Immunohistochemical diagnosis of abdominal and lymph node tuberculosis by detecting Mycobacterium tuberculosis complex specific antigen MPT64

Purohit, Manju; Mustafa, Tehmina; Wiker, Harald G.; Mørkve, Odd; Sviland, Lisbet

doi:10.1186/1746-1596-2-36

Cited by 64 publications

(69 citation statements)

References 25 publications

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“…Histological features may be atypical at various extra-pulmonary sites and with concomitant immunosuppression. Thus, the explicit diagnosis of TB with direct evidences can only be reached in 20-25% cases [4,5]. In resource poor settings, however, indirect evidences are then the mainstay for the diagnosis.…”

Section: Methodological Issuesmentioning

confidence: 99%

“…Ethanol-fixed aspirate smears can be stored at room temperature, and can easily be transported if molecular facilities are not available at the local health centre. However, the sensitivity of conventional PCR is low in pauci-bacillary EPTB and nested PCR or real time PCR is required to achieve a better sensitivity than AFB staining or culture [4,5,16].…”

Section: Molecular Methodsmentioning

confidence: 99%

“…It is simple, cheap, and quick. Positive ZN test requires more than 10 6 bacteria/g tissue, so of limited diagnostic value 0-40% [4,5] in majority of pauci-bacillary EPTB samples. As for pulmonary TB the centrifugation of EPTB samples and fluorochrome staining with ultraviolet microscopy increases the sensitivity of microscopy by 10% of ZN staining [6].…”

Section: Direct Methods Tissue and Aspirate Microscopy And Stainingmentioning

confidence: 99%

“…insertion element IS-6110 carried in multiple copies by most strains belonging to M. tuberculosis) are in routine use [5]. It is a suitable method for sensitive and fast detection of M. tuberculosis complex DNA in histological material including formalin-fixed tissues and dried scraped material [4,5,16]. This has major implications both in TB endemic and non-endemic areas especially when culture is negative or a fresh specimen is not available for further investigation and thus avoids over treatment and more invasive procedures.…”

Section: Molecular Methodsmentioning

confidence: 99%

“…In recent years, several reports have described immunostaining techniques as an alternative to conventional acid-fast staining [4,16]. The improvement in sensitivity may partly be attributed to the additional detection of degraded bacilli, unlike the ZN staining that requires intact bacilli.…”

Section: Immunohistochemistry (Ihc) and Immunocytochemistry (Icc) Basmentioning

confidence: 99%

See 4 more Smart Citations

Laboratory Diagnosis of Extra-pulmonary Tuberculosis (EPTB) in Resource- constrained Setting: State of the Art, Challenges and the Need

Purohit

Mustafa²

2015

JCDR

125

136

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Section: Methodological Issuesmentioning

confidence: 99%

Section: Molecular Methodsmentioning

confidence: 99%

Section: Direct Methods Tissue and Aspirate Microscopy And Stainingmentioning

confidence: 99%

Section: Molecular Methodsmentioning

confidence: 99%

Section: Immunohistochemistry (Ihc) and Immunocytochemistry (Icc) Basmentioning

confidence: 99%

See 3 more Smart Citations

Laboratory Diagnosis of Extra-pulmonary Tuberculosis (EPTB) in Resource- constrained Setting: State of the Art, Challenges and the Need

Purohit

Mustafa²

2015

JCDR

125

136

View full text Add to dashboard Cite

Diagnosing adult and pediatric extrapulmonary tuberculosis by MPT64 antigen detection with immunohistochemistry and immunocytochemistry using reproduced polyclonal antibodies

