Rapid Diagnosis of Tuberculous Meningitis by Latex Particle Agglutination

Krambovitis, Elias; Lock, PaulE.; McIllmurray, M B; Hendrickse, William; Holzel, Helen

doi:10.1016/s0140-6736(84)92792-2

Cited by 106 publications

(37 citation statements)

References 12 publications

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“…In addition to measuring M. tuberculosisspecific antibodies or antibody-secreting cells, assays to measure M. tuberculosis-specific antigens directly in the CSF have also been evaluated (32,82,86,92,103,125,202,203,205,236) (Table 3). A theoretical advantage of antigen detection over antibody detection would be that they would be released only as a result of the host's immune response or the result of treatment.…”

Section: Molecular and Biochemical Analysismentioning

confidence: 99%

Central Nervous System Tuberculosis: Pathogenesis and Clinical Aspects

et al. 2008

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SUMMARY Tuberculosis of the central nervous system (CNS) is a highly devastating form of tuberculosis, which, even in the setting of appropriate antitubercular therapy, leads to unacceptable levels of morbidity and mortality. Despite the development of promising molecular diagnostic techniques, diagnosis of CNS tuberculosis relies largely on microbiological methods that are insensitive, and as such, CNS tuberculosis remains a formidable diagnostic challenge. Insights into the basic neuropathogenesis of Mycobacterium tuberculosis and the development of an appropriate animal model are desperately needed. The optimal regimen and length of treatment are largely unknown, and with the rising incidence of multidrug-resistant strains of M. tuberculosis, the development of well-tolerated and effective antibiotics remains a continued need. While the most widely used vaccine in the world largely targets this manifestation of tuberculosis, the BCG vaccine has not fulfilled the promise of eliminating CNS tuberculosis. We put forth this review to highlight the current understanding of the neuropathogenesis of M. tuberculosis, to discuss certain epidemiological, clinical, diagnostic, and therapeutic aspects of CNS tuberculosis, and also to underscore the many unmet needs in this important field.

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Section: Molecular and Biochemical Analysismentioning

confidence: 99%

Central Nervous System Tuberculosis: Pathogenesis and Clinical Aspects

et al. 2008

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“…In most of the cases, diagnosis relies on clinical observations, imaging of the infected area, and detection of Mycobacterium tuberculosis in CSF by acid-fast bacillus (AFB) staining and culturing. A number of immunological and molecular methods have been reported, but these cannot be employed in standard pathology laboratories and are often not useful for early confirmative diagnosis of TBM (3,7,11,15,22,23,25,26,31,35).…”

mentioning

confidence: 99%

Demonstration of Components of Antigen 85 Complex in Cerebrospinal Fluid of Tuberculous Meningitis Patients

Kashyap

Dobos

Belisle

et al. 2005

Clin Vaccine Immunol

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Tuberculosis is the leading cause of death among communicable diseases, killing nearly 2 million people each year (2, 13). Among tubercular infections, tuberculous meningitis (TBM) leads to multiple central nervous system (CNS) complications and remains a major health problem in underdeveloped and developing countries (1, 9, 16). Even in developed countries where a decade ago it was rare, it has reappeared following human immunodeficiency virus infection (6, 14, 29). Early and rapid confirmatory diagnosis is still difficult due to the clinical picture of TBM and similarities of TBM cerebrospinal fluid (CSF) to that of partially treated pyogenic meningitis, which results in frequent diagnostic confusion (4,21,28,33). Early and reliable diagnosis of TBM still poses a great challenge. In most of the cases, diagnosis relies on clinical observations, imaging of the infected area, and detection of Mycobacterium tuberculosis in CSF by acid-fast bacillus (AFB) staining and culturing. A number of immunological and molecular methods have been reported, but these cannot be employed in standard pathology laboratories and are often not useful for early confirmative diagnosis of TBM (3,7,11,15,22,23,25,26,31,35).To overcome the deficiencies in TBM diagnosis, we set forth to identify specific protein markers unique to CSF samples collected from suspected patients with TBM. By analyzing the total sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) protein profile of such CSF, we observed a 30-kDa protein band specific to these patients (18). Further, all 30-kDa protein-positive CSF samples tested with polyvalent antibodies against culture filtrate proteins (CFP) of M. tuberculosis strain H 37 Rv by the single radial immunodiffusion (SRID) method indicated that the CSF of TBM patients possesses M. tuberculosis antigens (17).These early investigations led us to hypothesize that molecular identification of the TBM-specific 30-kDa CSF protein would allow for development of specific reagents and protocols for the rapid and accurate diagnosis of TBM. In this report, the application of two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) and liquid chromatography tandem mass spectrometry (LC-MS/MS) identified two mycobacterial proteins of the antigen 85 (Ag85) complex (Rv3804c and Rv1886c) and one host-derived protein (immunoglobulin [Ig] kappa light * Corresponding author. Mailing address:

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“…During the past two decades several biochemical (3, 6, 7), immunological (1,2,5,8,11), and molecular biological methods (4) have been described as an adjunct for the laboratory diagnosis of TBM. All of these studies are aimed at the analysis of CSF and measure either the host response to infection or the breakdown products of M. tuberculosis bacilli.…”

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confidence: 99%

Immunocytochemical Method for Early Laboratory Diagnosis of Tuberculous Meningitis

Sumi¹,

Mathai²,

Reuben³

et al. 2002

Clin Vaccine Immunol

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A simple immunocytochemical method was standardized for the direct demonstration of mycobacterial antigen in cerebrospinal fluid (CSF) specimens of patients with tuberculous meningitis (TBM). CSF-cytospin smears were prepared from 22 patients with a clinical diagnosis of TBM and also from an equal number of patients with nontuberculous neurological diseases (disease control). Immunocytological demonstration of mycobacterial antigens in the cytoplasm of monocytoid cells was attempted, by using rabbit immunoglobulin G to Mycobacterium tuberculosis as the primary antibody. Of the 22 CSF-cytospin smears from TBM patients, 16 showed positive immunostaining, while all of the CSF-cytospin smears from the disease control showed negative immunostaining for mycobacterial antigen. The technical aspects of this immunocytological method for the demonstration of mycobacterial antigens are simple, rapid, and reproducible, as well as specific, and therefore can be applied for the early diagnosis of TBM, particularly in patients in whom bacteriological methods did not demonstrate the presence of M. tuberculosis in the CSF.

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Rapid Diagnosis of Tuberculous Meningitis by Latex Particle Agglutination

Cited by 106 publications

References 12 publications

Central Nervous System Tuberculosis: Pathogenesis and Clinical Aspects

Central Nervous System Tuberculosis: Pathogenesis and Clinical Aspects

Demonstration of Components of Antigen 85 Complex in Cerebrospinal Fluid of Tuberculous Meningitis Patients

Immunocytochemical Method for Early Laboratory Diagnosis of Tuberculous Meningitis

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