Diagnostic potential of a serological assay for the diagnosis of ulcerans disease based on the putative Mycobacterium ulcerans toxin

Mycobacterium ulcerans infection is an important and potentially disfiguring disease of man. A rapid diagnostic assay for detection of this organism is required urgently. Serological assays require a species-specific protein to ensure a high level of specificity and thus reduce the occurrence of false positive results. As M. ulcerans had been reported to produce a unique cytotoxin, it was thought that this would provide an ideal antigen on which to base a serological assay for detection of M. ulcerans during infection. Crude culture filtrates, prepared by previously documented methods, were assayed for toxic activity by in-vitro cytotoxicity assays and in-vivo mouse footpad assays. To evaluate the uniqueness of the cytotoxic factor, other species of mycobacteria were also assayed. Analysis of these assays showed that similar biological activity is present in various other mycobacterial species. Furthermore, it was possible to neutralise this activity in all species tested with a polyclonal antiserum raised against M. ulcerans. As the cytotoxic factor was found not to be specific to M. ulcerans, it is unlikely that a serological assay based on such a molecule will be of use.