A Study of Tubercular Antigen and Antibody in Childhood Tuberculosis

Ashtekar, M D; Samuel, A.M.; Kameswaran, Mythili; Kadival, G V; Sakhalkar, V S; Rajadhyaksha, Surekha

doi:10.1093/tropej/38.1.22

Cited by 5 publications

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“…Although one of the major drawbacks, especially in serological tests, is the persistence of antibodies even after effective treatment, measurement of the antibody response to 38-kDa antigen has been found to be useful in assessing the effectiveness of treatment in patients with tuberculous meningitis (24). A radioimmunoassay for the detection of M. tuberculosis antigen and anti-M. tuberculosis antibodies developed at the Laboratory Nuclear Medicine Section of the Bhabha Atomic Research Centre has been tested with samples from patients with various clinical manifestations of tuberculosis (1,2,22,24,(36)(37)(38). It was demonstrated that detection of antigen and antibody gave a good sensitivity and specificity for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Almost all the assays developed at the Laboratory Nuclear Medicine Section of the Bhabha Atomic Research Centre require the detection of both antigen and antibody from clinical samples (1,2,(21)(22)(23)(36)(37)(38). With the incidence of tuberculosis being on the rise and with the added risk of coinfection with human immunodeficiency virus (HIV), the need at this time is for a test with good sensitivity and specificity for rapid and early diagnosis.…”

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Evaluation of an In-House-Developed Radioassay Kit for Antibody Detection in Cases of Pulmonary Tuberculosis and Tuberculous Meningitis

Kameswaran

Shetty

Ray

et al. 2002

Clin Vaccine Immunol

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A radioassay for the detection of antitubercular antibody has been developed. The technique involves the addition of 125 I-labeled Mycobacterium tuberculosis antigen as a tracer, diluted clinical sample (serum or cerebrospinal fluid [CSF]), and heat-inactivated Staphylococcus aureus to capture the antibody, incubation for 4 h, and quantitation of the amount of antibody present in the sample. A total of 330 serum samples from patients with pulmonary tuberculosis and 138 control serum samples from individuals who were vaccinated with M. bovis BCG and from patients with pulmonary disorders of nontubercular origin were analyzed. Also, 26 CSF samples from patients with tuberculous meningitis and 24 CSF samples as controls from patients with central nervous system disorders of nontuberculous origin were analyzed. Sensitivities of 80 and 73% were observed for patients with pulmonary tuberculosis and tuberculous meningitis, respectively, and specificities of 90 and 88% were seen for the two groups of patients, respectively. The sensitivity was lower, however, for human immunodeficiency virus-infected patients coinfected with M. tuberculosis. The control population could be differentiated from the patient population. This assay is rapid and user friendly and, with its good sensitivity and specificity, should benefit the population by providing diagnoses early in the course of disease and, hence, permit the early administration of appropriate chemotherapy.Tuberculosis, caused by Mycobacterium tuberculosis, represents a major health problem worldwide. It is estimated that almost one-third of the entire world's population is exposed to this disease (26). In 1993, the World Health Organization declared tuberculosis a global emergency and estimated that by the start of the new millennium there would be more than 1 billion newly infected individuals and more than 17 million deaths due to this disease if control programs were not implemented properly. These control programs are dependent on good tests for early diagnosis, constant monitoring of disease status, and response to and completion of treatment.The diagnosis of tuberculosis has never been simple, especially in children and in patients with extrapulmonary tuberculosis, from whom clinical specimens for microscopy and culture are not easily obtained. Even in patients with pulmonary tuberculosis, diagnosis by microscopy is rather insensitive and culture is time-consuming.Since the mid-1970s radioimmunoassay and enzyme-linked immunosorbent assay (ELISA) techniques have been developed for the detection of M. tuberculosis antigen and anti-M. tuberculosis antibody from clinical specimens, and these assays have various degrees of sensitivity and specificity (1, 2, 4, 7, 8, 13, 21-25, 28, 36-39, 41, 43). Almost all the assays developed at the Laboratory Nuclear Medicine Section of the Bhabha Atomic Research Centre require the detection of both antigen and antibody from clinical samples (1, 2, 21-23, 36-38). With the incidence of tuberculosis being on the rise and with the added...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Evaluation of an In-House-Developed Radioassay Kit for Antibody Detection in Cases of Pulmonary Tuberculosis and Tuberculous Meningitis

Kameswaran

Shetty

Ray

et al. 2002

Clin Vaccine Immunol

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“…Crianças com TB, no entanto, tendem a apresentar títulos menores que os adultos. Tais títu-los tendem a aumentar proporcionalmente à idade e duração da doença, refletindo a maturação do sistema imunológico e a exposição prolongada à micobactéria 50,51 .…”

