Diagnosis of tuberculosis by a visually detectable immunoassay for lipoarabinomannan
Diagnosis of tuberculosis by a visually detectable immunoassay for lipoarabinomannan
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DOI：
10.1164/ajrccm.161.5.9908125
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发表时间：
2000-05-01
影响因子：
24.7
通讯作者：
Hahn, WE
中科院分区：
文献类型：
--
作者：
Chan, ED;Reves, R;Hahn, WE
从痰、组织或体液中回收结核杆菌是诊断结核病（TB）的标准，尽管该过程技术要求高且相对不敏感。我们已经开发了一种简化的，目视可检测的，胶体金为基础的血清学检测定性检测IgG针对分枝杆菌细胞壁组分阿拉伯甘露聚糖脂（LAM）。本研究的目的是确定该检测方法在活动性肺结核患者和有或无潜伏感染的对照患者中的准确性。在活动性结核病患者中，抗LAM IgG的敏感性为85%至93%。在5例涂片阴性的活动性结核病患者中，所有患者的抗LAM IgG检测均呈阳性。该试验的特异性取决于是否存在结核感染。在美国，由健康青年和风湿病患者组成的公民，特异性为100%。在结核菌素皮试阴性或阳性的结核感染高危人群中，特异性为89%。该试验的阴性和阳性预测值分别为98%和52%。我们的结论是，抗LAM IgG免疫测定是相对敏感和特异性的活动性结核病，因此，一个潜在的有用的筛选试验活动性结核病。
Recovery of tubercle bacilli from sputum, tissue, or body fluid is the standard for the diagnosis of tuberculosis (TB) although this process is technically demanding and relatively insensitive. We have developed a simplified, visually detectable, colloidal gold-based serological assay to qualitatively detect IgG directed against the mycobacterial cell wall component lipoarabinomannan (LAM). The objective of this investigation is to determine the accuracy of this assay in patients with active pulmonary TB and in control patients with or without latent infection. In patients with active TB, the sensitivity of anti-LAM IgG was 85 to 93%. In five patients with active TB who were smear-negative, all tested positive for anti-LAM IgG. The specificity of the test depended on the presence of tuberculous infection. In U.S, citizens comprised of young healthy adults and rheumatology patients, the specificity was 100%. In an at-risk population for tuberculous infection who were either tuberculin skin test-negative or positive, the specificity was 89%. The negative and positive predictive values of the test were 98% and 52% respectively. We conclude that anti-LAM IgG immunoassay is relatively sensitive and specific for active TB and thus, a potentially useful screening test for active TB.