Serodiagnosis of pulmonary disease due to Mycobacterium avium complex with an enzyme immunoassay that uses a mixture of glycopeptidolipid antigens
Serodiagnosis of pulmonary disease due to Mycobacterium avium complex with an enzyme immunoassay that uses a mixture of glycopeptidolipid antigens
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DOI：
10.1086/344277
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发表时间：
2002-12-01
影响因子：
11.8
通讯作者：
Kobayashi, K
中科院分区：
文献类型：
--
作者：
Kitada, S;Maekura, R;Kobayashi, K
鸟分枝杆菌复合群（MAC）引起的肺部疾病很难与其他分枝杆菌（如结核分枝杆菌和堪萨斯分枝杆菌）引起的肺部疾病区分开来。我们开发了一种酶免疫测定法（EIA），用于诊断MAC肺部疾病，使用糖肽脂（GPL）抗原特异性MAC，我们用它来诊断免疫功能正常的患者。MAC病、MAC定植、M. Kansasii病、结核病和健康受试者分别为0.778 ± 0.784、0.042 ± 0.035、0.059 ± 0.035、0.071 ± 0.035和0.030 ± 0.027。在MAC疾病患者中检测到抗GPL抗体水平显著增加。抗GPL抗体水平反映了疾病活动性，因为在培养结果转换的培养阴性患者中，抗GPL抗体水平降低。以血清学阳性率为0.119为界值时，EIA诊断MAC病的敏感性为92.3%，特异性为96.7%。血清抗GPL抗体的测量对于MAC疾病的诊断和活动性评估都是有用的。
It is difficult to distinguish pulmonary disease due to Mycobacterium avium complex (MAC) from that due to other mycobacteria, such as Mycobacterium tuberculosis and Mycobacterium kansasii. We developed an enzyme immunoassay (EIA) for diagnosis of MAC pulmonary diseases that uses glycopeptidolipid (GPL) antigens specific for MAC, and we used it for diagnosis in immunocompetent patients. The mean optical densities ( standard deviation) of serum immunoglobulin G antibodies to GPLs in patients with MAC disease, MAC colonization, M. kansasii disease, and tuberculosis and in healthy subjects were 0.778 +/- 0.784, 0.042 +/- 0.035, 0.059 +/- 0.035, 0.071 +/- 0.035, and 0.030 +/- 0.027, respectively. A significant increase in the level of anti-GPL antibodies was detected in patients with MAC disease. The level of anti-GPL antibodies reflected disease activity, because the level was decreased in culture-negative patients who had conversion of culture results. When a cutoff level of seropositivity (0.119) was defined, the sensitivity of EIA for diagnosis of MAC disease was 92.3%, and the specificity was 96.7%. Measurement of serum anti-GPL antibodies is useful for both the diagnosis of and assessment of activity in MAC disease.