Wang L, Izumi S, He H, Fujiwara N, Saita N, Yano I, Kobayashi K, Tatsumi N
Department of Bacteriology, Osaka City University Medical School, Japan.
Nihon Hansenbyo Gakkai Zasshi. 1999 Nov;68(3):165-74. doi: 10.5025/hansen.68.165.
IgG and/or IgM antibodies against mycobacterial cord factor (trehalose 6,6'-dimycolate, TDM) in sera of 65 patients of Hansen's disease (21 cases with smear-positive and 44 cases with smear-negative) and 60 healthy individuals were tested by enzyme-linked immunosorbent assay (ELISA) with TDM purified from Mycobacterium tuberculosis H37Rv as an antigen. Of 65 patients with Hansen's disease, 58 cases (89.2%) had positive results (21 samples from 21 patients, 100% with acid-fast bacilli positive in the lesion, and 37 samples from 44 patients, 84.0% with acid-fast bacilli negative Hansen's disease diagnosed clinically). The sensitivity and specificity of anti-cord factor ELISA were higher than those of anti-phenolic glycolipid-I (PGL-I) agglutination test. Among the total, 34 patients were classified clinically into three types of the disease, lepromatous leprosy (LL), borderline lepromatous (BL) and borderline tuberculoid (BT). The antibody titer showed LL > BL > BT, indicating that the elevation of anti-cord factor antibody titers appeared to be parallel with the degree of humoral immune response against M. leprae. By using semisynthetic cord factor consisting of a single subclass of mycolic acid from M. tuberculosis, it was revealed that sera from patients with Hansen's disease were highly reactive against alpha-mycoloyl cord factor (alpha-TDM) and less reactive against methoxy mycoloyl TDM (methoxy TDM), differed from sera of tuberculosis patients, which were highly reactive against both methoxy and alpha-mycoloyl cord factor (alpha-TDM). Most of sera from patients with Hansen's disease were more reactive against TMM than TDM, differed from sera of tuberculosis patients which were highly reactive against TDM. ELISA using TDM as an antigen is simple, reproducible and useful for the rapid serodiagnosis of Hansen's disease, especially for smear-negative cases.
采用酶联免疫吸附测定（ELISA），以从结核分枝杆菌H37Rv纯化的海藻糖二霉菌酸酯（TDM）为抗原，检测了65例麻风病患者（21例涂片阳性和44例涂片阴性）及60名健康个体血清中抗分枝杆菌索状因子（海藻糖6,6'-二霉菌酸酯，TDM）的IgG和/或IgM抗体。65例麻风病患者中，58例（89.2%）检测结果为阳性（21例患者的21份样本，病变处抗酸杆菌均为阳性；44例患者的37份样本，临床诊断为抗酸杆菌阴性的麻风病）。抗索状因子ELISA的敏感性和特异性高于抗酚糖脂-I（PGL-I）凝集试验。其中，34例患者根据临床症状分为瘤型麻风（LL）、界线类偏瘤型（BL）和界线类偏结核型（BT）三种类型。抗体滴度显示为LL＞BL＞BT，表明抗索状因子抗体滴度的升高似乎与针对麻风分枝杆菌的体液免疫反应程度平行。通过使用由结核分枝杆菌单一子类分枝菌酸组成的半合成索状因子，发现麻风病患者血清对α-分枝菌酰索状因子（α-TDM）反应强烈，而对甲氧基分枝菌酰TDM（甲氧基TDM）反应较弱，这与结核患者血清不同，后者对甲氧基和α-分枝菌酰索状因子（α-TDM）均反应强烈。大多数麻风病患者血清对TMM的反应比对TDM的反应更强，这与结核患者血清不同，后者对TDM反应强烈。以TDM为抗原的ELISA简单、可重复，对麻风病的快速血清学诊断有用，尤其适用于涂片阴性的病例。
