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首页> 外文期刊>Clinical and diagnostic laboratory immunology >Immunoglobulin A (IgA) and IgG Immune Responses against P-90 Antigen for Diagnosis of Pulmonary Tuberculosis and Screening for Mycobacterium tuberculosis Infection
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Immunoglobulin A (IgA) and IgG Immune Responses against P-90 Antigen for Diagnosis of Pulmonary Tuberculosis and Screening for Mycobacterium tuberculosis Infection

机译：针对P-90抗原的免疫球蛋白A（IgA）和IgG免疫反应，用于肺结核的诊断和结核分枝杆菌感染的筛查

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摘要

The purpose of the present study was to evaluate the usefulness of detection of serum immunoglobulin A (IgA) and IgG antibodies directed against the mycobacterial P-90 antigen for the diagnosis of active pulmonary tuberculosis (PTB) among symptomatic individuals and for the detection of Mycobacterium tuberculosis infections among close contacts of PTB patients. Two commercially available enzyme immunoassay (EIA) kits (IgA EIA-TB [EIA-IgA] and IgG EIA-TB [EIA-IgG]; Kreatech Diagnostics) were evaluated in a blinded fashion by using stored serum samples from 268 individuals, including 69 patients with PTB, 41 patients with diseases other than tuberculosis (TB), 12 subjects with healed PTB, 39 close contacts of PTB patients, and 107 healthy volunteers. For the EIA-IgA, the sensitivity was 74% and the specificity was 68% when a cutoff determined by a receiver operator characteristic curve was used. For the EIA-IgG, the sensitivity was 69% and the specificity was 64%. The EIA-IgA was positive for 54% of healthy close contacts of PTB patients but only 8% of healthy controls without contact with a PTB patient or a prior personal history of TB (P < 0.001). The relatively low sensitivities and specificities of these serologic tests make them poor tools for the diagnosis of PTB among patients with suspected PTB. However, the relatively high prevalence of positive EIA-IgA results among healthy close contacts of PTB patients warrants further evaluation of this test with close contacts and other populations at risk for recent M. tuberculosis exposure and development of disease.
机译：本研究的目的是评估针对分枝杆菌P-90抗原的血清免疫球蛋白A（IgA）和IgG抗体的检测对有症状个体中活动性肺结核（PTB）的诊断和对<结核分枝杆菌患者密切接触者中的结核分枝杆菌感染。通过使用来自268个个体（包括69个个体）的储存血清样本以盲法评估了两种市售的酶免疫测定（EIA）试剂盒（IgA EIA-TB [EIA-IgA]和IgG EIA-TB [EIA-IgG]; Kreatech Diagnostics） PTB患者，41例非结核（TB）疾病，12例PTB治愈的患者，39例PTB患者的密切接触者和107名健康志愿者。对于EIA-IgA，当使用由接收者操作者特征曲线确定的临界值时，灵敏度为74％，特异性为68％。对于EIA-IgG，敏感性为69％，特异性为64％。 EIA-IgA在54％的PTB患者健康密切接触中呈阳性，但在未与PTB患者接触或先前有结核病个人史的健康对照中只有8％（ P <0.001）。这些血清学检测的相对较低的敏感性和特异性使其成为可疑PTB患者诊断PTB的不良工具。但是，PTB患者健康密切接触者中EIA-IgA阳性阳性结果的相对较高，需要进一步评估具有密切接触者和其他近期罹患M风险的人群的此项测试。结核病的暴露和疾病的发展。

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