https://scholars.lib.ntu.edu.tw/handle/123456789/508222
標題: | Sero-diagnosis of mycobacterium avium complex lung disease using serum immunoglobulin a antibody against glycopeptidolipid antigen in Taiwan | 作者: | CHIN-CHUNG SHU Ato M. JANN-TAY WANG Jou R. JANN-YUAN WANG Kobayashi K. HSIN-CHIH LAI CHONG-JEN YU LI-NA LEE KWEN-TAY LUH |
公開日期: | 2013 | 卷: | 8 | 期: | 11 | 起(迄)頁: | e80473 | 來源出版物: | PLoS ONE | 摘要: | Background: Lung disease (LD) due to non-tuberculous mycobacteria is an important clinical concern. Mycobacterium avium complex (MAC) is one of the most common causative agents but the diagnosis of MAC-LD remains challenging. Detection of serum IgA antibody against MAC glycopeptidolipid (GPL) has recently been shown to improve the diagnosis of MAC-LD, but has yet to be validated worldwide. Methods: This prospective study was conducted in a tertiary referral center in northern Taiwan and enrolled patients with MAC-LD, MAC contamination, other lung diseases, and control subjects. Serum immunoglobulin A (IgA) antibody against MAC-GPL was detected in the participants and its specificity and sensitivity was assessed. Results: There were 56 patients with MAC-LD, 11 with MAC contamination, 13 M. kansasii-LD, 26 LD due to rapidlygrowing mycobacteria (RGM), 48 pulmonary tuberculosis, and 42 household contacts of patients with TB. Patients with MAC-LD were older and 32% of them had an underlying co-morbidity. By logistic regression, serum MAC-GPL IgA level was an independent predictor of MAC-LD among the study subjects and those with culture-positive specimens for MAC. By the receiver operating characteristic curve, serum MAC-GPL IgA had a good power to discriminate MAC-LD from MAC contamination. Under the optimal cut-off value of 0.73 U/mL, its sensitivity and specificity were 60% and 91%, respectively. Among MAC-LD patients, presence of co-morbidity was associated with MAC-GPL <0.73 U/ml in logistic regression analysis. Conclusions: Measurement of serum anti-MAC-GPL IgA level is useful for the diagnosis of MAC-LD. However, its implement in clinical practice for immuno-compromised hosts needs careful consideration. ? 2013 Shu et al. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/508222 | ISSN: | 1932-6203 | DOI: | 10.1371/journal.pone.0080473 | SDG/關鍵字: | Adult; Aged; Aged, 80 and over; Antibodies, Bacterial; Antigens, Bacterial; Female; Glycoconjugates; Humans; Immunoglobulin A; Male; Middle Aged; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection; Pneumonia, Bacterial; Prospective Studies; Risk Factors; ROC Curve; Sensitivity and Specificity |
顯示於: | 醫學檢驗暨生物技術學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。