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Assessment of an ELISA for serodiagnosis of active pulmonary tuberculosis in a Cuban population
Authors: Julio Cesar Ayala, Elsa Pimienta, Caridad Rodríguez, Mónica Sarzo, Jony Jones3 , Carlos Vallín1 , Alina Guerrero , María Teresa Milanés , Jozef Anné , Lieve Van Mellaert , Kris Huygen
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Objective: To explore the serodiagnostic potential of the five recombinant Mycobacterium
tuberculosis antigens CFP-10 (Rv3874), ESAT-6 (Rv3875), APA (Rv1860), PstS-1 (Rv0934), Ag85A
(Rv3804c) and their combination in a Cuban population with active pulmonary tuberculosis.
Methods: The serodiagnostic potential of the recombinant antigens rESAT-6, rCFP-10, rAPA,
rPstS-1 produced in Escherichia coli, rAg85A produced in Streptomyces lividans and the
combination of the five proteins was evaluated by an indirect ELISA. Humoral immune
response was analysed in a group of 140 patients with active pulmonary tuberculosis (smear-,
Mantoux- and culture-positive) and in a control group consisting of 34 bacillus CalmetteGuerin
vaccinated, Mantoux-negative, healthy subjects.
Results: With the exception of CFP-10, the use of the separate recombinant antigens or the
antigenic cocktail in ELISA-based serodiagnosis resulted in a significant difference in the mean
optical densitiy values between sera of patients and healthy subjects. The highest sensitivity of
the assay using single antigens, being 58.57%, was achieved with rPstS-1 compared to 27.14%
with rCFP-10, 31.65% with Ag85A, 42.86% with rAPA and 44.29% with rESAT-6. Single
antigen ELISAs provided high specificity values ranging from 94.12% to 97.06%. A cocktail of
the aforementioned antigens increased the sensitivity to 87.14% and the specificity to 97.06%.
Conclusions: An ELISA using a multi-antigen mix containing recombinant immuno-dominant
antigens of Mycobacterium tuberculosis, namely, rCFP-10, rESAT-6, rAPA, rPstS-1 and rAg85,
increases the sensitivity and specificity compared with that using the single antigens and shows
potential as a complementary tool for the diagnosis of active pulmonary tuberculosis in Cuba.