Abstract

Tuberculous glycolipid (TBGL) is a component of the Mycobacterium tuberculosis cell wall, and anti-TBGL antibodies are used for serodiagnosis of tuberculosis. Anti-TBGL IgG and IgA levels were measured in 45 pulmonary TB patients (PTB), 26 extra-pulmonary TB patients (ETB), 16 AIDS-TB patients, and 58 healthy controls (HC) including 39 health care workers (HW) and 19 newly enrolled students (ST). Anti-TBGL IgG measurements yielded 68.9% and 46.2% sensitivity in PTB and ETB, respectively, and 81.0% specificity. However, anti-TBGL IgA measurements were significantly less sensitive in detecting ETB than PTB (15.4% versus 46.7% sensitivity) but showed up to 89.7% specificity. Samples from AIDS-TB patients exhibited low reaction of anti-TBGL IgG and IgA with 6.3% and 12.5% sensitivity, respectively. Unlike anti-lipoarabinomannan (LAM) IgG that was found to elevate in sputum smearpositive subjects, anti-TBGL IgG and IgA elevated in those with cavitation and bronchiectasis, respectively. Anti-TBGL IgG in cavitary TB yielded 78.2% sensitivity compared to 57.1% in those otherwise. Meanwhile, higher anti-TBGL IgA titers were observed in HW than in ST, and increasing anti-TBGL IgG titers were observed in HW on follow-up. Therefore, higher anti-TBGL antibody titers are present in patients presenting cavities and bronchiectasis and subjects under TB exposure risk.

Highlights

  • In 2013, tuberculosis (TB) infected 9 million new individuals and caused 1.5 million deaths, making it one of the most critical infectious diseases worldwide

  • For anti-tuberculous glycolipid antigen (TBGL) IgA, significantly higher titers were observed in the pulmonary TB (PTB) samples compared to those of other groups (p < 0.0001 for healthy controls (HC), p < 0.001 for AIDS-TB, and p < 0.05 for extrapulmonary TB patients (ETB))

  • For anti-LAM IgG, significantly larger number of samples with higher responses was found amongst those from PTB patients compared to HC (p < 0.001) or AIDS-TB (p < 0.05) patients

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Summary

Introduction

In 2013, tuberculosis (TB) infected 9 million new individuals and caused 1.5 million deaths, making it one of the most critical infectious diseases worldwide. The specific IgG response to tuberculous glycolipid antigen (TBGL), a combination of trehalose-6,6󸀠-dimycolate (TDM) and minor glycolipids, has been used to diagnose clinical TB infection in Japan, with approximately 80% sensitivity and specificity [4, 5]. In a study in the Philippines, elevated anti-TBGL antibody titers were observed in healthcare workers (HW) with LTBI [9]. No study has evaluated anti-TBGL antibodies in TB patients or healthy individuals in China. It is important to evaluate anti-TBGL antibodies in the context of varied TB pathogenesis attributable to pulmonary TB (PTB) patients, extrapulmonary TB (ETB) patients, and AIDS-TB patients

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