Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1992 Apr;47(4):270–275. doi: 10.1136/thx.47.4.270

Clinical value of the measurement of Mycobacterium tuberculosis specific antibody in pulmonary tuberculosis.

G H Bothamley 1, R Rudd 1, F Festenstein 1, J Ivanyi 1
PMCID: PMC463688  PMID: 1585290

Abstract

BACKGROUND: A serological test that could help to diagnose tuberculosis, especially smear negative disease, would contribute to patient management. METHODS: Levels of antibody to distinct antigens of Mycobacterium tuberculosis were assessed for their value in the diagnosis and management of pulmonary tuberculosis. Serum was taken from 52 patients who were smear positive, from 27 patients who were smear negative but with evidence of active tuberculosis (sputum culture positive in 16, response to antituberculosis chemotherapy in 11), from 11 patients with old healed tuberculosis (pre-antibiotic era), and from 39 healthy subjects vaccinated with BCG. RESULTS: In smear positive tuberculosis an enzyme linked immunosorbent assay using a single 38 kDa antigen gave a diagnostic sensitivity of 80% with a 100% specificity. In smear negative pulmonary tuberculosis, however, combination of the 19 kDa antigen, lipoarabinomannan (ML 34 epitope), and hsp 65 (TB 78 epitope) was needed to achieve a sensitivity of 64% with a specificity of 95%. Recurrent and extensive radiographic disease with a poor prognosis was associated with high anti-38 kDa and low anti-14 kDa antibody levels in patients with active disease. Patients with less pulmonary cavitation had high anti-19 kDa titres. Bacteriological relapse during treatment was indicated by a rise in anti-14 kDa (TB68 epitope) antibodies. Four patients with non-tuberculous mycobacterial infection showed no anti-38 kDa antibody. CONCLUSION: Antigen or epitope specific serology may help in the diagnosis, assessment of prognosis, and monitoring of chemotherapy in patients with pulmonary tuberculosis.

