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

• Autor(a) principal: Limong, Loanda Carvalho Sant’ Ana
• Data de Publicação: 2009
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/12528
• topic: Mycobacterium tuberculosis; Hsp-X; Imunoglobulina M; Imunoglobulina G; Imunoglobulina A; Tuberculose pleural; Mycobacterium tuberculosis; Hsp-X; Immunoglobulin M; Immunoglobulin G; Immunoglobulin A; Pleural tuberculosis; CIENCIAS DA SAUDE::SAUDE COLETIVA::SAUDE PUBLICA

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.