Diagnosis of NTM active infection in lymphadenopathy patients with anti-interferon-gamma auto-antibody using inhibitory ELISA vs. indirect ELISA
Diagnosis of NTM active infection in lymphadenopathy patients with anti-interferon-gamma auto-antibody using inhibitory ELISA vs. indirect ELISA
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DOI：
10.1038/s41598-020-65933-x
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发表时间：
2020-06-02
影响因子：
4.6
通讯作者：
Lertmemongkolchai, Ganjana
中科院分区：
文献类型：
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作者：
Nithichanon, Arnone;Chetchotisakd, Ploenchan;Lertmemongkolchai, Ganjana
抗干扰素γ (ifn - γ)自身抗体是成人机会性非结核分枝杆菌（NTM）感染的已知原因。由于细菌培养的敏感性较低，并且检测中和性自身抗体需要特殊的实验室设备，因此对这些患者的诊断很困难。我们对102例淋巴结病患者中用于检测抗ifn - γ自身抗体的间接和抑制性ELISA进行了回顾性评价。我们评估了NTM分离和/或NTM感染诊断的医院记录。结果表明，抑制性ELISA与间接ELISA相比具有相容的敏感性、优越的特异性和预测值，后者在淋巴结病患者NTM感染诊断中具有100%的特异性和阳性预测值。结果证实了ntm感染患者的血浆样本在间接和/或抑制性ELISA检测中呈阳性的功能分析结果是ifn - γ中和自身抗体。抗干扰素γ自身抗体的抑制滴度可用于区分活动性和非活动性NTM感染患者。因此，抑制性ELISA是一种实用、快速、高效的工具，可在确诊前常规检测抗ifn - γ自身抗体和NTM感染诊断，为活动性感染治疗提供及时的治疗策略。
The anti-interferon-gamma (IFN-gamma) autoantibody is a known cause of opportunistic non-tuberculous mycobacterial (NTM) infection in adults. Diagnosis of those patients is difficult due to the low sensitivity of bacterial culture, and because detection of the neutralizing autoantibody needs special laboratory devices. We conducted a retrospective review of indirect and inhibitory ELISA, both used for detection of anti-IFN-gamma auto-antibody in 102 patients with lymphadenopathies. We assessed hospital records of NTM isolation and/or diagnosis of NTM infection. The review revealed the compatible sensitivity and superior specificity and predictive values for inhibitory ELISA over against indirect ELISA-the latter achieving 100% specificity and positive predictive value for diagnosis of NTM infection in patients with lymphadenopathies. The results confirm functional assays that show plasma samples from NTM-infected patients with positive results by either indirect and/or inhibitory ELISA are IFN-gamma neutralizing autoantibodies. The inhibitory titer of anti-IFN-gamma auto-antibody can be used to distinguish patients with active from inactive NTM infection. Inhibitory ELISA is thus a practical, rapid, high performance tool for routine detection of anti-IFN-gamma autoantibody and NTM infection diagnosis before confirmation, enabling a timely therapeutic strategy for active infection treatment.