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Title: | ESAT-6/CFP-10 Fusion Protein and Peptides for Optimal Diagnosis of Mycobacterium Tuberculosis Infection by Ex Vivo Enzyme-Linked Immunospot Assay in The Gambia |
Authors: | Hill, Philip C. Jackson-Sillah, Dolly Fox, Annette Franken, Kees L. M. C. Lugos, Moses D. Jeffries, David J. Donkor, Simon A. Hammond, Abdulrahman S. Adegbola, Richard A. Ottenhoff, Tom H. M. Klein, Michel R. Brookes, Roger H. |
Issue Date: | 2005 |
Publisher: | Journal of Clinical Microbiology |
Series/Report no.: | Vol. 43;No. 5; Pp 2070 - 2074 |
Abstract: | Overlapping peptides of Mycobacterium tuberculosis antigens ESAT-6 and CFP-10 offer increased specificity
over the purified protein derivative skin test when they were used in an ex vivo enzyme-linked immunospot
(ELISPOT) assay for gamma interferon detection for the diagnosis of M. tuberculosis infection from recent
exposure. We assessed whether equivalent results could be obtained for a fusion protein of the two antigens and
whether a combined readout would offer increased sensitivity in The Gambia. We studied the ELISPOT assay
results for 488 household contacts of 88 sputum smear-positive tuberculosis (TB) cases. The proportions of
subjects positive by each test and by the tests combined were assessed across an exposure gradient, defined
according to sleeping proximity to a TB case. Eighty-eight (18%) subjects were positive for CFP-10 peptides,
148 (30%) were positive for ESAT-6 peptides, 161 (33%) were positive for both peptides, and 168 (34%) were
positive for the fusion protein; 188 (39%) subjects had either a positive result for a peptide or a positive result
for the fusion protein. There was reasonable agreement between the peptide and the protein results (kappa
statistic 0.78) and no significant discordance (P 0.38). There was a strong correlation between the fusion
protein and combined peptide spot counts (r 0.9), and responses to the peptide and the proteins all increased
significantly according to M. tuberculosis exposure. The proportion of subjects positive for either the pool of
peptides or the fusion protein offered maximum sensitivity, being significantly higher than the proportion of
subjects positive for ESAT-6 peptides alone (P 0.007). A fusion protein of ESAT-6 and CFP-10 is equivalent
to overlapping peptides for the diagnosis of latent M. tuberculosis infection. Use of a combination of peptides
and fusion protein offers improved sensitivity. |
URI: | http://hdl.handle.net/123456789/1689 |
ISSN: | 1098-660X |
Appears in Collections: | Medical Laboratory Sciences
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