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Curr Microbiol (2012) 65:313318
DOI 10.1007/s00284-012-0157-9
Clinical Value of ELISA-MPT64 for the Diagnosis of Tuberculous Pleurisy
Zhonghua Liu Changtai Zhu Hua Yang Haili Hu
Yonghong Feng Lianhua Qin Zhenling Cui Aixiao Bi
Ruijuan Zheng Ruiliang Jin Lin Fan Zhongyi Hu
Received: 31 March 2012 / Accepted: 17 May 2012 / Published online: 7 June 2012 Springer Science+Business Media, LLC 2012
Abstract Tuberculous pleurisy is one of the common extrapulmonary tuberculosis diseases. However, the diagnosis of tuberculous pleurisy still lacks a useful and effective tool, mainly due to paucity of Mycobacterium tuberculosis organisms in pleural effusion. Previous studies have conrmed that the MPT64 protein is highly specic and is secreted only by M. tuberculosis (MTB) complex. Therefore, in this study, we developed ELISA based on recombinantly expressed MPT64 in combination with rabbit polyclonal antibodies. The ELISA-MPT64 method was validated using MTB strains and tested against clinical samples. Nested PCR, LwensteinJensen (LJ) culture and smear microscopy were employed as the comparative tools for assessing the performance of the assay. Our results demonstrate that the newly established ELISA-MPT64 technique is a rapid and useful tool for the diagnosis of tuberculous pleurisy.
Introduction
Tuberculous pleurisy is a common manifestation of extra-pulmonary tuberculosis, with more than 500,000 cases diagnosed each year worldwide [8]. With the increase in multi-drug-resistant TB strains, and even super-resistant strains, together with Human immunodeciency virus
(HIV) secondary infection, case numbers of tuberculous pleurisy are growing. A confounding problem for the control of tuberculous pleurisy is the lack of a useful and effective tool for its diagnosis. This is mainly due to the paucity of M. tuberculosis organisms in pleural effusion, resulting in a relatively low sensitivity of the routinely used testing methods [26]. However, in recent years, deaminase adenosine activity (ADA) tests [2, 15, 24], interferon gamma (IFN-) concentration assay [10, 17, 29], lipoarabinomannan (LAM) detection [6, 9], nucleic acid amplication tests (NAATs) [3, 16, 21], and IFN- releasing assays (IGRAs) [11, 30] for assessing pleural uid have been reported to be relatively reliable and effective. These markers have, however, been revealed to have an uncertain diagnostic accuracy and/or more complicated technical demands, which limits their clinical application. Therefore, it remains an urgent need to develop a simple and useful tool for the diagnosis of...