Diagnostic Value of Early Secreted Antigenic Target-6 for the Diagnosis of Tuberculous Meningitis Patients

Kashyap, Rajpal S.; Ramteke, Suman; Morey, Shweta H; Purohit, Hemant J.; Taori, Girdhar M.; Daginawala, Hatim F.

doi:10.1007/s15010-009-8261-x

Cited by 28 publications

(23 citation statements)

References 27 publications

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“…Previously, ESAT-6 was used as a diagnostic reagent to discriminate TB infection from previous Bacillus Calmette-Guérin (BCG) vaccination (Kashyap et al 2009). However, it also involves in the virulence and pathogenicity of MTB (Boggaram et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Early Diagnosis of Tuberculosis-Associated IgA Nephropathy with ESAT-6

Zhao

Sun

et al. 2017

Tohoku J. Exp. Med.

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IgA nephropathy (IgAN) is the most common cause of primary renal diseases worldwide, and the early secreted antigenic target of 6 (ESAT-6) which was secreted by Mycobacterium tuberculosis (MTB) may be involved in the development and progression of IgAN. This study aimed to investigate the role of ESAT-6 for early diagnosis of IgAN caused by MTB infection. From 2011 to 2014, 21 patients with renal tuberculosis (RTB), 25 with IgAN, and 46 with IgAN infected with MTB (IgAN/MTB) were enrolled. Serum levels of antibodies against Mycobacterium tuberculosis antigen 85A (Ag85A) were measured by ELISA. Urine culture and phage amplified biologically assay were performed to detect MTB. HE staining was used to observe the morphological changes in kidney tissues. Immunohistochemistry was applied to detect the expression of ESAT-6. Immunofluorescence staining was conducted to detect IgA1. Positive rates of serum anti-Ag85A antibody and urine culture for MTB were higher in the RTB and IgAN/MTB groups than those in the IgAN group. The positive rates of plaques were also higher in RTB and IgAN/MTB groups than the positive rate in the IgAN group. By contrast, the positive rate of ESAT-6 was lower in the IgAN group than that in the RTB group or the IgAN/MTB group, whereas the expression levels of IgA1 were higher in the IgAN and IgAN/MTB groups, compared with the RTB group. Our findings suggest that ESAT-6 and IgA1 may be helpful for early diagnosis of IgAN caused by MTB infection.

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Section: Introductionmentioning

confidence: 99%

Early Diagnosis of Tuberculosis-Associated IgA Nephropathy with ESAT-6

Zhao

Sun

et al. 2017

Tohoku J. Exp. Med.

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“…Smear microscopy under high-burden programmatic conditions has a dismal yield (0-20%) (8,9,12,13). Culture results are delayed for several weeks, and the yields are variable (5-83%) (10,14).…”

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confidence: 99%

Cerebrospinal T-Cell Responses Aid in the Diagnosis of Tuberculous Meningitis in a Human Immunodeficiency Virus– and Tuberculosis-Endemic Population

