The Enzyme-Linked Immunosorbent Assay Method for IgG Antibody to Purified Protein Derivative in Cerebrospinal Fluid of Patients with Tuberculous Meningitis

Abstract

Three patients with culture-proven Mycobacterium tuberculosis meningitis were studied. Analysis of cerebrospinal fluid with an enzyme-linked immunosorbent assay (ELISA) method measuring IgG antibody to purified protein derivative rapidly yielded positive results, whereas results of acid-fast smears were negative and cultures took several weeks before growth appeared. We did serial studies of cerebrospinal fluid and sera from one patient. Initially, greater amounts of IgG antibody to purified protein derivative were present in the cerebrospinal fluid than in the serum. The antibody level in the cerebrospinal fluid paralleled the patient's clinical course, cerebrospinal fluid cell count, protein level, and glucose level. Cerebrospinal fluid samples from 33 hospitalized control patients were negative for antibody to purified protein derivative. The ELISA method measuring IgG antibody to purified protein derivative should be evaluated as a means of early diagnosis and management of patients with suspected tuberculous meningitis.

Isolation of two antigens from the culture filtrates of Mycobacterium tuberculosis and their applications in the laboratory diagnosis of the tuberculous meningitis

“…During the past decade several immunodiagnostic assays (ELISA) have been described as an aid in the laboratory diagnosis of TBM. In these studies various mycobacterial antigens, such as purified protein derivative [10], commercial BCG [8] and sonicated antigens [15], have been used in the ELISA as the solid-phase absorbent. Specificity in ELISA depends upon the purity of mycobacterial antigens, so that non-specific reactions could be eliminated.…”

Diagnosis of tuberculous meningitis by enzyme-linked immunosorbent assay to detect mycobacterial antigen and antibody in cerebrospinal fluid

“…Earlier published reports have used variety of mycobacterial antigens in ELISA to detect anti-mycobacterial antibody in CSF and have emphasised their diagnostic significance in patients with TBM. These include purified protein derivative [8], BCG [6], sonicated antigen [10], M. tuberculosis antigen-5 [4] and lipo-arbinomannan [2]. Variations in the antibody response to different antigenic preparations of M. tuberculosis are well known.…”

Cerebrospinal Fluid Infections

“…All but one of 134 control cerebrospinal fluid samples were negative. Kalish and coworkers [41] reported an ELISA for detecting antibodies to the purified protein derivative of Mycobacterium tuberculosis. Only three patients were tested, but all three were positive and all of 33 hospital control cerebrospinal fluid samples were negative.…”