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dc.contributor.authorJones, Alison
dc.contributor.authorPitts, Mark
dc.contributor.authorAl Dulayymi, Juma’a R.
dc.contributor.authorGibbons, James
dc.contributor.authorRamsay, Andrew
dc.contributor.authorGoletti, Delia
dc.contributor.authorGwenin, Christopher D.
dc.contributor.authorBaird, Mark S.
dc.identifier.citationJones , 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 .
dc.identifier.otherPURE: 250826008
dc.identifier.otherPURE UUID: 9cca180f-fc79-4703-869e-e5066860a8c9
dc.identifier.otherRIS: urn:1479C870DE795190BBF801694B1FF7D7
dc.identifier.otherScopus: 85027325929
dc.identifier.otherWOS: 000407548800007
dc.descriptionFunding for this work was provided by theWelsh Government A4B Programme, grant HE06 POC1022 to MSB and CDG.en
dc.description.abstractBackground:  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.
dc.relation.ispartofPLoS Oneen
dc.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.en
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.titleNew synthetic lipid antigens for rapid serological diagnosis of tuberculosisen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.description.statusPeer revieweden

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