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Cell wall mycolic acids (MA) from Mycobacterium tuberculosis (M.tb) are CD1b presented antigens that can be used to detect antibodies as surrogate markers of active TB, even in HIV coinfected patients. The use of the complex mixtures of natural MA is complicated by an apparent antibody cross-reactivity with cholesterol. Here firstly we report three recombinant monoclonal scFv antibody fragments in the chicken germ-line antibody repertoire, which demonstrate the possibilities for cross-reactivity: the first recognized both cholesterol and mycolic acids, the second mycolic acids but not cholesterol, and the third cholesterol but not mycolic acids. Secondly, MA structure is experimentally interrogated to try to understand the cross-reactivity. Unique synthetic mycolic acids representative of the three main functional classes show varying antigenicity against human TB patient sera, depending on the functional groups present and on their stereochemistry. Oxygenated (methoxy- and keto-) mycolic acid was found to be more antigenic than alpha-mycolic acids. Synthetic methoxy-mycolic acids were the most antigenic, one containing a trans-cyclopropane apparently being somewhat more antigenic than the natural mixture. Trans-cyclopropane-containing keto- and hydroxy-mycolic acids were also found to be the most antigenic among each of these classes. However, none of the individual synthetic mycolic acids significantly and reproducibly distinguished the pooled serum of TB positive patients from that of TB negative patients better than the natural mixture of MA. This argues against the potential to improve the specificity of serodiagnosis of TB with a defined single synthetic mycolic acid antigen from this set, although sensitivity may be facilitated by using a synthetic methoxy-mycolic acid.

The integrity and properties of mycolic acid (MA) antigens integrated into a self-assembled monolayer (SAM) of N-(2-mercaptoethyl)octadecanamide, (MEODA), on a gold electrode have been interrogated using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). EIS data showed that Au-MEODA and Au-MEODA-MA behave as microelectrode arrays, with pinholes acting as the microelectrodes that permit electron transport between a redox-active probe in solution and the underlying gold surface. The average radii of the pinholes (r a ) and half the distance between the centers of the neighbouring pinholes (r b ), were estimated from EIS using the pore size model, and discussed. Anti-MA antibodies present in a tuberculosis (TB)-infected patient (co-infected with HIV) strongly interact with Au-MEODA-MA showing a rather compact and stable bio-complex structure that is virtually defect-free. The electrochemical impedimetric properties associated with the ability of the Au-MEODA-MA to discriminate between TB positive and negative human sera are also discussed. We prove that the Au-MEODA and Au-MEODA-MA electrodes, as well as the MA-anti-MA antibody interactions, are characterized with time-constant dispersion, typical of microstructures with grain/grain boundary phases. These crucial physico-electrochemical insights into the behaviour of surface-confined MA should provide a useful basis for the design and development of a potential impedimetric immunosensing platform for active tuberculosis.

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