Improving the diagnosis of active tuberculosis: a novel approach using magnetic particle-based chemiluminescence LAM assay
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 |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
BMC pulmonary medicine - 24(2024), 1 vom: 27. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Li, Yan [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| Themen: |
Chemiluminescence assay(CLIA) |
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| Anmerkungen: |
© The Author(s) 2024 |
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| doi: |
10.1186/s12890-024-02893-2 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
SPR054936160 |
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| 245 | 1 | 0 | |a Improving the diagnosis of active tuberculosis: a novel approach using magnetic particle-based chemiluminescence LAM assay |
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| 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. 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. | ||
| 650 | 4 | |a Tuberculosis (TB) |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Lipoarabinomannan (LAM) |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Chemiluminescence assay(CLIA) |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Ru, Zhiwei |4 aut | |
| 700 | 1 | |a Wei, Hongxia |4 aut | |
| 700 | 1 | |a Wu, Ming |4 aut | |
| 700 | 1 | |a Xie, Guihua |4 aut | |
| 700 | 1 | |a Lou, Jianrong |4 aut | |
| 700 | 1 | |a Yang, Xiang |4 aut | |
| 700 | 1 | |a Zhang, Xilin |4 aut | |
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