Sariko Margaretha, Anderson Caitlin, Mujaga Buliga S, Gratz Jean, Mpagama Stellah G, Heysell Scott, Kibiki Gibson, Mmbaga Blandina, Houpt Eric, Thomas Tania
Kilimanjaro Clinical Research Institute, Moshi, Tanzania.
Kilimanjaro Christian Medical University College, Moshi Tanzania.
PLoS One. 2017 Jan 13;12(1):e0169118. doi: 10.1371/journal.pone.0169118. eCollection 2017.
We aimed to evaluate the antibody in lymphocyte supernatant (ALS) assay as a biomarker to diagnose tuberculosis among adults from Tanzania with and without HIV.
Adults admitted with suspicion for tuberculosis had sputa obtained for GeneXpert MTB/RIF, acid-fast bacilli smear and mycobacterial culture; blood was obtained prior to treatment initiation and after 4 weeks. Adults hospitalized with non-infectious conditions served as controls. Peripheral blood mononuclear cells were cultured unstimulated for 72 hours. Anti-mycobacterial antibodies were measured from culture supernatants by ELISA, using BCG vaccine as the coating antigen. Median ALS responses were compared between cases and controls at baseline and between cases over time.
Of 97 TB cases, 85 were microbiologically confirmed and 12 were clinically diagnosed. Median ALS responses from TB cases (0.366 OD from confirmed cases and 0.285 from clinical cases) were higher compared to controls (0.085, p<0.001). ALS responses did not differ based on HIV status, CD4 count or sputum smear status. Over time, the median ALS values declined significantly (0.357 at baseline; 0.198 after 4-weeks, p<0.001).
Robust ALS responses were mounted by patients with TB regardless of HIV status, CD4 count, or low sputum bacillary burden, potentially conferring a unique niche for this immunologic biomarker for TB.
我们旨在评估淋巴细胞上清液抗体（ALS）检测作为一种生物标志物，用于诊断坦桑尼亚有或无艾滋病毒的成年人中的结核病。
因疑似结核病入院的成年人采集痰液进行GeneXpert MTB/RIF检测、抗酸杆菌涂片和分枝杆菌培养；在开始治疗前和4周后采集血液。因非感染性疾病住院的成年人作为对照。外周血单个核细胞未经刺激培养72小时。使用卡介苗作为包被抗原，通过ELISA法从培养上清液中检测抗分枝杆菌抗体。比较病例组和对照组在基线时以及病例组随时间的ALS反应中位数。
97例结核病病例中，85例经微生物学确诊，12例为临床诊断。结核病病例的ALS反应中位数（确诊病例为0.366 OD，临床病例为0.285）高于对照组（0.085，p<0.001）。ALS反应在艾滋病毒感染状况、CD4细胞计数或痰涂片状况方面无差异。随着时间推移，ALS值中位数显著下降（基线时为0.357；4周后为0.198，p<0.001）。
无论艾滋病毒感染状况、CD4细胞计数或痰中细菌负荷低如何，结核病患者都会产生强烈的ALS反应，这可能使这种用于结核病的免疫生物标志物具有独特的优势。