Patel

Singh²,

Connolly³

et al. 2010

Am J Respir Crit Care Med

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Rationale: Current tools for the rapid diagnosis of tuberculous meningitis (TBM) are suboptimal. We evaluated the clinical utility of a quantitative RD-1 IFN-g T-cell enzyme-linked immunospot (ELISPOT) assay (T-SPOT.TB), using cerebrospinal fluid cells for the rapid immunodiagnosis of TBM. Objectives: To evaluate the diagnostic utility of the RD1 antigenspecific ELISPOT assay for the diagnosis of tuberculous meningitis. Methods: The ELISPOT assay was evaluated in 150 patients with suspected TBM who were categorized as definite-TBM, probable-TBM, and non-TBM. Culture or polymerase chain reaction positivity for Mycobacerium tuberculosis served as the reference standard. To determine the diagnostic value of the ELISPOT assay, a clinical prediction rule was derived from baseline clinical and laboratory parameters using a multivariable regression model. Measurements and Main Results: A total of 140 patients (81% HIVinfected; median CD4 count, 160 cells/mm 3 ) were included in the final analysis. When comparing the definite-TBM (n 5 38) and non-TBM groups (n 5 48), the ELISPOT assay (cut point of >228 spot-forming cells per 1 million mononuclear cells) was a useful rule-in test: sensitivity 58% (95% confidence interval [CI], 41-74); specificity 94% (95% CI, 83-99). However, ELISPOT outcomes improved when other rapid tests were concurrently used to exclude bacterial (Gram stain) and cryptococcal meningitis (latex-agglutination test) within the non-TBM group. Using this approach, the ELISPOT assay (cut point of >46 spot-forming cells) was an excellent rule-in test: sensitivity 82% (95% CI, 66-92); specificity 100% (95% CI, 78-100); positive predictive value, 100% (95% CI, 89-100); negative predictive value, 68% (95% CI, 45-86); area under the curve, 0.90. The ELISPOT assay had incremental diagnostic value compared with the clinical prediction rule. Conclusions: The RD-1 ELISPOT assay, using cerebrospinal fluid mononuclear cells and in conjunction with other rapid confirmatory tests (Gram stain and cryptococcal latex-agglutination test), is an accurate rapid rule-in test for TBM in a TB and HIV endemic setting.

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“…This group included non-TBM and non-BM infectious patients of viral and fungal meningitis with the observations as reported earlier [15,16] along with good clinical response to antiviral and antifungal drugs respectively.…”

Section: Sample Size Calculationmentioning

confidence: 99%

“…Recruitment of patients in this group was done as per the laboratory findings reported earlier by us [15,16].…”

Section: Sample Size Calculationmentioning

confidence: 99%

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Rapid Diagnosis and Simultaneous Identification of Tuberculous and Bacterial Meningitis by a Newly Developed Duplex Polymerase Chain Reaction

et al. 2015

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The present study describes the development and evaluation of a duplex polymerase chain reaction (D-PCR) for diagnosis and simultaneous identification of tuberculous meningitis (TBM) and bacterial meningitis (BM) in a single reaction. A D-PCR with primers amplifying portions of the Mycobacterium tuberculosis IS6110 and the eubacteria 16SrDNA sequence in a same reaction mix was developed and tested on DNA extracted from 150 clinical CSF samples from different categories (TBM = 39, BM = 26, control infectious and non-infectious category = 85). The results indicate a clear differentiation between bands for eubacteria and M. tuberculosis with an analytical sensitivity of 10 3 cfu/ml for eubacteria and 10 2 cfu/ml for M. tuberculosis. When evaluated in clinical samples, D-PCR overall diagnosed 100 % confirmed TBM and 100 % confirmed BM cases with overall specificity of 96.5 %. D-PCR can be an effective tool for diagnosis and simultaneous identification of TBM or BM in a single PCR reaction. It saves time, cost, labour and sample amount and help in administration of appropriate antimicrobial therapy.The proposed diagnostic assay would be helpful in correct and rapid management of TBM and BM patients.

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Diagnostic Value of Early Secreted Antigenic Target-6 for the Diagnosis of Tuberculous Meningitis Patients

Abstract: The detection of ESAT-6 in the CSF of TBM patients by indirect ELISA is a promising method and can be used to develop an immunodiagnostic assay with increased sensitivity and specificity.

Cited by 28 publications

References 27 publications

Early Diagnosis of Tuberculosis-Associated IgA Nephropathy with ESAT-6

Early Diagnosis of Tuberculosis-Associated IgA Nephropathy with ESAT-6

Cerebrospinal T-Cell Responses Aid in the Diagnosis of Tuberculous Meningitis in a Human Immunodeficiency Virus– and Tuberculosis-Endemic Population

Rapid Diagnosis and Simultaneous Identification of Tuberculous and Bacterial Meningitis by a Newly Developed Duplex Polymerase Chain Reaction

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