Sero-Diagnosis of Mycobacterium avium Complex Lung Disease Using Serum Immunoglobulin A Antibody against Glycopeptidolipid Antigen in Taiwan

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Shu, Chin-Chung ; Ato, Manabu ; Wang, Jann-Tay ; Jou, Ruwen ; Wang, Jann-Yuan ; Kobayashi, Kazuo ; Lai, Hsin-Chih ; Yu, Chong-Jen ; Lee, Li-Na ; Luh, Kwen-Tay
• Description:
  Background
  
  Lung disease (LD) due to non-tuberculous mycobacteria is an important clinical concern. Mycobacterium avium complex (MAC) is one of the most common causative agents but the diagnosis of MAC-LD remains challenging. Detection of serum IgA antibody against MAC glycopeptidolipid (GPL) has recently been shown to improve the diagnosis of MAC-LD, but has yet to be validated worldwide.
  
  Methods
  
  This prospective study was conducted in a tertiary referral center in northern Taiwan and enrolled patients with MAC-LD, MAC contamination, other lung diseases, and control subjects. Serum immunoglobulin A (IgA) antibody against MAC-GPL was detected in the participants and its specificity and sensitivity was assessed.
  
  Results
  
  There were 56 patients with MAC-LD, 11 with MAC contamination, 13 M. kansasii-LD, 26 LD due to rapidly-growing mycobacteria (RGM), 48 pulmonary tuberculosis, and 42 household contacts of patients with TB. Patients with MAC-LD were older and 32% of them had an underlying co-morbidity. By logistic regression, serum MAC-GPL IgA level was an independent predictor of MAC-LD among the study subjects and those with culture-positive specimens for MAC. By the receiver operating characteristic curve, serum MAC-GPL IgA had a good power to discriminate MAC-LD from MAC contamination. Under the optimal cut-off value of 0.73 U/mL, its sensitivity and specificity were 60% and 91%, respectively. Among MAC-LD patients, presence of co-morbidity was associated with MAC-GPL <0.73 U/ml in logistic regression analysis.
  
  Conclusions
  
  Measurement of serum anti-MAC-GPL IgA level is useful for the diagnosis of MAC-LD. However, its implement in clinical practice for immuno-compromised hosts needs careful consideration.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Antigens, Bacterial Female Glycoconjugates Humans Immunoglobulin A Male Middle Aged Mycobacterium Avium-intracellulare Infection Mycobacterium Avium Complex Pneumonia, Bacterial Prospective Studies Risk Factors ROC Curve Sensitivity And Specificity

  More +
• Source:
  PLoS One. 2013; 8(11).
• Document Type:
  Journal Article
• Place as Subject:
  Taiwan
• Volume:
  8
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:27738d6afeb902939a96ffacc82bc55417cbe191a53f8c4c72d49392ca0ef352
• Download URL:
  https://stacks.cdc.gov/view/cdc/21351/cdc_21351_DS1.pdf
• File Type:
  [PDF - 693.96 KB ]