Details:

Alternative Title:
PLoS One
Personal Author:
Shu, Chin-Chung ; Ato, Manabu ; Wang, Jann-Tay ; Jou, Ruwen ; Wang, Jann-Yuan ; ... More +
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 Less -
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.


Subject:
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Research Article

Source:
PLoS One. 2013; 8(11).
Document Type:
Journal Article
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:27738d6afeb902939a96ffacc82bc55417cbe191a53f8c4c72d49392ca0ef352
File Type:

Supporting Files

• 	license.txt	txt
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  	pone.0080473.g001.jpg	jpeg
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  	pone.0080473.g002.jpg	jpeg
  	pone.0080473.nxml	txt

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