Full text

PDF
270

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alde S. L., Piñasco H. M., Pelosi F. R., Budani H. F., Palma-Beltran O. H., Gonzalez-Montaner L. J. Evaluation of an enzyme-linked immunosorbent assay (ELISA) using an IgG antibody to Mycobacterium tuberculosis antigen 5 in the diagnosis of active tuberculosis in children. Am Rev Respir Dis. 1989 Mar;139(3):748–751. doi: 10.1164/ajrccm/139.3.748. [DOI] [PubMed] [Google Scholar]
  2. Balestrino E. A., Daniel T. M., de Latini M. D., Latini O. A., Ma Y., Scocozza J. B. Serodiagnosis of pulmonary tuberculosis in Argentina by enzyme-linked immunosorbent assay (ELISA) of IgG antibody to Mycobacterium tuberculosis antigen 5 and tuberculin purified protein derivative. Bull World Health Organ. 1984;62(5):755–761. [PMC free article] [PubMed] [Google Scholar]
  3. Banks J., Hunter A. M., Campbell I. A., Jenkins P. A., Smith A. P. Pulmonary infection with Mycobacterium kansasii in Wales, 1970-9: review of treatment and response. Thorax. 1983 Apr;38(4):271–274. doi: 10.1136/thx.38.4.271. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Barnes P. F., Leedom J. M., Chan L. S., Wong S. F., Shah J., Vachon L. A., Overturf G. D., Modlin R. L. Predictors of short-term prognosis in patients with pulmonary tuberculosis. J Infect Dis. 1988 Aug;158(2):366–371. doi: 10.1093/infdis/158.2.366. [DOI] [PubMed] [Google Scholar]
  5. Benjamin R. G., Daniel T. M. Serodiagnosis of tuberculosis using the enzyme-linked immunoabsorbent assay (ELISA) of antibody to Mycobacterium tuberculosis antigen 5. Am Rev Respir Dis. 1982 Dec;126(6):1013–1016. doi: 10.1164/arrd.1982.126.6.1013. [DOI] [PubMed] [Google Scholar]
  6. Chaparas S. D., Vandiviere H. M., Melvin I., Koch G., Becker C. Tuberculin test. Variability with the Mantoux procedure. Am Rev Respir Dis. 1985 Jul;132(1):175–177. doi: 10.1164/arrd.1985.132.1.175. [DOI] [PubMed] [Google Scholar]
  7. Coates A. R., Hewitt J., Allen B. W., Ivanyi J., Mitchison D. A. Antigenic diversity of Mycobacterium tuberculosis and Mycobacterium bovis detected by means of monoclonal antibodies. Lancet. 1981 Jul 25;2(8239):167–169. doi: 10.1016/s0140-6736(81)90355-x. [DOI] [PubMed] [Google Scholar]
  8. Cook G. C. Tuberculosis--certainly not a disease of the past! Q J Med. 1985 Sep;56(221):519–521. [PubMed] [Google Scholar]
  9. Daniel T. M., De Murillo G. L., Sawyer J. A., Griffin A. M., Pinto E., Debanne S. M., Espinosa P., Cespedes E. Field evaluation of enzyme-linked immunosorbent assay for the serodiagnosis of tuberculosis. Am Rev Respir Dis. 1986 Oct;134(4):662–665. doi: 10.1164/arrd.1986.134.4.662. [DOI] [PubMed] [Google Scholar]
  10. Daniel T. M., Debanne S. M., van der Kuyp F. Enzyme-linked immunosorbent assay using Mycobacterium tuberculosis antigen 5 and PPD for the serodiagnosis of tuberculosis. Chest. 1985 Sep;88(3):388–392. doi: 10.1378/chest.88.3.388. [DOI] [PubMed] [Google Scholar]
  11. Davies P. D. The slowing of the decline in tuberculosis notifications and HIV infection. Respir Med. 1989 Jul;83(4):321–322. doi: 10.1016/s0954-6111(89)80204-5. [DOI] [PubMed] [Google Scholar]
  12. Grange J. M. The humoral immune response in tuberculosis: its nature, biological role and diagnostic usefulness. Adv Tuberc Res. 1984;21:1–78. [PubMed] [Google Scholar]
  13. Hewitt J., Coates A. R., Mitchison D. A., Ivanyi J. The use of murine monoclonal antibodies without purification of antigen in the serodiagnosis of tuberculosis. J Immunol Methods. 1982 Dec 17;55(2):205–211. doi: 10.1016/0022-1759(82)90032-1. [DOI] [PubMed] [Google Scholar]
  14. Horne N. W. Problems of tuberculosis in decline. Br Med J (Clin Res Ed) 1984 Apr 28;288(6426):1249–1251. doi: 10.1136/bmj.288.6426.1249. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Howard W. L., Klopfenstein M. D., Steininger W. J., Woodruff C. E. The loss of tuberculin sensitivity in certain patients with active pulmonary tuberculosis. Chest. 1970 Jun;57(6):530–534. doi: 10.1378/chest.57.6.530. [DOI] [PubMed] [Google Scholar]
  16. Humphries M. J., Byfield S. P., Darbyshire J. H., Davies P. D., Nunn A. J., Citron K. M., Fox W. Deaths occurring in newly notified patients with pulmonary tuberculosis in England and Wales. Br J Dis Chest. 1984 Apr;78(2):149–158. [PubMed] [Google Scholar]