Section: Imunologia E Patogêneseunclassified

The challenge of pediatric tuberculosis in face of new diagnostic techniques

et al. 2009

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Objectives: To present an updated review concerning new assays for diagnosing tuberculosis based on in vitro interferon-gamma production by host T cells, and compare them with tuberculin skin test. Sources:A literature review was carried out based on Medline and LILACS databases (2000-2008) searching for the following keywords: tuberculosis, interferon-gamma, quantiFERON, ELISPOT and T-SPOT.TB. Summary of the findings:These new assays proved to have, in general, equal or superior sensitivity and specificity than the tuberculin skin test not only in adults but also in children and immunosuppressed patients for the diagnosis of both latent tuberculosis infection or active disease, with some advantages such as less cross-reactivity as a result of previous BCG vaccination, less influence of anergy and better accuracy in small children. In the United States, these assays have been used instead of the tuberculin skin test and, although still very expensive, the World Health Organization will be making its economic viability a priority. Conclusions:Always having in mind the importance of clinical and epidemiological histories, these new assays based on interferon-gamma release present promising results and should be considered in tuberculosis investigation procedures for all patients, however with a special concern in the risk groups (i.e., children and immunosuppressed patients).J Pediatr (Rio J). 2009;85(3):183-193: Tuberculosis, interferongamma, quantiFERON, ELISPOT, children, immunosuppression. ResumoObjetivo: Apresentar uma revisão atualizada sobre os novos métodos para o diagnóstico da tuberculose baseados na produção in vitro de interferon-gama (IFN-γ) por células T dos pacientes sob investigação, comparando-os com a tradicional prova tuberculínica. (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) utilizando as palavras-chave tuberculose, interferon-gama, quantiFERON, ELISPOT e T-SPOT.TB. Fontes dos dados: Revisão de literatura utilizando os bancos de dados MEDLINE e LILACS Síntese dos dados:Esses novos testes mostraram-se, de um modo geral, tão ou mais sensíveis e específicos que a prova tuberculínica, tanto em adultos como em crianças e imunossuprimidos, para o diagnóstico da infecção latente e da doença ativa, apresentando vantagens como a menor interferência da vacinação prévia pelo BCG, menor influência de estados anérgicos e melhor acurácia em crianças menores. Nos Estados Unidos, já estão sendo utilizados em substituição à prova tuberculínica, e apesar dos custos ainda elevados, a Organização Mundial de Saúde vai priorizar a sua viabilidade econômica. Conclusões:Sempre levando em conta a importância da história clínica e epidemiológica, os novos testes baseados na produção de IFN-γ apresentam resultados promissores e deverão ser considerados na investigação de tuberculose em qualquer paciente, mas especialmente nos grupos de risco, como as crianças e os imunossuprimidos.J Pediatr (Rio J). 2009;85(3):183-193

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“…Such titers tend to increase proportionally to age and disease duration, reflecting the maturation of the immune system and the long-lasting exposure to mycobacteria. 50,51 TNF-α plays an important role in the immune response to Mycobacterium tuberculosis and in the disease immunopathology. 8 It is a pro-inflammatory cytokine produced by macrophages activated as a response to several stimuli such as lipopolysaccharides and viral and bacterial infections.…”

Section: Immunology and Pathogenesismentioning

confidence: 99%

O desafio da tuberculose na faixa etária pediátrica frente a novas técnicas diagnósticas

Sztajnbok

Boecha

Sztajnbok

et al. 2009

J. Pediatr. (Rio J.)

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Objectives: To present an updated review concerning new assays for diagnosing tuberculosis based on in vitro interferon-gamma production by host T cells, and to compare them with tuberculin skin test.Sources: A literature review was carried out based on MEDLINE and LILACS databases (2000-2008) searching for the following keywords: tuberculosis, interferon-gamma, quantiFERON, ELISPOT and T-SPOT.TB. Summary of the findings:These new assays proved to have, in general, equal or superior sensitivity and specificity than the tuberculin skin test not only in adults but also in children and immunosuppressed patients for the diagnosis of both latent tuberculosis infection or active disease, with some advantages such as less cross-reactivity as a result of previous BCG vaccination, less influence of anergy and better accuracy in small children. In the United States, these assays have been used instead of the tuberculin skin test and, although still very expensive, the World Health Organization will be making its economic viability a priority. Conclusions:Always having in mind the importance of clinical and epidemiological histories, these new assays based on interferon-gamma release present promising results and should be considered in tuberculosis investigation procedures for all patients, however with a special concern in the risk groups (i.e., children and immunosuppressed patients).J Pediatr (Rio J). 2009;85(3):183-193: Tuberculosis, interferon-gamma, quantiFERON, ELISPOT, children, immunosuppression.

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A Study of Tubercular Antigen and Antibody in Childhood Tuberculosis

Cited by 5 publications

References 0 publications

Evaluation of an In-House-Developed Radioassay Kit for Antibody Detection in Cases of Pulmonary Tuberculosis and Tuberculous Meningitis

Evaluation of an In-House-Developed Radioassay Kit for Antibody Detection in Cases of Pulmonary Tuberculosis and Tuberculous Meningitis

The challenge of pediatric tuberculosis in face of new diagnostic techniques

O desafio da tuberculose na faixa etária pediátrica frente a novas técnicas diagnósticas

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