Serodiagnosis of Mycobacterium avium-complex pulmonary disease using an enzyme immunoassay kit
Serodiagnosis of Mycobacterium avium-complex pulmonary disease using an enzyme immunoassay kit
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DOI：
10.1164/rccm.200705-771oc
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发表时间：
2008-04-01
影响因子：
24.7
通讯作者：
Maekura, Ryoji
中科院分区：
文献类型：
--
作者：
Kitada, Seigo;Kobayashi, Kazuo;Maekura, Ryoji
基本原理鸟分枝杆菌复合型肺病（MAC-PD）的诊断和/或与肺结核（TB）的鉴别有时是复杂和耗时的。目的：我们在一项六个机构的多中心研究中调查了基于酶免疫测定（EIA）试剂盒的血清学试验是否有助于诊断MAC-PD并将其与其他肺部疾病区分开来。研制了检测MAC糖肽-脂核心抗原特异性伊加抗体的酶免疫试剂盒。检测70例MAC-PD患者、18例MAC污染患者、37例肺结核患者、45例其他肺部疾病患者和76例健康人血清中的伊加抗体水平。将临界点设定为0.7 U/ml导致该试剂盒诊断MAC-PD的灵敏度和特异性分别为843和100%。MAC-PD中结节性支气管扩张症的抗体水平也明显高于纤维空洞性疾病（P < 0.05）。MAC-PD患者胸部CT病变程度与抗体水平呈正相关（r = 0.43，P < 0.05）。结论：EIA试剂盒可用于MAC-PD的快速诊断及与肺结核的鉴别诊断，如能在其他人群中得到验证，可在临床上推广应用。
Rationale The diagnosis of Mycobacterium avium-complex pulmonary disease (MAC-PD) and/or its discrimination from pulmonary tuberculosis (TB) is sometimes complicated and time consuming.Objectives: We investigated in a six-institution multicenter study whether a serologic test based on an enzyme immunoassay (EIA) kit was useful for diagnosing MAC-PD and for distinguishing it from other lung diseases.Methods: An EIA kit detecting serum IgA antibody to glycopeptido-lipid core antigen specific for MAC was developed. Antibody levels were measured in sera from 70 patients with MAC-PD, 18 with MAC contamination, 37 with pulmonary TB, 45 with other lung diseases, and 76 healthy subjects.Measurements and Main Results: Significantly higher serum IgA antibody levels were detected in patients with MAC-PD than in the other groups (P < 0.0001). Setting the cutoff point at 0.7 U/ml resulted in a sensitivity and specificity of the kit for diagnosing MAC-PD of 843 and 100%, respectively. Significantly higher antibody levels were also found in patients with nodular-bronchiectatic disease compared with fibrocavitary disease in MAC-PD (P < 0.05). There was a positive correlation between the extent of disease on chest computed tomography scans and the levels of antibody (r = 0.43, P < 0.05) in patients with MAC-PD.Conclusions: The EIA kit is useful for the rapid diagnosis of MAC-PD and for differentiating MAC-PD from pulmonary TB and, if validated by studies in other populations, could find wide application in clinical practice.