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New synthetic lipid antigens for rapid serological diagnosis of tuberculosis

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Ramsay_2017_PLoSONE_LipidAntigens_CC.pdf (1.475Mb)
Date
14/08/2017
Author
Jones, Alison
Pitts, Mark
Al Dulayymi, Juma’a R.
Gibbons, James
Ramsay, Andrew
Goletti, Delia
Gwenin, Christopher D.
Baird, Mark S.
Keywords
RA0421 Public health. Hygiene. Preventive Medicine
DAS
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Abstract
Background:  During pulmonary tuberculosis (PTB) antibodies are generated to trehalose esters of mycolic acids which are cell wall lipids of Mycobacterium tuberculosis (Mtb). Attempts have been made to use these complex natural mixtures in serological tests for PTB diagnosis. Aim:  The aim of this work was to determine whether a serological test based on a panel of defined individual trehalose esters of characteristic synthetic mycolic acids has improved diagnostic accuracy in distinguishing patients with culture positive PTB from individuals who were Mtb culture negative.  Method:  One hundred serum samples from well-characterized patients with presumptive tuberculosis, and diagnosed as having pulmonary smear and culture positive TB, or being culture and smear negative were evaluated by ELISA using different combinations of synthetic antigens and secondary antibodies. Using cut-off values determined from these samples, we validated this study blind in samples from a further 249 presumptive TB patients. Results:  With the first 100 samples, detailed responses depended both on the precise structure of the antigen and on the secondary antibody. Using a single antigen, a sensitivity/specificity combination for smear and culture positive PTB detection of 85 and 88% respectively was achieved; this increased to 96% and 95% respectively by a statistical combination of the results with seven antigens. In the blind study a sensitivity/specificity of 87% and 83% was reached with a single antigen. With some synthetic antigens, the responses from all 349 samples were significantly better than those with the natural mixture. Combining the results for seven antigens allowed a distinction between culture positive and negative with a ROC AUC of 0.95.  Conclusion:  We have identified promising antigen candidates for serological assays that could be used to diagnose PTB and which could be the basis of a much-needed, simple, rapid diagnostic test that would bring care closer to communities.
Citation
Jones , A , Pitts , M , Al Dulayymi , J R , Gibbons , J , Ramsay , A , Goletti , D , Gwenin , C D & Baird , M S 2017 , ' New synthetic lipid antigens for rapid serological diagnosis of tuberculosis ' , PLoS One , vol. 12 , no. 8 , e0181414 . https://doi.org/10.1371/journal.pone.0181414
Publication
PLoS One
Status
Peer reviewed
DOI
https://doi.org/10.1371/journal.pone.0181414
ISSN
1932-6203
Type
Journal article
Rights
© 2017 Jones et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Description
Funding for this work was provided by theWelsh Government A4B Programme, grant HE06 POC1022 to MSB and CDG.
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  • University of St Andrews Research
URL
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0181414#sec020
URI
http://hdl.handle.net/10023/11470

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