Pukazhvanthen Paramanandhan, Anbarasu Deenadayalan, Basirudeen Syed Ahamed Kabeer, Raja Alamelu, Singh Mahavir
Tuberculosis (Edinb). 2014 Dec;94(6):622-33. doi: 10.1016/j.tube.2014.09.006.
Serodiagnostic potential of four recombinant proteins (38 kDa[Rv0934], MPT64[Rv1980c], Adk[Rv0733], and BfrB[Rv3874]) was evaluated in Healthy control subjects (HCS), Healthy household contacts (HHC), Pulmonary tuberculosis patients (PTB), and Human immuno deficiency virus & Tuberculosis co-infected patients (HIV-TB). All the antigens tested individually for the detection of serum IgG by indirect ELISA. All the four antigens have a significantly higher antibody response in PTB compared to healthy controls (P < 0.05). The sensitivity of individual antigens ranged from 20% to 52.5% for the prefixed specificity of 95%. When results of all 4 antigens were combined the sensitivity was increased to 75% and specificity was reduced 89% in HCS. In smear- and culture-positive (S+C+) PTB, four antigen combination gives maximum sensitivity (89.6%) with 89% specificity. In smear negative culture negative (S-C+) PTB, three antigen combination (38 kDa with MPT64 and BfrB) gives maximum sensitivity (69.5%) and specificity (91.6%). In HIV-TB, 4 antigen combinations give the maximum sensitivity of 51.2% with 89% specificity. Combining serology (Four antigen combination) with smear was able to increase the sensitivity from 70% to 92.5% in culture positive PTB. So, we propose that this serology test can be used as adjunct test along with smear for rapid diagnosis of PTB.
在健康对照受试者（HCS）、健康家庭接触者（HHC）、肺结核患者（PTB）以及人类免疫缺陷病毒与肺结核合并感染患者（HIV-TB）中评估了四种重组蛋白（38 kDa[Rv0934]、MPT64[Rv1980c]、Adk[Rv0733]和BfrB[Rv3874]）的血清学诊断潜力。通过间接ELISA分别检测所有抗原的血清IgG。与健康对照相比，所有四种抗原在PTB患者中的抗体反应均显著更高（P < 0.05）。对于预先设定的95%的特异性，单个抗原的敏感性范围为20%至52.5%。当将所有4种抗原的结果合并时，HCS中的敏感性提高到75%，特异性降低到89%。在涂片和培养均阳性（S+C+）的PTB患者中，四种抗原组合的敏感性最高（89.6%），特异性为89%。在涂片阴性培养阳性（S-C+）的PTB患者中，三种抗原组合（38 kDa与MPT64和BfrB）的敏感性最高（69.5%），特异性为91.6%。在HIV-TB患者中，4种抗原组合的敏感性最高为51.2%，特异性为89%。在培养阳性的PTB患者中，将血清学检测（四种抗原组合）与涂片检查相结合能够将敏感性从70%提高到92.5%。因此，我们建议这种血清学检测可作为涂片检查的辅助检测方法用于PTB的快速诊断。
