Reação imunoenzimática (ELISA) para detecção de imunoglobulina M, imunoglobulina G e imunoglobulina A contra a proteína rHsp-X (Rv 2031c) de mycobacterium tuberculosis em pacientes com tuberculose pleural
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2009-12-18
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Universidade Federal de Goiás
Resumo
Pleural tuberculosis (TBP) has often spontaneous resolution, even without
treatment. However, the lack of proper diagnosis and treatment can lead to the
occurrence of pulmonary and/or extra-pulmonary tuberculosis in 65% of the
cases, in the five years subsequent. The objective of this study was to
evaluate the effectiveness of the recombinant Hsp-X antigen (rHsp-X) in
an enzyme immunoassay for determining the presence of TBP in patients
with pleural effusion. For this study we used 132 samples of serum and
pleural fluid (PF) from patients with pleural effusion. Of these, 97 samples
were from TBP patients and 35 patients with diseases other than
tuberculosis (NTBP) (28 patients with metastatic cancer, 1 patient with
congestive heart failure, 2 patients whit liver failure, 1 patient with
systemic lupus erythematosus and 3 patients with parapneumonic
effusion). The IgM levels of PF were higher in patients with PTB than
NTBP, the sensitivity and specificity of the ELISA for the PF was 42% and
83%, respectively. Testing for IgG from the serum and the PF against the
recombinant antigen Hsp-X were not effective in discriminating TB
patients from other diseases, the sensitivity was found to be 13% and 16%
using serum and LP, respectively, with the same specificity of 83%. TBP
patients presented higher levels of IgA specific for the rHSP-X than NTBP,
the IgA ELISA using PF presented better sensitivity (65%) than using
serum (39%), while the IgA ELISA for both types of samples presented the
same specificity (83%). In conclusion, the recognition of Mycobacterium
tuberculosis rHsp-X by IgA antibodies from the PF of patients with TBP
reveals its possible role in the development of a diagnostic test for
additional cases of TBP. Further studies must be conducted to confirm
this hypothesis.
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Citação
LIMONG, L. C. S. A. Reação imunoenzimática (ELISA) para detecção de imunoglobulina M, imunoglobulina G e imunoglobulina A contra a proteína rHsp-X (Rv 2031c) de mycobacterium tuberculosis em pacientes com tuberculose pleural. 2009. 104 f. Dissertação (Mestrado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2009.