The value of pleural fluid anti-A60 IgM in BCG-vaccinated tuberculous pleurisy patients

Kunter, Erdoğan; Cerrahoğlu, Kamil; İlvan, Ahmet; Işıtmangil, Turgut; Türken, Orhan; Okutan, Oğuzhan; Kartaloğlu, Zafer; Çavuşlu, Şaban

doi:10.1046/j.1469-0691.2003.00536.x

Cited by 15 publications

(15 citation statements)

References 20 publications

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“…Kunter et al, after evaluating IgM anti-A60 in PF, reported similar sensitivity (77%) and specificity (94%) (17). However, when the combined results of all dilutions were analyzed, the sensitivity was higher (Ն80%) than that obtained in the histopathological biopsy examinations (74%), which in this particular case is a decided advantage.…”

Section: Discussionmentioning

confidence: 82%

Assessment of the IgA Immunoassay Diagnostic Potential of the Mycobacterium tuberculosis MT10.3-MPT64 Fusion Protein in Tuberculous Pleural Fluid

Araujo

Maciel

Trajman

et al. 2010

Clin Vaccine Immunol

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Pleural tuberculosis (PL-TB) remains difficult to diagnose. An enzyme-linked immunosorbent assay (ELISA) was developed based on a construction containing the fusion of the Rv3019c (MT10.3) and Rv1980c (MPT64) gene sequences, and its performance was evaluated in an area where TB is endemic. A total of 92 pleural fluid (PF) samples at serial dilutions of 1:50 to 1:800 were included in the ELISA IgA MT10. 4%). Our findings demonstrated the promising use of this test as an adjunct in PL-TB diagnoses, particularly in cases with lower bacterial loads and false-negative results in the reference tests, since the new test includes such important features as quick and easy application, high sensitivity and, perhaps most importantly, affordability, which is so crucial for its widespread use in developing countries.Tuberculosis (TB) is the leading cause of preventable morbidity and mortality from infectious agents worldwide. A global plan has been outlined to eradicate the disease by 2050 (37). To reach this goal, both political commitments and increments in interdisciplinary research are needed; because the specific diagnostics, drugs, and vaccines available for this purpose have been insufficient in eradicating the disease, the development of more effective tools and strategies is urgently needed (7).In Brazil, the TB prevalence rate is approximately 60 per 100,000 inhabitants (44). Generally speaking, the incidence of pleural tuberculosis (PL-TB) is closely related to the local disease prevalence. Moreover, PL-TB is the major cause of pleural effusions, responsible for approximately 50% of all related diagnoses in Brazil (25, 32).TB diagnoses have traditionally relied on the identification of acid-fast bacilli (AFB) and the culture of clinical specimens. However, low sensitivities (5 and 47%, respectively) are achieved with PL-TB. Besides, the final culture results may take as long as 4 to 6 weeks to complete, delaying the initiation of specific therapy.The histopathological examination of pleural biopsy specimens comprises the standard PL-TB reference test. Nevertheless, its sensitivity is highly variable (39 to 84%), it is expensive and time-consuming, and its proper administration requires skilled personnel. It is clear that there is an overriding need for the development of a simple, fast, effective, and affordable yet robust tool that would be readily available throughout the national public health care sector to aid in the diagnosis of PL-TB, with special emphasis on developing countries (12,15,30). What is most frequently used is an enzyme-linked immunosorbent assay (ELISA) together with commercial and inhouse antibody tests, which have been developed using antigens in a cocktail-like format. The downside is that lower reactivity has been described for this format compared with the rates obtained after testing these components individually (9,13,22). In our previous studies, when the single proteins MPT64 and MT10.3 were tested individually for each patient, the combined results achieved a 76% sensitivity rate in...

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Section: Discussionmentioning

confidence: 82%

Assessment of the IgA Immunoassay Diagnostic Potential of the Mycobacterium tuberculosis MT10.3-MPT64 Fusion Protein in Tuberculous Pleural Fluid

Araujo

Maciel

Trajman

et al. 2010

Clin Vaccine Immunol

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“…Sample sizes in the three studies were between 81 206 and 125 207 and TB prevalence ranged from 56% 208 to 70%. 207 The commercial tests (ICT, 208 Anda TB IgG 207 and Anda TB IgM 207 ) were each evaluated in serum and in pleural fluid samples. The in-house test evaluation 206 was carried out with pleural fluid samples only.…”

Section: Anti-tb Antibody Testsmentioning

confidence: 99%

A systematic review of rapid diagnostic tests for the detection of tuberculosis infection

Dinnes¹,

Deeks²,

Kunst³

et al. 2007

Health Technol Assess

530

361

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) programme, now part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the costs, effectiveness and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs-led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in the NHS, the public and consumer groups and professional bodies such as ...

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“…Among pleural fluid antibody tests, detection of IgA against MPT-64 and MT-10.3 (Rv3019c), two recombinant protein antigens, had the best sensitivity [20,40]. Anti-A60 IgM and IgG antibodies in pleural fluid had suboptimal sensitivity for TB [41]. Using antibodies against five different antigens, CHIERAKUL et al [42] found the performance of serology of pleural fluid to be disappointing, with sensitivity and specificity ,60%.…”

Section: B-cell Response (Antibody Detection)mentioning

confidence: 99%

Novel tests for diagnosing tuberculous pleural effusion: what works and what does not?

Trajman

Pai²,

Dheda³

et al. 2008

European Respiratory Journal

140

121

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Tuberculous pleuritis is a common manifestation of extrapulmonary tuberculosis and is the most common cause of pleural effusion in many countries. Conventional diagnostic tests, such as microscopic examination of the pleural fluid, biochemical tests, culture of pleural fluid, sputum or pleural tissue, and histopathological examination of pleural tissue, have known limitations. Due to these limitations, newer and more rapid diagnostic tests have been evaluated. In this review, the authors provide an overview of the performance of new diagnostic tests, including markers of specific and nonspecific immune response, nucleic acid amplification and detection, and predictive models based on combinations of markers. Directions for future development and evaluation of novel assays and biomarkers for pleural tuberculosis are also suggested.

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The value of pleural fluid anti-A60 IgM in BCG-vaccinated tuberculous pleurisy patients

Abstract: We suggest that in populations where tuberculosis prevalence is high and BCG vaccination is common, pleural fluid anti-A60 IgM can facilitate the diagnosis of TP.

Cited by 15 publications

References 20 publications

Assessment of the IgA Immunoassay Diagnostic Potential of the Mycobacterium tuberculosis MT10.3-MPT64 Fusion Protein in Tuberculous Pleural Fluid

Assessment of the IgA Immunoassay Diagnostic Potential of the Mycobacterium tuberculosis MT10.3-MPT64 Fusion Protein in Tuberculous Pleural Fluid

A systematic review of rapid diagnostic tests for the detection of tuberculosis infection

Novel tests for diagnosing tuberculous pleural effusion: what works and what does not?

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