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EVALUATION OF LIONEX TB KITS AND MYCOBACTERIAL ANTIGENS FOR IGG AND IGA DETECTION IN CEREBROSPINAL FLUID FROM TUBERCULOSIS MENINGITIS PATIENTS
Líquido Cefalorraquidiano
Ensaio de Imunoadsorção Enzimática
Mycobacterium tuberculosis
Resposta imune
cerebrospinal fluid
ELISA
meningoencephalitis tuberculosis
Mycobacterium tuberculosis
immune response
Author
Affilliation
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Microbiologia Celular. Rio de Janeiro, RJ. Brasil.
Lionex Diagnostics and Therapeutics. Braunschweig, Germany.
Lionex Diagnostics and Therapeutics. Braunschweig, Germany.
Universidade Federal do Rio de Janeiro. Laboratório Neurolife. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Microbiologia Celular. Rio de Janeiro, RJ. Brasil.
Universidade Federal do Rio de Janeiro. Laboratório Neurolife. Rio de Janeiro, RJ, Brasil.
Lionex Diagnostics and Therapeutics. Braunschweig, Germany.
Lionex Diagnostics and Therapeutics. Braunschweig, Germany.
Universidade Federal do Rio de Janeiro. Laboratório Neurolife. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Microbiologia Celular. Rio de Janeiro, RJ. Brasil.
Universidade Federal do Rio de Janeiro. Laboratório Neurolife. Rio de Janeiro, RJ, Brasil.
Abstract
To evaluate commercial Lionex TB together with four antigens of Mycobacterium tuberculosis (MPT-64, MT10.3, 16 kDa and 38 kDa) for IgG and IgA cerebrospinal fluid (CSF) detection in the diagnosis of tuberculosis meningitis (TBM) with CSF negative acid-fast bacilli staining, 19 cases of TBM, 64 cases of other infectious meningoencephalitis and 73 cases of other neurological disorders were tested by enzyme linked immunosorbent assay. IgA-MPT-64 and IgG Lionex showed the highest sensitivities, specificities, positive predictive value and negative predictive value (63.2%, 47.4%; 95%, 93.7%; 40%, 98% and 28.4%, 97.1%, respectively). However, while grey zone was 12.7% and 6%, respectively, lowering sensitivity but maintains high specificity (≥ 95%). High protein concentration in CSF was associated with antibody positivity CSF/HIV+ which did not influence the sensitivity of both tests. To our knowledge, this is the first description of IgA-MPT-64 and IgG Lionex antibodies in CSF-TBM and, although there is good specificity, adjustments are needed based on antigen composition to enhance sensitivity.
Keywords in Portuguese
TuberculoseLíquido Cefalorraquidiano
Ensaio de Imunoadsorção Enzimática
Mycobacterium tuberculosis
Resposta imune
Keywords
tuberculosiscerebrospinal fluid
ELISA
meningoencephalitis tuberculosis
Mycobacterium tuberculosis
immune response
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