Intrathecal synthesis of anti-mycobacterial antibodies in patients with tuberculous meningitis. An immunoblotting study.

Abstract

Cerebrospinal fluid (CSF) and serum samples from eight patients with bacteriologically proven (6) An A60-based ELISA-type immunoassay has been developed for serological analysis of tuberculosis in humans (Baelden et al, unpublished). The use of A60 as a new tuberculin for cutaneous testing has been proposed.2' In this study, an immunoblotting method was applied to CSF and paired sera samples of patients with TM. Using this test the intrathecal synthesis of oligoclonal anti-mycobacterial IgG antibodies was followed. In addition, immunoblotting experiments were performed in parallel with whole mycobacterial homogenates and with the purified antigen A60, to explore the importance of this antigen in the case of intrathecal mycobacterial infection.Patients (table 1) We studied eight patients (six females, two males; seven white, one oriental; age: 141-53 years), six of them with bacteriologically proven and two with clinically suspected TM. Three patients were also affected by lung

Paratuberculosis

“…The branched glycan core and lipid components have negligible antigenicity (23 (14,16,31,49,50,183). Sensitins, bacterial extracts used for cutaneous testing, contain TMA components that are partly responsible for the elicited DHR (79,92).…”

Immunologic Diagnosis of Neurotuberculosis

“…Subsequent studies revealed a local production of antimycobacterial antibodies anti PPD in the CSF (Kalish et al, 1983). In 1990, Sindic proved the presence of IgG in the CSF against the antigen of M. tbc H37Ra and A60 (Sindic et al, 1990) In this study antimycobacterial antibodies appeared in the subarachnoid space as early as 15 days after clinical onset and persisted up to 69 months. The delayed immune response after the disappearance of the antigenic stimulus could persist as a result of immune disorders of active B cells clones.…”

“…Sindic proved that most antibodies synthesized intrathecally are directed against antigen A60 (Sindic et al, 1990). He also revealed the presence of Ig in the subarahnoidian space after 14-27 days of disease and their persistence after several years.…”

“…In neurological localizations however, antibodies also appear in the CSF as a result of intratechal synthesis (Sindic et al, 1990;Kinmann et al, 1981;Kalish et al, 1983) and active secretion by choroidal plexuses. False positive antibodies in the CSF are possible in areas endemic for TB, where healthy persons or patients with pulmonary TB present high serum levels of antimycobacterial antibodies able to difusse from the serum to the CSF.…”

Comparación de adenosina deaminasa y detección de anticuerpos anti-antígeno A60 para el diagnóstico de meningitis tuberculosa

“…Microbiología anti-A60 en la MTBC ha sido variable en los estudios publicados 8,[17][18][19] . La sensibilidad reportada ha sido inconsistente, con valores desde 50% para detección de IgG e IgA anti-A60 en pacientes inmunocompetentes hasta 100% de detección para IgG, aun en estadios precoces de la enfermedad 20,21 .…”