Antibodies against Immunodominant Antigens of Mycobacterium tuberculosis in Subjects with Suspected Tuberculosis in the United States Compared by HIV Status
Antibodies against Immunodominant Antigens of Mycobacterium tuberculosis in Subjects with Suspected Tuberculosis in the United States Compared by HIV Status
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DOI：
10.1128/cvi.00503-09
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发表时间：
2010-03-01
影响因子：
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通讯作者：
Laal, Suman
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文献类型：
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作者：
Achkar, Jacqueline M.;Jenny-Avital, Elisabeth;Laal, Suman
结核分枝杆菌蛋白苹果酸合酶（MS）和MPT 51的免疫优势已在结核病（TB）流行国家的病例对照研究中得到证实。这些抗原用于TB血清学诊断的价值现在在美国肺TB疑似诊断为TB、HIV相关TB或其他呼吸道疾病（ORD）的横断面研究中进行评估。通过酶联免疫吸附试验（ELISA）测定TB疑似患者和特征良好的对照组样品对重组纯化MS和MPT 51的血清抗体反应性。TB疑似患者被诊断为TB（n = 87; 49%痰镜检阴性，20% HIV+）或ORD（n = 63; 58% HIV+）。抗体对MS和MPT 51的反应性在U. S. HIV+/TB组高于HIV+/TB组（P < 0.001），潜伏期TB组高于对照组（P < 0.001）。对两种抗原的抗体反应性在U. S. HIV+/TB和HIV +/ORD之间的差异无统计学意义（MS组P = 0.052，MPT 51组P = 0.001）。S. HIV+ TB疑似者，抗MPT 51抗体阳性反应与TB密切相关（比值比，11.0; 95%置信区间，2.3 - 51.2; P = 0.002）。这些发现对在HIV+受试者中使用这些抗原进行结核病血清学诊断具有重要意义。
The immunodominance of Mycobacterium tuberculosis proteins malate synthase (MS) and MPT51 has been demonstrated in case-control studies with patients from countries in which tuberculosis ( TB) is endemic. The value of these antigens for the serodiagnosis of TB now is evaluated in a cross-sectional study of pulmonary TB suspects in the United States diagnosed to have TB, HIV-associated TB, or other respiratory diseases (ORD). Serum antibody reactivity to recombinant purified MS and MPT51 was determined by enzyme-linked immunosorbent assays (ELISAs) of samples from TB suspects and well-characterized control groups. TB suspects were diagnosed with TB (n = 87; 49% sputum microscopy negative, 20% HIV+) or ORD (n = 63; 58% HIV+). Antibody reactivity to MS and MPT51 was significantly higher in U. S. HIV+/TB samples than in HIV+/TB samples (P < 0.001), and it was significantly higher in both TB groups than in control groups with latent TB infection ( P < 0.001). Antibody reactivity to both antigens was higher in U. S. HIV+/TB samples than in HIV+/ORD samples (P = 0.052 for MS, P = 0.001 for MPT51) but not significantly different between HIV+/TB and HIV+/ORD. Among U. S. HIV+ TB suspects, a positive anti-MPT51 antibody response was strongly and significantly associated with TB ( odds ratio, 11.0; 95% confidence interval, 2.3 to 51.2; P = 0.002). These findings have implications for the adjunctive use of TB serodiagnosis with these antigens in HIV+ subjects.