Kitada Seigo, Maekura Ryoji, Toyoshima Naomi, Fujiwara Nagatoshi, Yano Ikuya, Ogura Takeshi, Ito Masami, Kobayashi Kazuo
Department of Host Defense, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan.
Clin Infect Dis. 2002 Dec 1;35(11):1328-35. doi: 10.1086/344277. Epub 2002 Nov 7.
It is difficult to distinguish pulmonary disease due to Mycobacterium avium complex (MAC) from that due to other mycobacteria, such as Mycobacterium tuberculosis and Mycobacterium kansasii. We developed an enzyme immunoassay (EIA) for diagnosis of MAC pulmonary diseases that uses glycopeptidolipid (GPL) antigens specific for MAC, and we used it for diagnosis in immunocompetent patients. The mean optical densities (+/- standard deviation) of serum immunoglobulin G antibodies to GPLs in patients with MAC disease, MAC colonization, M. kansasii disease, and tuberculosis and in healthy subjects were 0.778+/-0.784, 0.042+/-0.035, 0.059+/-0.035, 0.071+/-0.035, and 0.030+/-0.027, respectively. A significant increase in the level of anti-GPL antibodies was detected in patients with MAC disease. The level of anti-GPL antibodies reflected disease activity, because the level was decreased in culture-negative patients who had conversion of culture results. When a cutoff level of seropositivity (0.119) was defined, the sensitivity of EIA for diagnosis of MAC disease was 92.3%, and the specificity was 96.7%. Measurement of serum anti-GPL antibodies is useful for both the diagnosis of and assessment of activity in MAC disease.
将鸟分枝杆菌复合群（MAC）所致肺部疾病与其他分枝杆菌，如结核分枝杆菌和堪萨斯分枝杆菌所致肺部疾病区分开来很困难。我们开发了一种用于诊断MAC肺部疾病的酶免疫测定法（EIA），该方法使用对MAC具有特异性的糖肽脂（GPL）抗原，并将其用于免疫功能正常患者的诊断。MAC病患者、MAC定植患者、堪萨斯分枝杆菌病患者、结核病患者以及健康受试者血清中针对GPLs的免疫球蛋白G抗体的平均光密度（±标准差）分别为0.778±0.784、0.042±0.035、0.059±0.035、0.071±0.035和0.030±0.027。在MAC病患者中检测到抗GPL抗体水平显著升高。抗GPL抗体水平反映了疾病活动情况，因为在培养结果转阴的培养阴性患者中该水平有所下降。当定义血清阳性的临界值为0.119时，EIA诊断MAC病的敏感性为92.3%，特异性为96.7%。检测血清抗GPL抗体对MAC病的诊断和活动评估均有用。
