Serodiagnostic Contributions of Antibody Titers against Mycobacterial Lipid Antigens in Mycobacterium avium Complex Pulmonary Disease
Serodiagnostic Contributions of Antibody Titers against Mycobacterial Lipid Antigens in Mycobacterium avium Complex Pulmonary Disease
复制标题
DOI：
10.1086/600888
复制
发表时间：
2009-08-15
影响因子：
11.8
通讯作者：
Ishizaka, Akitoshi
中科院分区：
文献类型：
--
作者：
Nishimura, Tomoyasu;Hasegawa, Naoki;Ishizaka, Akitoshi
背景。虽然肺结核的发病率正在下降，但禽分枝杆菌复合体（MAC）肺部疾病的免疫功能正常患者的数量正在稳步增加。因此，尽管MAC肺部疾病不具有传染性，但需要快速准确地诊断。我们检测了血清免疫球蛋白G抗体抗种特异性和常见分枝杆菌脂质抗原在MAC肺病诊断中的作用。采集65例MAC肺病患者、15例疑似MAC肺病患者、25例肺结核患者、10例堪萨斯分枝杆菌患者和100名健康志愿者（对照组）的血清样本。测定了小鼠血清抗海藻糖单菌酸酯（TMM-M）和极性糖肽类脂质抗原（GPL）的免疫球蛋白G抗体滴度。MAC肺部疾病患者抗TMM-M和极- gpl抗体滴度明显高于其他患者组和对照组。通过受体操作者特征曲线分析，检测TMM-M的最佳抗体滴度光密度为0.27，灵敏度为89.2%，特异性为97.0%；检测apolar-GPL的最佳抗体滴度光密度为0.33，灵敏度为89.2%，特异性为94.0%。测定抗TMM-M和极- gpl的抗体滴度将有助于MAC肺病的诊断和分枝杆菌肺病的鉴别诊断。
Background. Although the incidence of pulmonary tuberculosis is decreasing, the number of immunocompetent patients with Mycobacterium avium complex (MAC) pulmonary disease is steadily increasing. Therefore, albeit not contagious, MAC pulmonary disease needs to be diagnosed rapidly and accurately. We examined the serodiagnostic contributions of serum immunoglobulin G antibody titers against the species-specific and -common mycobacterial lipid antigens in the diagnosis of MAC pulmonary disease.Methods. Serum samples were obtained from 65 patients with MAC pulmonary disease, 15 patients with suspected MAC disease, 25 patients with pulmonary tuberculosis, 10 patients with Mycobacterium kansasii disease, and 100 healthy volunteers (control subjects). We measured the serum immunoglobulin G antibody titers against trehalose monomycolate (TMM-M) and apolar-glycopeptidolipid (GPL), lipid antigens extracted from MAC.Results. In patients with MAC pulmonary disease, the antibody titers against TMM-M and apolar-GPL were significantly higher than those in the other patient groups or in the control subjects. By receiver operator characteristic curve analysis, an optical density of 0.27, corresponding to the optimal cutoff antibody titer against TMM-M, was associated with a sensitivity of 89.2% and a specificity of 97.0%, and an optical density of 0.33, corresponding to the optimal cutoff antibody titer against apolar-GPL, was associated with a sensitivity of 89.2% and a specificity of 94.0%.Conclusions. Measurements of antibody titers against TMM-M and apolar-GPL would be useful in the diagnosis of MAC pulmonary disease and in the differential diagnosis of mycobacterial pulmonary disease.