Bethunaickan Ramalingam, Baulard Alain R, Locht Camille, Raja Alamelu
Department of Immunology, Tuberculosis Research Centre (ICMR), Chetput, Chennai, India.
Scand J Infect Dis. 2007;39(10):867-74. doi: 10.1080/00365540701402954.
The objective of this study is to evaluate the recombinant 27kDa (MPT51, Rv3803c) antigen of M. tuberculosis H37Rv, expressed in E. coli in enzyme linked immunosorbent assays (ELISA) to estimate the IgG, IgA and IgM levels in sera from adult pulmonary tuberculosis patients and control groups. Sera from smear and culture positive tuberculosis patients (S + C +) were positive for anti-MPT51 IgG, IgA and IgM, with a sensitivity of 57%, 47% and 13%, respectively. The sensitivity of the test improved to a level of 71% for IgG+IgA without significantly compromising the specificity (IgG of 98%, IgG+IgA of 95%). Addition of IgM results did not enhance the sensitivity appreciably, over and above that of IgG+IgA (72% vs 71%). Among the smear-negative but culture-positive cases (S-C+), 34% were positive for IgG, while in smear and culture-negative but X-ray-positive cases (S-C-), 42% were positive for IgG. Polyethylene glycol precipitation (PEG) of the circulating immune complex (CIC) in sera was carried out. The CIC-bound antibodies to MPT51 were assessed using ELISA. Measuring the IgG+IgA combination positivities of the CIC-bound antibodies gave a poor sensitivity of 21%, 18% and 10%, respectively. The specificity of the assay by these combinations was maintained at 94%.
本研究的目的是评估在大肠杆菌中表达的结核分枝杆菌H37Rv重组27kDa（MPT51，Rv3803c）抗原，通过酶联免疫吸附测定（ELISA）来估计成年肺结核患者和对照组血清中的IgG、IgA和IgM水平。涂片和培养阳性的肺结核患者（S + C +）血清中抗MPT51 IgG、IgA和IgM呈阳性，敏感性分别为57%、47%和13%。IgG+IgA检测的敏感性提高到71%，而特异性没有显著降低（IgG为98%，IgG+IgA为95%）。加入IgM结果并未显著提高IgG+IgA的敏感性（72%对7开）。在涂片阴性但培养阳性的病例（S-C+）中，34%的IgG呈阳性，而在涂片和培养阴性但X线阳性的病例（S-C-）中，42%的IgG呈阳性。对血清中的循环免疫复合物（CIC）进行聚乙二醇沉淀（PEG）。使用ELISA评估与CIC结合的抗MPT51抗体。检测与CIC结合抗体的IgG+IgA组合阳性率，敏感性分别为21%、18%和10%，较差。这些组合检测的特异性维持在94%。
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