Helle,

Kanthali,

Ishtiaq

et al. 2024

The Journal of Pathology CR

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Diagnosing extrapulmonary tuberculosis (EPTB) is challenging. Immunohistochemistry or immunocytochemistry has been used to diagnose tuberculosis (TB) by detection of MPT64 antigen from various extrapulmonary specimens and has shown good diagnostic performance in our previous studies. The test can distinguish between disease caused by Mycobacterium tuberculosis (Mtb) complex and nontuberculous mycobacteria and can be applied on formalin‐fixed paraffin‐embedded tissue. As the antibodies previously used were in limited supply, a new batch of polyclonal antibodies was developed for scale‐up and evaluated for the first time in this study. Our aim was to assess the diagnostic accuracy of the MPT64 test with reproduced antibodies in the high burden settings of Pakistan and India. Patients were enrolled prospectively. Samples from suspected sites of infection were collected and subjected to histopathologic and/or cytologic evaluation, routine TB diagnostics, GeneXpert MTB/RIF (Xpert), and the MPT64 antigen detection test. Patients were followed until the end of treatment. Based on a composite reference standard (CRS), 556 patients were categorized as TB cases and 175 as non‐TB cases. The MPT64 test performed well on biopsies with a sensitivity and specificity of 94% and 75%, respectively, against a CRS. For cytology samples, the sensitivity was low (36%), whereas the specificity was 81%. Overall, the MPT64 test showed higher sensitivity (73%) than Xpert (38%) and Mtb culture (33%). The test performed equally well in adults and children. We found an additive diagnostic value of the MPT64 test in conjunction with histology and molecular tests, increasing the yield for EPTB. In conclusion, immunochemical staining with MPT64 antibodies improves the diagnosis of EPTB in high burden settings and could be a valuable addition to routine diagnostics.

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Rapid diagnosis of tuberculosis in aspirate, effusions, and cerebrospinal fluid by immunocytochemical detection of Mycobacterium tuberculosis complex specific antigen MPT64

Purohit

Mustafa

Wiker

et al. 2011

Diagnostic Cytopathology

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The aim of the study was to evaluate the diagnostic potential of immunocytochemical staining for the detection of Mycobacterium tuberculosis complex-specific antigen MPT64, in tuberculous lymph node aspirates, cerebrospinal fluid, and effusions from pleura and abdomen. One hundred ninety patients with a diagnosis of tuberculosis (cases) and 80 patients with nontuberculous lesions (controls) were enrolled and differentiated on the basis of clinical features, histology, cytology, clinical biochemistry, Ziehl-Neelsen staining, Lowenstein-Jensen culture, and response to antituberculous therapy. Cervical lymph nodes fine-needle aspirate (n = 150), cerebrospinal fluid (n = 27), pleural fluid (n = 41), and peritoneal fluid (n = 52) were collected and stained with anti-MPT64 and anti-BCG antibodies using immunocytochemistry. Nested-PCR for IS6110 was done for comparison and to calculate the diagnostic indices of the ICC staining. ICC staining with anti-MPT64 was positive in 128/190 (67.4%) tuberculous smears and in 4/80 (5%) control smears thus giving sensitivity of 67.4% and the specificity of 95%, while anti-BCG was positive in 112 (58.9%) tuberculous smears and in 16/80 (20%) control smears with sensitivity of 58.9% and specificity of 80%. When diagnostic validation of ICC was done using PCR as the gold standard, the overall sensitivity, specificity, positive- and negative-predictive values for ICC staining in smears with anti-MPT64 was 96, 96, 95, and 97%, respectively, while the corresponding values for anti-BCG were 87, 88, 86, and 88%. ICC staining using anti-MPT64 represents a robust and simple method for establishing an early etiological diagnosis of M. tuberculosis complex infection in extrapulmonary tuberculosis.

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Immunohistochemical diagnosis of abdominal and lymph node tuberculosis by detecting Mycobacterium tuberculosis complex specific antigen MPT64

Abstract: Background: The aim of this study was to evaluate the diagnostic potential of immunohistochemistry using an antibody to the secreted mycobacterial antigen MPT64, in abdominal and lymph node tuberculosis.

Cited by 64 publications

References 25 publications

Laboratory Diagnosis of Extra-pulmonary Tuberculosis (EPTB) in Resource- constrained Setting: State of the Art, Challenges and the Need

Laboratory Diagnosis of Extra-pulmonary Tuberculosis (EPTB) in Resource- constrained Setting: State of the Art, Challenges and the Need

Diagnosing adult and pediatric extrapulmonary tuberculosis by MPT64 antigen detection with immunohistochemistry and immunocytochemistry using reproduced polyclonal antibodies

Rapid diagnosis of tuberculosis in aspirate, effusions, and cerebrospinal fluid by immunocytochemical detection of Mycobacterium tuberculosis complex specific antigen MPT64

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