Combined Use of Serum and Urinary Antibody for Diagnosis of Tuberculosis

• Published in: The Journal of infectious diseases Vol. 188; no. 3; pp. 371 - 377
• Main Authors: Singh, Krishna K., Dong, Yuxin, Hinds, Laura, Keen, Marc A., Belisle, John T., Zolla-Pazner, Susan, Achkar, Jacqueline M., Arthur J., Nadas, Arora, Vijay K., Laal, Suman
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-08-2003; University of Chicago Press; Oxford University Press
• Subjects: Adult; Aged; Antibodies; Antibodies, Bacterial - blood; Antibodies, Bacterial - urine; Antigens; Antigens, Bacterial - analysis; Antigens, Bacterial - immunology; Bacterial diseases; Bacterial Proteins - analysis; Bacterial Proteins - immunology; Biological and medical sciences; Female; Glycoproteins - analysis; Glycoproteins - immunology; HIV; Human bacterial diseases; Humans; Immunoassay - methods; Infectious diseases; Male; Medical diagnostic tests; Medical sciences; Middle Aged; Mycobacterium tuberculosis; Mycobacterium tuberculosis - immunology; Mycobacterium tuberculosis - isolation & purification; Reactivity; Sensitivity and Specificity; Specimens; Tuberculosis; Tuberculosis - blood; Tuberculosis - diagnosis; Tuberculosis - urine; Tuberculosis and atypical mycobacterial infections; Tuberculosis vaccine; Urine; Infection; Human; Urine; Tuberculosis; Antibody; Bacteriosis; Serum; Mycobacterial infection; Diagnosis; Immunological method
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/376532

Efforts to devise immunoassays for tuberculosis (TB) that can be adapted to rapid formats are ongoing. The present study was aimed at determining whether urinary anti-Mycobacterium tuberculosis antibodies are present in patients with TB, to evaluate the feasibility of developing a urine antibody-based diagnostic test. Urinary antibodies directed against the culture filtrate proteins of M. tuberculosis, MPT 32, and the 81-kDa GlcB protein were detectable in patients with TB, although the sensitivity of antibody detection was lower (53%-64%), compared with serum antibodies (68%-77%). Surprisingly, with all 3 antigens, the use of paired serum and urine samples provided higher sensitivities of antibody detection than either single specimen, and anti-GlcB antibodies were present in the serum and/or urine of 39 (90%) of 43 smear-positive patients with TB. Although, with the current methods and antigens, the level of sensitivity is insufficient to design a urinary antibody diagnostic test, these studies provide the foundation for further studies on the development of a urine antibody-based immunoassay for TB.