  17. Ivanyi J., Krambovitis E., Keen M. Evaluation of a monoclonal antibody (TB72) based serological test for tuberculosis. Clin Exp Immunol. 1983 Nov;54(2):337–345. [PMC free article] [PubMed] [Google Scholar]
  18. Jackett P. S., Bothamley G. H., Batra H. V., Mistry A., Young D. B., Ivanyi J. Specificity of antibodies to immunodominant mycobacterial antigens in pulmonary tuberculosis. J Clin Microbiol. 1988 Nov;26(11):2313–2318. doi: 10.1128/jcm.26.11.2313-2318.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Ma Y., Wang Y. M., Daniel T. M. Enzyme-linked immunosorbent assay using Mycobacterium tuberculosis antigen 5 for the diagnosis of pulmonary tuberculosis in China. Am Rev Respir Dis. 1986 Dec;134(6):1273–1275. doi: 10.1164/arrd.1986.134.5.1273. [DOI] [PubMed] [Google Scholar]
  20. McNicol M. Trends in the epidemiology of tuberculosis--a physician's view. J Clin Pathol. 1983 Oct;36(10):1087–1090. doi: 10.1136/jcp.36.10.1087. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Mitchison D. A., Aber V. R., Ahmad F. J., Allen B. W., Devi S. Evaluation of a serological test for tuberculosis. Br Med J. 1977 May 28;1(6073):1383–1384. doi: 10.1136/bmj.1.6073.1383. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Nicholls A. C. A serodiagnostic test for tuberculosis. J Clin Pathol. 1975 Nov;28(11):850–853. doi: 10.1136/jcp.28.11.850. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Nicholls A. C., Horsfield K. Serological diagnosis of tuberculosis: a report of 12 months' clinical experience. Thorax. 1976 Jun;31(3):289–293. doi: 10.1136/thx.31.3.289. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Olds G. R., Sanson A. J., Daniel T. M. Characterization of Mycobacterium tuberculosis antigen 5 epitopes by using a panel of 19 monoclonal antibodies. J Clin Microbiol. 1987 Mar;25(3):471–475. doi: 10.1128/jcm.25.3.471-475.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Results of a World Health Organization-sponsored workshop to characterize antigens recognized by mycobacterium-specific monoclonal antibodies. Infect Immun. 1986 Feb;51(2):718–720. doi: 10.1128/iai.51.2.718-720.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Sada E., Brennan P. J., Herrera T., Torres M. Evaluation of lipoarabinomannan for the serological diagnosis of tuberculosis. J Clin Microbiol. 1990 Dec;28(12):2587–2590. doi: 10.1128/jcm.28.12.2587-2590.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Sada E., Ferguson L. E., Daniel T. M. An ELISA for the serodiagnosis of tuberculosis using a 30,000-Da native antigen of Mycobacterium tuberculosis. J Infect Dis. 1990 Oct;162(4):928–931. doi: 10.1093/infdis/162.4.928. [DOI] [PubMed] [Google Scholar]
  28. Smith M. J., Citron K. M. Clinical review of pulmonary disease caused by Mycobacterium xenopi. Thorax. 1983 May;38(5):373–377. doi: 10.1136/thx.38.5.373. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Turneer M., Van Vooren J. P., De Bruyn J., Serruys E., Dierckx P., Yernault J. C. Humoral immune response in human tuberculosis: immunoglobulins G, A, and M directed against the purified P32 protein antigen of Mycobacterium bovis bacillus Calmette-Guérin. J Clin Microbiol. 1988 Sep;26(9):1714–1719. doi: 10.1128/jcm.26.9.1714-1719.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Wiker H. G., Harboe M., Bennedsen J., Closs O. The antigens of Mycobacterium tuberculosis, H37Rv, studied by crossed immunoelectrophoresis. Comparison with a reference system for Mycobacterium bovis, BCG. Scand J Immunol. 1988 Feb;27(2):223–239. doi: 10.1111/j.1365-3083.1988.tb02342.x. [DOI] [PubMed] [Google Scholar]
  31. Wilkins E. G., Ivanyi J. Potential value of serology for diagnosis of extrapulmonary tuberculosis. Lancet. 1990 Sep 15;336(8716):641–644. doi: 10.1016/0140-6736(90)92144-7. [DOI] [PubMed] [Google Scholar]
  32. Wilkins E., Bothamley G., Jackett P. A rapid, simple enzyme immunoassay for detection of antibody to individual epitopes in the serodiagnosis of tuberculosis. Eur J Clin Microbiol Infect Dis. 1991 Jul;10(7):559–563. doi: 10.1007/BF01967273. [DOI] [PubMed] [Google Scholar]
  33. Wolinsky E. Nontuberculous mycobacteria and associated diseases. Am Rev Respir Dis. 1979 Jan;119(1):107–159. doi: 10.1164/arrd.1979.119.1.107. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES