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Free Content IgA antibody responses to Mycobacterium tuberculosis recombinant MPT-64 and MT-10.3 (Rv3019c) antigens in pleural fluid of patients with tuberculous pleurisy

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SETTING: Microbiological tests lack sensitivity for pleural tuberculosis (TB) and histopathology is expensive, time consuming and needs specialised personnel. Immunoassay (ELISA) may be a promising approach in this respect.

OBJECTIVE: To evaluate the reactivity of IgA antibody to MPT-64 and MT-10.3 recombinant mycobacterial protein antigens in pleural fluid as a marker of pleural TB, based on the fact that IgA is the main antibody in the mucosa/serosa of the gastrointestinal and respiratory tract.

METHOD: Anti-MPT-64 and MT-10.3 IgA response was determined by ELISA in 72 patients with pleural TB and 27 with other pleural conditions.

RESULTS: High sensitivities for IgA were measured against MPT-64 (52/72, 72%) and MT-10.3 (52/72, 72%) antigens. Combining the sensitivities of both antigens, further increase in sensitivity (55/72, 76%) was obtained with no loss of specificity (96%). Similar IgA reactivity was obtained from culture-negative and culture-positive specimens. In eight pleural TB patients with human immunodeficiency virus (HIV) co-infection, the sensitivity was 88% (7/8).

CONCLUSION: To our knowledge, this is the first description of the presence of IgA antibody pleural TB effusion reactive to MPT-64 and MT-10.3, with sensitivity similar to histopathological examination, which is presently considered the gold standard for pleural TB.
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Keywords: IgA; MPT-64; MT-10.3; pleural tuberculosis; recombinant antigen

Document Type: Regular Paper

Affiliations: 1: Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; and Fundação Técnico-Educacional Souza Marques, Rio de Janeiro, Brazil 2: Laboratório de Hanseníase, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil 3: Fundação Técnico-Educacional Souza Marques, Rio de Janeiro, Brazil; and Universidade Gama Filho, Rio de Janeiro, Brazil 4: Universidade Gama Filho, Rio de Janeiro, Brazil 5: Lionex Diagnostics & Therapeutics GmbH, Braunschweig, Germany

Publication date: 01 April 2005

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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