuals. Its diagnostic value was compared with the commercially available enzyme-linked immunosorbent assay kit, the TB-directly observed therapy (DOT) kit. In the controls, the rate of positive antibody response to the TB-DOT kit was significantly higher than that of the recombinant antigen. The area under the receiver operating characteristic curve was 0.751, and the optimum sensitivity and specificity for detecting antibody responses to the recombinant antigen were 65.4% and 84.8%, respectively. The recombinant 38-kDa–16-kDa—ESAT-6 MTB antigen was more effective than the TB-DOT kit in distinguishing between TB patients and controls, and may be an optimal combination of antigens to provide a useful tool for the sensitive and specific diagnosis of patients with TB.
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Affiliation(s)
- L Wu
- Department of Respiratory Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - M Zhang
- Department of Respiratory Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - M Sun
- Department of Respiratory Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - B Jia
- Department of Respiratory Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - X Wang
- Department of Respiratory Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
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Chaudhary M, Gupta S, Khare S, Lal S. Diagnosis of tuberculosis in an era of HIV pandemic: a review of current status and future prospects. Indian J Med Microbiol 2011; 28:281-9. [PMID: 20966555 DOI: 10.4103/0255-0857.71805] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
HIV and tuberculosis co-infection interact in fundamentally important ways. This interaction is evident patho-physiologically, clinically and epidemiologically. There are several differences between HIV-infected and HIV-uninfected patients with tuberculosis (TB) that have practical diagnostic implications. TB is more likely to be disseminated in nature and more difficult to diagnose by conventional diagnostic procedures as immunosuppression progresses. As TB rates continue to increase in HIV-endemic regions, improved diagnostic techniques merit consideration as TB-control strategies. There is a need to develop more user friendly techniques, which can be adapted for use in the high-burden and low-income countries. This review focuses on the diagnostic challenges in HIV-TB co-infection with an update on the current techniques and future prospects in an era of HIV pandemic.
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Affiliation(s)
- M Chaudhary
- Microbiology Division, National Institute of Communicable Diseases, Delhi, India.
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Yang H, Liu ZH, Zhang LT, Wang J, Yang HS, Qin LH, Jin RL, Feng YH, Cui ZL, Zheng RJ, Hu ZY. Selection and application of peptide mimotopes of MPT64 protein in Mycobacterium tuberculosis. J Med Microbiol 2011; 60:69-74. [PMID: 20930053 DOI: 10.1099/jmm.0.025098-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Antibody responses can be useful markers of tuberculosis (TB) infection, especially in the screening of extra-pulmonary TB. MPT64 is an important antigen in Mycobacterium tuberculosis (MTB) infection and is used in serological diagnosis. However, large variability in the diagnostic accuracy of MPT64 as a serological tool has limited its application. Phage-displayed random peptide libraries have emerged as a powerful technique to select peptides (epitopes) or mimotopes that may serve as surrogate diagnostic markers in serological tests. In the present study, this method was employed to identify mimotopes of the MPT64 protein of MTB by screening a linear heptapeptide library with rabbit antibodies raised against MPT64 protein. Two antigenic mimotopes (M2 and M6) resembling B-cell epitopes of MPT64 were identified that bound the affinity purified anti-MPT64 polyclonal antibodies and competed with MPT64 for antibody binding. From the results of sequence alignment and a structure modelling figure of MPT64, the sequence of the 2nd to 5th amino acids (DSML) of M2 was totally consistent with the sequence of the 224th to 227th amino acids of MPT64 and the peptide is located on the surface of the space structure of MPT64, suggesting that it might be a linear epitope of MPT64. The recognition of both phage-displayed and synthetic peptides of M2 by the anti-MPT64 polyclonal antibodies also supported this. Although no recurring sequence and no analogue to MPT64 of M6 were found for sequence alignment, the recognition of both phage-displayed and synthetic peptides of M6 by the anti-MPT64 polyclonal antibodies indicated that it might be a mimotope of a conformational epitope of MPT64. According to the results of the reactivity of human sera with synthetic M2 and M6 peptides and MPT64, M2 showed a significantly higher AUC and sensitivity than M6 and MPT64, especially for the sera from sputum-negative TB patients, suggesting that the M2 mimotope may be useful in serological diagnostic testing for TB.
