Jackett P S, Bothamley G H, Batra H V, Mistry A, Young D B, Ivanyi J
Medical Research Council Unit for Tuberculosis and Related Infections, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.
J Clin Microbiol. 1988 Nov;26(11):2313-8. doi: 10.1128/jcm.26.11.2313-2318.1988.
A serological survey was performed in groups of patients with active sputum smear-positive or smear-negative pulmonary tuberculosis, healthy household contacts, and controls. Sera were tested for titers of antibodies which bound to each of five purified mycobacterial antigens by enzyme immunoassay and for competition of binding to single epitopes, using six radiolabeled monoclonal antibodies directed toward corresponding molecules. The evaluation of diagnostic specificity was based on a positive score represented by titers above the cutoff point of 2 standard deviations above the mean titer of a control group. For smear-positive samples, the best sensitivity (83%) was achieved by exclusive use of the 38-kilodalton (kDa) antigen or its corresponding monoclonal antibodies. For smear-negative samples, levels of antibodies binding to the 19-kDa antigen showed a lower sensitivity of 62% compared with the control group or 38% compared with the contact group. Titers of antibody binding to the 14-kDa antigen were raised in Mycobacterium bovis BCG-vaccinated contacts, indicating that the greatest potential of this antigen may be in the detection of infection in a population for which tuberculin testing is unreliable. The results demonstrated the differing antibody responses to each of the tested antigens and distinct associations with the stage of infection or disease.
对痰涂片阳性或涂片阴性的活动性肺结核患者组、健康家庭接触者和对照组进行了血清学调查。通过酶免疫测定法检测血清中与五种纯化的分枝杆菌抗原结合的抗体滴度，并使用六种针对相应分子的放射性标记单克隆抗体检测与单个表位结合的竞争性。诊断特异性的评估基于一个阳性分数，该分数由高于对照组平均滴度2个标准差的截止点以上的滴度表示。对于涂片阳性样本，仅使用38千道尔顿（kDa）抗原或其相应的单克隆抗体可获得最佳敏感性（83%）。对于涂片阴性样本，与对照组相比，与19 kDa抗原结合的抗体水平显示敏感性较低，为62%；与接触组相比，为38%。在接种卡介苗的接触者中，与14 kDa抗原结合的抗体滴度升高，表明该抗原的最大潜力可能在于检测结核菌素试验不可靠人群中的感染。结果表明，对每种测试抗原的抗体反应不同，且与感染或疾病阶段有明显关联。
