Validation of the ALS assay in adult patients with culture confirmed pulmonary tuberculosis.
BACKGROUND: We have earlier shown that Bacille Calmette-Guérin (BCG) vaccine-specific IgG Antibodies in Lymphocyte Supernatant (ALS) can be used for diagnosis of active tuberculosis (TB) in adults and children. METHODOLOGY/PRINCIPAL FINDINGS: The ALS method was validated in a larger cohort (n = 212)...
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doaj-ef3ff5410ecc4a96af1efeedcff477472020-11-25T02:00:26ZengPublic Library of Science (PLoS)PLoS ONE1932-62032011-01-0161e1642510.1371/journal.pone.0016425Validation of the ALS assay in adult patients with culture confirmed pulmonary tuberculosis.Rokeya Sultana RekhaS M Mostafa KamalPeter AndersenZeaur RahimMd Imranul HoqGul AraJan AnderssonDavid SackRubhana RaqibBACKGROUND: We have earlier shown that Bacille Calmette-Guérin (BCG) vaccine-specific IgG Antibodies in Lymphocyte Supernatant (ALS) can be used for diagnosis of active tuberculosis (TB) in adults and children. METHODOLOGY/PRINCIPAL FINDINGS: The ALS method was validated in a larger cohort (n = 212) of patients with suspicion of pulmonary TB using multiple antigens (BCG, LAM, TB15.3, TB51A, CFP10-ESAT6-A, CFP, CW) from Mycobacterium tuberculosis. The sensitivity and specificity of the ALS assay was calculated using non-TB patients as controls. The sensitivity and the specificity were highest with BCG vaccine (90% and 88% respectively) followed by LAM (89% and 87% respectively). Simultaneous assessment of multiple antigen-specific antibodies increased sensitivity (91%) and specificity (88%). Using higher lymphocyte count in smaller volume of culture media increased detection and reduced the assay duration to ∼30 hrs. Twenty one patients with clinical findings strongly suggestive of TB finally diagnosed as non-TB patients were positive by the ALS assay, of which 9 (43%) were positive for 7 antigens and 19 (90%) for at least 3 antigens. CONCLUSIONS/SIGNIFICANCE: Our findings show that simultaneous detection of antigens improves the diagnostic potential of the ALS assay; the modified method increases sensitivity and can provide results in <48 hours, and enable detection of some cases of pulmonary TB that are not detectable by standard methods.http://europepmc.org/articles/PMC3025031?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rokeya Sultana Rekha S M Mostafa Kamal Peter Andersen Zeaur Rahim Md Imranul Hoq Gul Ara Jan Andersson David Sack Rubhana Raqib |
spellingShingle |
Rokeya Sultana Rekha S M Mostafa Kamal Peter Andersen Zeaur Rahim Md Imranul Hoq Gul Ara Jan Andersson David Sack Rubhana Raqib Validation of the ALS assay in adult patients with culture confirmed pulmonary tuberculosis. PLoS ONE |
author_facet |
Rokeya Sultana Rekha S M Mostafa Kamal Peter Andersen Zeaur Rahim Md Imranul Hoq Gul Ara Jan Andersson David Sack Rubhana Raqib |
author_sort |
Rokeya Sultana Rekha |
title |
Validation of the ALS assay in adult patients with culture confirmed pulmonary tuberculosis. |
title_short |
Validation of the ALS assay in adult patients with culture confirmed pulmonary tuberculosis. |
title_full |
Validation of the ALS assay in adult patients with culture confirmed pulmonary tuberculosis. |
title_fullStr |
Validation of the ALS assay in adult patients with culture confirmed pulmonary tuberculosis. |
title_full_unstemmed |
Validation of the ALS assay in adult patients with culture confirmed pulmonary tuberculosis. |
title_sort |
validation of the als assay in adult patients with culture confirmed pulmonary tuberculosis. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2011-01-01 |
description |
BACKGROUND: We have earlier shown that Bacille Calmette-Guérin (BCG) vaccine-specific IgG Antibodies in Lymphocyte Supernatant (ALS) can be used for diagnosis of active tuberculosis (TB) in adults and children. METHODOLOGY/PRINCIPAL FINDINGS: The ALS method was validated in a larger cohort (n = 212) of patients with suspicion of pulmonary TB using multiple antigens (BCG, LAM, TB15.3, TB51A, CFP10-ESAT6-A, CFP, CW) from Mycobacterium tuberculosis. The sensitivity and specificity of the ALS assay was calculated using non-TB patients as controls. The sensitivity and the specificity were highest with BCG vaccine (90% and 88% respectively) followed by LAM (89% and 87% respectively). Simultaneous assessment of multiple antigen-specific antibodies increased sensitivity (91%) and specificity (88%). Using higher lymphocyte count in smaller volume of culture media increased detection and reduced the assay duration to ∼30 hrs. Twenty one patients with clinical findings strongly suggestive of TB finally diagnosed as non-TB patients were positive by the ALS assay, of which 9 (43%) were positive for 7 antigens and 19 (90%) for at least 3 antigens. CONCLUSIONS/SIGNIFICANCE: Our findings show that simultaneous detection of antigens improves the diagnostic potential of the ALS assay; the modified method increases sensitivity and can provide results in <48 hours, and enable detection of some cases of pulmonary TB that are not detectable by standard methods. |
url |
http://europepmc.org/articles/PMC3025031?pdf=render |
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