LEVELS OF ANTIBODY TO DEFINED ANTIGENS OF MYCOBACTERIUM-TUBERCULOSIS IN TUBERCULOUS MENINGITIS
LEVELS OF ANTIBODY TO DEFINED ANTIGENS OF MYCOBACTERIUM-TUBERCULOSIS IN TUBERCULOUS MENINGITIS
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DOI：
10.1128/jcm.27.5.821-825.1989
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发表时间：
1989-05-01
影响因子：
9.4
通讯作者：
IVANYI, J
中科院分区：
文献类型：
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作者：
CHANDRAMUKI, A;BOTHAMLEY, GH;IVANYI, J
该研究的目的是开发一种针对结核性脑膜炎的抗体免疫测定法，其灵敏度高于最初的细菌涂片，同时保持 100% 的特异性。使用酶联免疫吸附测定技术测量脑脊液中五种纯化的结核分枝杆菌抗原的抗体滴度。 74 名结核性脑膜炎患者（26 名培养阳性）与 26 名化脓性脑膜炎患者、69 名疑似但排除结核性脑膜炎患者以及 29 名其他神经系统疾病患者进行了比较。对 14 千道尔顿 (kDa) 抗原和阿拉伯脂甘露聚糖的抗体反应都是免疫显性的，占对结核分枝杆菌可溶性提取物具有任何抗体滴度的抗体反应的 74%。通过使用免疫球蛋白 G 滴度对脂阿拉伯甘露聚糖和 14、19 和 38 kDa 抗原，灵敏度达到 61%（培养阳性样品为 77%）。因此，估计脑脊液中针对选定分枝杆菌抗原的抗体水平对于结核性脑膜炎的诊断是有价值的。讨论了14-kDa抗原和阿拉伯脂甘露聚糖在结核性脑膜炎发病机制中免疫优势的可能原因。
The aim of the study was to develop an antibody immunoassay for tuberculous meningitis with a sensitivity greater than that of the initial bacterial smear while maintaining a 100% specificity. Antibody titers to five purified antigens of Mycobacterium tuberculosis were measured in cerebrospinal fluid by using an enzyme-linked immunosorbent assay technique. Seventy-four patients with tuberculous meningitis (26 culture positive) were compared with 26 patients with purulent meningitis, 69 patients with suspected but excluded tuberculous meningitis, and 29 patients with other neurological diseases. Antibody responses to both the 14-kilodalton (kDa) antigen and lipoarabinomannan were immunodominant, accounting for 74% of those with any antibody titer to a soluble extract of M. tuberculosis. A sensitivity of 61% was achieved (77% for the culture-positive samples) by using immunoglobulin G titers to lipoarabinomannan and the 14-, 19- and 38-kDa antigens. Thus, estimation of levels of antibody in cerebrospinal fluid to selected mycobacterial antigens would be valuable in the diagnosis of tuberculous meningitis. The possible reasons for the immunodominance of the 14-kDa antigen and lipoarabinomannan in the pathogenesis of tuberculous meningitis are discussed.