Reação imunoenzimática (ELISA) para detecção de imunoglobulina M, imunoglobulina G e imunoglobulina A contra a proteína rHsp-X (Rv 2031c)de Mycobacterium tuberculosis em pacientes com tuberculose pleural / Linked immunosorbent assay (ELISA) for detection of immunoglobulin M, immunoglobulin G and immunoglobulin A against the protein rHsp-X (Rv2031c) of Mycobacterium tuberculosis in patients with pleural tuberculosis

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

18/12/2009

RESUMO

Pleural tuberculosis (TBP) has often spontaneous resolution, even without treatment. However, the lack of proper diagnosis and treatment can lead to the occurrence of pulmonary and/or extra-pulmonary tuberculosis in 65% of the cases, in the five years subsequent. The objective of this study was to evaluate the effectiveness of the recombinant Hsp-X antigen (rHsp-X) in an enzyme immunoassay for determining the presence of TBP in patients with pleural effusion. For this study we used 132 samples of serum and pleural fluid (PF) from patients with pleural effusion. Of these, 97 samples were from TBP patients and 35 patients with diseases other than tuberculosis (NTBP) (28 patients with metastatic cancer, 1 patient with congestive heart failure, 2 patients whit liver failure, 1 patient with systemic lupus erythematosus and 3 patients with parapneumonic effusion). The IgM levels of PF were higher in patients with PTB than NTBP, the sensitivity and specificity of the ELISA for the PF was 42% and 83%, respectively. Testing for IgG from the serum and the PF against the recombinant antigen Hsp-X were not effective in discriminating TB patients from other diseases, the sensitivity was found to be 13% and 16% using serum and LP, respectively, with the same specificity of 83%. TBP patients presented higher levels of IgA specific for the rHSP-X than NTBP, the IgA ELISA using PF presented better sensitivity (65%) than using serum (39%), while the IgA ELISA for both types of samples presented the same specificity (83%). In conclusion, the recognition of Mycobacterium tuberculosis rHsp-X by IgA antibodies from the PF of patients with TBP reveals its possible role in the development of a diagnostic test for additional cases of TBP. Further studies must be conducted to confirm this hypothesis.

ASSUNTO(S)

mycobacterium tuberculosis hsp-x imunoglobulina m imunoglobulina g imunoglobulina a e tuberculose pleural medicina tuberculose pleural; mycobacterium tuberculosis; hsp-x; imunoglobulina mycobacterium tuberculosis hsp-x immunoglobulin m immunoglobulin g immunoglobulin a and pleural tuberculosis

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