Identification of specific antibodies against the Ag85C-MPT51-HspX fusion protein (CMX) for serological screening of tuberculosis in endemic area

Expert Rev Clin Immunol. 2017 Aug;13(8):837-843. doi: 10.1080/1744666X.2017.1345626. Epub 2017 Jun 30.

Abstract

Objectives: Development of new tools for rapid and accurate diagnosis of tuberculosis (TB) is considered a strategy for controlling the disease. The recombinant CMX fusion protein is composed of immunodominant epitopes of the Ag85C (Rv0129c), MPT51 (Rv3803c) and the entire HspX (Rv2031c) proteins from Mycobacterium tuberculosis H37Rv (Mtb). The aim of this study was to evaluate the applicability of a test using the CMX protein in individuals suspected of TB.

Methods: Indirect ELISA was used to measure serum anti-CMX IgM and IgG in individuals with pulmonary TB.

Results: Patients with pulmonary TB had higher titers of IgM (OD = 0.502 ± 0.281) than healthy controls (OD = 0.200 ± 0.125). The cutoff for IgM-ELISA was determined using ROC curve analyzes (AUC = 0.868) with a sensitivity of 80.1% and a specificity of 78.2%. Patients with pulmonary TB also had higher titers of IgG (OD = 0.525 ± 0.391) than healthy controls (OD = 0.215 ± 0.077). The cutoff for IgG-ELISA was determined using ROC curve analyzes (AUC = 0.864) with a sensitivity of 81.7% and a specificity of 74.7%.

Conclusion: The results suggest that the recombinant protein CMX can be used in a serological test to complement the screening of individuals suspected of having active pulmonary TB.

Keywords: ELISA; Tuberculosis; humoral response; recombinant protein; serology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Bacterial / blood
  • Antigens, Bacterial / genetics*
  • Bacterial Proteins / genetics*
  • Brazil
  • Endemic Diseases
  • Female
  • Humans
  • Immunodominant Epitopes / genetics*
  • Male
  • Mass Screening
  • Middle Aged
  • Mycobacterium tuberculosis / genetics*
  • Mycobacterium tuberculosis / immunology
  • Recombinant Fusion Proteins / genetics
  • Recombinant Fusion Proteins / immunology*
  • Sensitivity and Specificity
  • Serology
  • Tuberculosis, Pulmonary / diagnosis*
  • Young Adult

Substances

  • Antibodies, Bacterial
  • Antigens, Bacterial
  • Bacterial Proteins
  • HspX protein, Mycobacterium tuberculosis
  • Immunodominant Epitopes
  • MPT51 protein, Mycobacterium
  • Recombinant Fusion Proteins
  • antigen 85C1, Mycobacterium tuberculosis