1887

Abstract

The diagnosis of tuberculous meningitis (TBM) is a major global health concern due to its protean nature. There is a need to identify better biomarkers for the rapid and definitive diagnosis of TBM. Lipids have been poorly explored as diagnostic markers in TBM.

Non-polar lipids (NPL) and mycobacterial sonicate extract (MTSE) antigens were assessed for diagnosis of .

A total of 110 cerebrospinal fluid samples were categorized as confirmed, suspected and non-TBM cases according to clinical presentation and laboratory investigations, which were further analysed by NPL and MTSE ELISA.

The sensitivity and specificity of the NPL ELISA were 39.6 and 96 %, respectively, whereas the MTSE ELISA was 17 % sensitive and 92 % specific. The combination of the NPL and MTSE ELISA test was superior to these tests alone, with sensitivity and specificity of 43 and 88 %, respectively.

This combination may be useful as an adjunct in the laboratory diagnosis of TBM. However, future studies in different settings among different populations, such as those with human immunodeficiency virus co-infection, are desirable to explore the full potential of biomarkers.

Funding
This study was supported by the:
  • Kavitha Kumar , UGC-DAE Consortium for Scientific Research, University Grants Commission , (Award No. 20-06/2010(i)EU-IV)
  • Prashant Giribhattanavar , Council of Scientific and Industrial Research, India , (Award No. 09/490(0083)/2012)
Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.0.000131
2020-05-11
2020-06-02
Loading full text...

Full text loading...

/deliver/fulltext/acmi/10.1099/acmi.0.000131/acmi000131.html?itemId=/content/journal/acmi/10.1099/acmi.0.000131&mimeType=html&fmt=ahah

