Improving the diagnosis of active tuberculosis : a novel approach using magnetic particle-based chemiluminescence LAM assay
© 2024. The Author(s)..
OBJECTIVES: Tuberculosis (TB) is a significant global health concern, given its high rates of morbidity and mortality. The diagnosis using urine lipoarabinomannan (LAM) primarily benefits HIV co-infected TB patients with low CD4 counts. The focus of this study was to develop an ultra-sensitive LAM assay intended for diagnosing tuberculosis across a wider spectrum of TB patients.
DESIGN & METHODS: To heighten the sensitivity of the LAM assay, we employed high-affinity rabbit monoclonal antibodies and selected a highly sensitive chemiluminescence LAM assay (CLIA-LAM) for development. The clinical diagnostic criteria for active TB (ATB) were used as a control. A two-step sample collection process was implemented, with the cutoff determined initially through a ROC curve. Subsequently, additional clinical samples were utilized for the validation of the assay.
RESULTS: In the assay validation phase, a total of 87 confirmed active TB patients, 19 latent TB infection (LTBI) patients, and 104 healthy control samples were included. Applying a cutoff of 1.043 (pg/mL), the CLIA-LAM assay demonstrated a sensitivity of 55.2% [95%CI (44.13%~65.85%)], and a specificity of 100% [95%CI (96.52%~100.00%)], validated against clinical diagnostic results using the Mann-Whitney U test. Among 11 hematogenous disseminated TB patients, the positive rate was 81.8%. Importantly, the CLIA-LAM assay consistently yielded negative results in the 19 LTBI patients.
CONCLUSION: Overall, the combination of high-affinity antibodies and the CLIA method significantly improved the sensitivity and specificity of the LAM assay. It can be used for the diagnosis of active TB, particularly hematogenous disseminated TB.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2024 |
---|---|
Erschienen: |
2024 |
Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
---|---|
Enthalten in: |
BMC pulmonary medicine - 24(2024), 1 vom: 27. Feb., Seite 100 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Li, Yan [VerfasserIn] |
---|
Links: |
---|
Themen: |
Chemiluminescence assay(CLIA) |
---|
Anmerkungen: |
Date Completed 29.02.2024 Date Revised 01.03.2024 published: Electronic Citation Status MEDLINE |
---|
doi: |
10.1186/s12890-024-02893-2 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM369038703 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | NLM369038703 | ||
003 | DE-627 | ||
005 | 20240301232731.0 | ||
007 | cr uuu---uuuuu | ||
008 | 240229s2024 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1186/s12890-024-02893-2 |2 doi | |
028 | 5 | 2 | |a pubmed24n1313.xml |
035 | |a (DE-627)NLM369038703 | ||
035 | |a (NLM)38413948 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Li, Yan |e verfasserin |4 aut | |
245 | 1 | 0 | |a Improving the diagnosis of active tuberculosis |b a novel approach using magnetic particle-based chemiluminescence LAM assay |
264 | 1 | |c 2024 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 29.02.2024 | ||
500 | |a Date Revised 01.03.2024 | ||
500 | |a published: Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a © 2024. The Author(s). | ||
520 | |a OBJECTIVES: Tuberculosis (TB) is a significant global health concern, given its high rates of morbidity and mortality. The diagnosis using urine lipoarabinomannan (LAM) primarily benefits HIV co-infected TB patients with low CD4 counts. The focus of this study was to develop an ultra-sensitive LAM assay intended for diagnosing tuberculosis across a wider spectrum of TB patients | ||
520 | |a DESIGN & METHODS: To heighten the sensitivity of the LAM assay, we employed high-affinity rabbit monoclonal antibodies and selected a highly sensitive chemiluminescence LAM assay (CLIA-LAM) for development. The clinical diagnostic criteria for active TB (ATB) were used as a control. A two-step sample collection process was implemented, with the cutoff determined initially through a ROC curve. Subsequently, additional clinical samples were utilized for the validation of the assay | ||
520 | |a RESULTS: In the assay validation phase, a total of 87 confirmed active TB patients, 19 latent TB infection (LTBI) patients, and 104 healthy control samples were included. Applying a cutoff of 1.043 (pg/mL), the CLIA-LAM assay demonstrated a sensitivity of 55.2% [95%CI (44.13%~65.85%)], and a specificity of 100% [95%CI (96.52%~100.00%)], validated against clinical diagnostic results using the Mann-Whitney U test. Among 11 hematogenous disseminated TB patients, the positive rate was 81.8%. Importantly, the CLIA-LAM assay consistently yielded negative results in the 19 LTBI patients | ||
520 | |a CONCLUSION: Overall, the combination of high-affinity antibodies and the CLIA method significantly improved the sensitivity and specificity of the LAM assay. It can be used for the diagnosis of active TB, particularly hematogenous disseminated TB | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Chemiluminescence assay(CLIA) | |
650 | 4 | |a Lipoarabinomannan (LAM) | |
650 | 4 | |a Tuberculosis (TB) | |
650 | 7 | |a Lipopolysaccharides |2 NLM | |
700 | 1 | |a Ru, Zhiwei |e verfasserin |4 aut | |
700 | 1 | |a Wei, Hongxia |e verfasserin |4 aut | |
700 | 1 | |a Wu, Ming |e verfasserin |4 aut | |
700 | 1 | |a Xie, Guihua |e verfasserin |4 aut | |
700 | 1 | |a Lou, Jianrong |e verfasserin |4 aut | |
700 | 1 | |a Yang, Xiang |e verfasserin |4 aut | |
700 | 1 | |a Zhang, Xilin |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t BMC pulmonary medicine |d 2001 |g 24(2024), 1 vom: 27. Feb., Seite 100 |w (DE-627)NLM114960313 |x 1471-2466 |7 nnns |
773 | 1 | 8 | |g volume:24 |g year:2024 |g number:1 |g day:27 |g month:02 |g pages:100 |
856 | 4 | 0 | |u http://dx.doi.org/10.1186/s12890-024-02893-2 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 24 |j 2024 |e 1 |b 27 |c 02 |h 100 |