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Affiliation(s)
- Hua Yang
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai 200433, PR China
| | - Zhong-Hua Liu
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai 200433, PR China
| | - Li-Ting Zhang
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai 200433, PR China
| | - Jie Wang
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai 200433, PR China
| | - Huan-Seng Yang
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai 200433, PR China
| | - Lian-Hua Qin
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai 200433, PR China
| | - Rui-Liang Jin
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai 200433, PR China
| | - Yong-Hong Feng
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai 200433, PR China
| | - Zhen-Ling Cui
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai 200433, PR China
| | - Rui-Juan Zheng
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai 200433, PR China
| | - Zhong-Yi Hu
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai 200433, PR China
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Guirat A, Koubaa M, Mzali R, Abid B, Ellouz S, Affes N, Ben Jemaa M, Frikha F, Ben Amar M, Beyrouti MI. Peritoneal tuberculosis. Clin Res Hepatol Gastroenterol 2011; 35:60-9. [PMID: 21215540 DOI: 10.1016/j.gcb.2010.07.023] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 05/27/2010] [Accepted: 07/19/2010] [Indexed: 02/04/2023]
Abstract
The peritoneum is one of the locations outside the most common pulmonary tuberculosis. Peritoneal tuberculosis poses a public health problem in endemic regions of the world. The phenomenon of migration, the increased use of immunosuppressive therapy and the epidemic of AIDS have contributed to a resurgence of this disease in regions where it was previously controlled. The aim of this review is to expose the clinical, biologic end radiologic futures of the peritoneal tuberculosis and to present the methods of diagnosis and treatment. The diagnosis of this disease is difficult and still remains a challenge because of its insidious nature, the variability of presentation and limitations of available diagnostic tests. The disease usually presents a picture of lymphocytic exudative ascites. There are many complementary tests with variable sensitivities and specificities to confirm the diagnosis of peritoneal tuberculosis. Isolation of mycobacteria by culture of ascitic fluid or histological examination of peritoneal biopsy ideally performed by laparoscopy remains the investigation of choice. The role of PCR, ascitic adenosine deaminase, interferon gamma and the radiometric BACTEC system can improve the diagnostic yield. An antituberculous treatment with group 1 of the WHO for 6 months is sufficient in most cases.
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Affiliation(s)
- A Guirat
- Service de chirurgie générale, CHU Habib Bourguiba, 3029 Sfax, Tunisia.
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Identification of Mycobacterium tuberculosis antigens of high serodiagnostic value. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2010; 17:1539-47. [PMID: 20719988 DOI: 10.1128/cvi.00198-10] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis, with several million new cases detected each year. Current methods of diagnosis are time-consuming and/or expensive or have a low level of accuracy. Therefore, new diagnostics are urgently needed to address the global tuberculosis burden and to improve control programs. Serological assays remain attractive for use in resource-limited settings because they are simple, rapid, and inexpensive and offer the possibility of detecting cases often missed by routine sputum smear microscopy. The aim of this study was to identify M. tuberculosis seroreactive antigens from a panel of 103 recombinant proteins selected as diagnostic candidates. Initial library screening by protein array analysis and enzyme-linked immunosorbent assay (ELISA) identified 42 antigens with serodiagnostic potential. Among these, 25 were novel proteins. The reactive antigens demonstrated various individual sensitivities, ranging from 12% to 78% (specificities, 76 to 100%). When the antigens were analyzed in combinations, up to 93% of antibody responders could be identified among the TB patients. Selected seroreactive proteins were used to design 3 new polyepitope fusion proteins. Characterization of these antigens by multiantigen print immunoassay (MAPIA) revealed that the vast majority of the TB patients (90%) produced antibody responses. The results confirmed that due to the remarkable variation in immune recognition patterns, an optimal multiantigen cocktail should be designed to cover the heterogeneity of antibody responses and thus achieve the highest possible test sensitivity.
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Wu X, Yang Y, Zhang J, Li B, Liang Y, Zhang C, Dong M. Comparison of antibody responses to seventeen antigens from Mycobacterium tuberculosis. Clin Chim Acta 2010; 411:1520-8. [PMID: 20599865 DOI: 10.1016/j.cca.2010.06.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2010] [Revised: 06/08/2010] [Accepted: 06/16/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND The detection of Mycobacteriumtuberculosis (MTB)-specific human antibodies has been an important diagnostic aid in the diagnosis of TB, especially for the bacterium-negative TB. The humoral antibody responses to different antigens of M.tuberculosis (MTB) are heterogeneous in active TB patients. Hence, detection of antibody responses to several MTB antigens may improve the sensitivity and specificity of serological diagnosis of active TB. METHODS Seventeen MTB antigens (38kD, 16kD, Ag85A, Ag85B, MPT32, MPT63, MPT64, Mtb39, MTB48, Mtb81, MTC28, Rv1009, ESAT6, CFP10, CFP10-ESAT6, katG, and LAM) were prepared by cloning, expression, and purification from E. coli, and their antigenicities were evaluated in the antibody responses of 210 active TB patients (103 sera from smear- or culture-positive patients, and 107 from smear- or culture-negative patients) and 192 healthy control (95 sera from purified protein derivative-negative healthy donors, and 97 sera from BCG-vaccinated individuals) by an enzyme-linked immunosorbent assay (ELISA). RESULTS The levels of antibodies against these antigens in bacterium-negative TB patients were significantly higher than that in healthy controls (p<0.001). The sensitivity with individual antigens to detect antibody responses ranged from 55.7 to 82.9%, with the specificity from 62.0 to 92.2%. Importantly, the sensitivity with five antigens (LAM, 38kD, katG, 16kD, and MPT63 or Mtb39) to detect antibody responses reached 69.5% (146/210), with a specificity of 91.1% (17/192), and the sensitivity with another five antigens (LAM, katG, 16kD, Mtb39 and Mtb81) to detect antibody responses reached 67.1% (141/210), with a specificity of 92.7% (14/192). CONCLUSIONS The combination of optimal multiple antigens to detect anti-MTB antibody responses increased the sensitivity and specificity. Therefore, detection of anti-MTB antibody responses with multiple antigens may be valuable in the clinical diagnosis of TB patients.
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Affiliation(s)
- Xueqiong Wu
- Institute for Tuberculosis Research, the 309th Hospital of Chinese PLA, Beijing 100091, China.
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