References

  1. World Health Organization Global Tuberculosis Report Geneva, Switzerland: World Health Organisation; 2018. WHO/HTM/TB/2013.11
    [Google Scholar]
  2. Rock RB, Olin M, Baker CA, Molitor TW, Peterson PK. Central nervous system tuberculosis: pathogenesis and clinical aspects. Clin Microbiol Rev 2008; 21:243–261 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  3. Brncić N, Gorup L. Tuberculous orchiepididymitis, meningoencephalitis and hydrocephalus. Coll Antropol 2011; 35 Suppl 2:285–287[PubMed][PubMed]
    [Google Scholar]
  4. Sütlaş PN, Ünal A, Forta H, Şenol S, Kırbaş D. Tuberculous meningitis in adults: review of 61 cases. Infection 2003; 31:387–391 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  5. Bhigjee AI, Padayachee R, Paruk H, Hallwirth-Pillay KD, Marais S et al. Diagnosis of tuberculous meningitis: clinical and laboratory parameters. Int J Infect Dis 2007; 11:348–354 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  6. Gourie-Devi M, Satishchandra P, Gokul BN, Sophia V, Harsha S. Short course treatment in culture positive tuberculous meningitis. Neurol. India 1989; 37:581–587
    [Google Scholar]
  7. Tyrrell FC, Budnick GE, Elliott T, Gillim-Ross L, Hildred MV et al. Probability of negative Mycobacterium tuberculosis complex cultures based on time to detection of positive cultures: a multicenter evaluation of commercial-broth-based culture systems. J Clin Microbiol 2012; 50:3275–3282 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  8. Török ME. Tuberculous meningitis: advances in diagnosis and treatment. Br Med Bull 2015; 113:117–131 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  9. Patil SA, Gourie-Devi M, Chaudhuri JR, Chandramuki A. Identification of antibody responses to Mycobacterium tuberculosis antigens in the CSF of tuberculous meningitis patients by Western blotting. Clin Immunol Immunopathol 1996; 81:35–40 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  10. Thakur A, Mandal A. Usefulness of ELISA using antigen A60 in serodiagnosis of neurotuberculosis. J Commun Dis 1996; 28:8–14[PubMed][PubMed]
    [Google Scholar]
  11. Kashyap RS, Ramteke SS, Morey SH, Purohit HJ, Taori GM et al. Diagnostic value of early secreted antigenic target-6 for the diagnosis of tuberculous meningitis patients. Infection 2009; 37:508–513 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  12. Arbues A, Lugo-Villarino G, Neyrolles O, Guilhot C, Astarie-Dequeker C. Playing hide-and-seek with host macrophages through the use of mycobacterial cell envelope phthiocerol dimycocerosates and phenolic glycolipids. Front Cell Infect Microbiol 2014; 4:173 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  13. Papa F, Cruaud P, David HL. Antigenicity and specificity of selected glycolipid fractions from Mycobacterium tuberculosis. Res Microbiol 1989; 140:569–578 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  14. Marais S, Thwaites G, Schoeman JF, Török ME, Misra UK et al. Tuberculous meningitis: a uniform case definition for use in clinical research. Lancet Infect Dis 2010; 10:803–812 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  15. Pirson C, Jones GJ, Steinbach S, Besra GS, Vordermeier HM. Differential effects of Mycobacterium bovis--derived polar and apolar lipid fractions on bovine innate immune cells. Vet Res 2012; 43:54 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  16. Julián E, Cama M, Martínez P, Luquin M. An ELISA for five glycolipids from the cell wall of Mycobacterium tuberculosis: Tween 20 interference in the assay. J Immunol Methods 2001; 251:21–30 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  17. Morandi M, Sali M, Manganelli R, Delogu G. Exploiting the mycobacterial cell wall to design improved vaccines against tuberculosis. J Infect Dev Ctries 2013; 7:169–181 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  18. Simonney N, Bourrillon A, Lagrange PH. Analysis of circulating immune complexes (CICs) in childhood tuberculosis: levels of specific antibodies to glycolipid antigens and relationship with serum antibodies. Int J Tuberc Lung Dis 2000; 4:152–160[PubMed][PubMed]
    [Google Scholar]
  19. Maekura R, Okuda Y, Nakagawa M, Hiraga T, Yokota S et al. Clinical evaluation of anti-tuberculous glycolipid immunoglobulin G antibody assay for rapid serodiagnosis of pulmonary tuberculosis. J Clin Microbiol 2001; 39:3603–3608 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  20. Zhao J, Zhu Z, Zhang X, Suzuki Y, Chagan-Yasutan H et al. Evaluation of anti-TBGL antibody in the diagnosis of tuberculosis patients in China. J Immunol Res 2015; 2015:1–9 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  21. Patil SA, Katoch K, Ramu G, Sengupta U. Detection of antibodies against phenolic glycolipid-1 (PGL-1), 35-kDa and 30-40-kDa components of Mycobacterium leprae in the cerebrospinal fluid of of leprosy patients. J Med Microbiol 1995; 43:115–119 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  22. Zhang J, Hu X, Hu X, Ye Y, Shang M et al. Clinical features, outcomes and molecular profiles of drug resistance in tuberculous meningitis in non-HIV patients. Sci Rep 2016; 6:19072 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  23. Gambhir IS, Mehta M, Singh DS, Khanna HD. Evaluation of CSF-adenosine deaminase activity in tubercular meningitis. J Assoc Physicians India 1999; 47:192–194[PubMed][PubMed]
    [Google Scholar]
  24. Nhu NTQ, Heemskerk D, Thu DDA, Chau TTH, Mai NTH et al. Evaluation of GeneXpert MTB/RIF for diagnosis of tuberculous meningitis. J Clin Microbiol 2014; 52:226–233 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  25. Patel VB, Connolly C, Singh R, Lenders L, Matinyenya B et al. Comparison of amplicor and GeneXpert MTB/RIF tests for diagnosis of tuberculous meningitis. J Clin Microbiol 2014; 52:3777–3780 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  26. Yu J, Wang Z-J, Chen L-H, Li H-H. Diagnostic accuracy of interferon-gamma release assays for tuberculous meningitis: a meta-analysis. Int J Tuberc Lung Dis 2016; 20:494–499 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  27. Chandramuki A, Lyashchenko K, Kumari HBV, Khanna N, Brusasca P et al. Detection of antibody to Mycobacterium tuberculosis protein antigens in the cerebrospinal fluid of patients with tuberculous meningitis. J Infect Dis 2002; 186:678–683 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  28. Restrepo BI, Pino PA, Volcy M, Franco AF, Kanaujia GV et al. Interpretation of mycobacterial antibodies in the cerebrospinal fluid of adults with tuberculous meningitis. Trop Med Int Health 2008; 13:653–658 [CrossRef][PubMed][PubMed]
    [Google Scholar]
  29. Patel VB, Bhigjee AI, Paruk HF, Singh R, Meldau R et al. Utility of a novel lipoarabinomannan assay for the diagnosis of tuberculous meningitis in a resource-poor high-HIV prevalence setting. Cerebrospinal Fluid Res 2009; 6:13 [CrossRef][PubMed][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/acmi/10.1099/acmi.0.000131
Loading
/content/journal/acmi/10.1099/acmi.0.000131
Loading

Data & Media loading...

Supplements

Supplementary material 1

PDF
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error