Immunoglobin G Antibodies to Purified-Protein-Derivative and Lipoarabinomannan-B by Enzyme-Linked Immunosorbent Assay in the Diagnosis of Tuberculous Pleural Effusion.

Moon, Tai Hoon; Cho, Chul Ho; Kwak, Seung Min; Kim, Jin Ju; Cho, Sang Nae

doi:1995.42.4.455

Tuberc Respir Dis > Volume 42(4); 1995 > Article

Original Article

Tuberculosis and Respiratory Diseases 1995;42(4):455-464.
DOI: https://doi.org/10.4046/trd.1995.42.4.455 Published online August 1, 1995.

Immunoglobin G Antibodies to Purified-Protein-Derivative and Lipoarabinomannan-B by Enzyme-Linked Immunosorbent Assay in the Diagnosis of Tuberculous Pleural Effusion.

Tai Hoon Moon, Chul Ho Cho, Seung Min Kwak, Jin Ju Kim, Sang Nae Cho

¹Department of Internal Medicine, Inha University College of Medicine, Sungnam, Korea.
²Department of Clinical Pathology, Inha University College of Medicine, Sungnam, Korea.
³Department of Microbiology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
Considering that both humoral and cell mediated immunities play an important role for human tuberculosis infection, enzyme-linked immunosorbent assay(ELISA) measurement of immunoglobulin G (IgG) antibody to mycobacterial antigens can be used for the serologic diagnosis of tuberculous pleural effusion. METHOD: We measured absorbance values of IgG antibodies to purified-protein-derivative (PPD) and lipoarabinomannan-B (LAM-B) in the pleural fluid (PF) and the serum in 40 tuberculous (TPE) and 19 nontuberculous pleural effusions (NTPE). RESULTS: 1) The IgG antibodies to PPD and LAM-B were significantly (P<0.0005) higher in the PF and the serum of TPE compared to NTPE. 2) The IgG antibodies to PPD and LAM-B in the serum were higher than that in PF. 3) Significant correlations were found between pleural and serum IgG antibodies to PPD and LAM-B. 4) With a cutoff value for IgG antibody to PPD in the PF of 0.091, sensitivity was 55.0% and specificity 94.7% in the diagnosis of TPE. 5) With a cutoff value for IgG antibody to LAM-B in the PF of 0.337, sensitivity was 50.0% and specificity 94.7% in the diagnosis of TPE. 6) The seropositive rates in TPE were not related to PPD skin test status, the amount of PF and coexisting active pulmonary tuberculosis. CONCLUSION: The assay of IgG antibodies to PPD and LAM-B might be useful for the diagnosis of TPE. Our study suggests the mechanism of passive transfer of IgG antibodies to PPD and LAM-B from the serum to the PF through pleural tissue.

Key Words: Tuberculous pleural effusion, PPD, LAM-B, ELISA