Use of an Enzyme-Linked Immunosorbent Assay Technique in the Differential Diagnosis of Active Pulmonary Tuberculosis in Humans

Abstract

Sera from patients with active pulmonary tuberculosis and pulmonary diseases frequently mimicking tuberculosis were assayed for immunoglobulin G antibody activity to purified protein derivative (PPD) by an enzyme-linked immunosorbent assay. A method of standardization was developed to limit assay variation. Patients with active pulmonary tuberculosis had a significantly greater mean level of antibody than had patients with atypical tuberculosis (P = 0.005), sarcoidosis (P = 0.0001), histoplasmosis (P = 0.004), blastomycosis (P = 0.008), or cryptococcosis (P = 0.017), patients who had received bacille Calmette-Guérin vaccination (P = 0.003) or who had a history of treated tuberculosis (P = 0.003), and PPD skin test-positive and skin test-negative control subjects (P = 0.001). This technique may have potential use as a rapid diagnostic aid in evaluating patients with suspected active pulmonary tuberculosis.

Interpretation of mycobacterial antibodies in the cerebrospinal fluid of adults with tuberculous meningitis

“…Tuberculous meningitis cases had positive anti-mycobacterial titres in CSF against at least one recombinant antigen (18 cases: 62%), culture filtrate (15 cases: 52%), or both (22: 76%; Table 2), with median anti-mycobacterial titres to the 19kDa, 38kDa and culture filtrate antigens higher for TBM patients than for controls (Figure 1). These findings reaffirmed that a proportion of patients with TBM do mount an antibody-mediated immune response to mycobacterial antigens (Kalish et al 1983;Hernandez et al 1984;Chandramuki et al 2002). Despite the use of recombinant antigens specific for M. tuberculosis, some control patients also had positive antibody responses, most frequently among the SACM controls (n = 10; 59%), rather than the (uninfected) 'reference' CSF controls (n = 5; 26%; Table 2).…”

Detection of antibodies to Mycobacterium tuberculosis plasma membrane antigen by enzyme-linked immunosorbent assay

“…"Antibody activity" was derived by dividing the OD value of the test sample by the OD value of the reference serum and multiplying by 40 (during initial experiments the OD readings of the reference serum were 0.4). A similar reference system was used by Kalish et al (1983) to measure circulating antibodies to purified protein derivative.…”

Enzyme immunoassay using BCG in serodiagnosis of pulmonary tuberculosis

“…by the periodate method (Nakane, 1974) and stored at 4°C until used. The optium conjugate concentration was determined as described previously (Ruitemberg et al 1976 (Kalish et al 1983; Herna'ndez, Mun-oz, &;Guiscafre, 1984).…”

“…Hence, there is still a need for an assay which would be capable of differentiating patients with active and inactive tuberculosis from each other and from healthy persons. Since many reports have recently demonstrated the usefulness of detection of antimyobacterial antibodies in sera for the diagnosis of tuberculosis infection (Nicholls, 1975;Nassau, Parsons & Johnson, 1976;Winters & Cox, 1981) many assays have been devised and, among these, immuoenzymatic assays have been demonstrated to be sensitive and specific (Kardjito & Grange, 1980;Grange, Gibson & Nassau, 1980;Tandon, Saxena & Saxena, 1980;Kalish et al 1983, Hernandez, Muinoz & Guiscafre, 1984. However the major problem of such assays is the need for certain specialized personnel and equipment which usually are not available in rural areas, especially in developing countries.…”