A Sensitive Urinary Lipoarabinomannan Test for Tuberculosis

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Apr 24

PMID 25905641

Citations 33

Authors

Beston Hamasur

Judith Bruchfeld

Paul van Helden

Gunilla Kallenius

Stefan Svenson

Affiliations

Soon will be listed here.

Abstract

We have previously developed a diagnostic test for tuberculosis based on detection of mycobacterial lipoarabinomannan (LAM) in urine. The method depended on a laborious concentration step. We have now developed an easy to perform test based on a magnetic immunoassay platform, utilizing high avidity monoclonal antibodies for the detection of LAM in urine. With this method the analytical sensitivity of the assay was increased 50-100-fold compared to conventional ELISA. In a pilot study of HIV-negative patients with microbiologically verified TB (n=17) and healthy controls (n=22) the sensitivity of the test was 82% and the specificity 100%. This is in stark positive contrast to a range of studies using available commercial tests with polyclonal anti-LAM Abs where the sensitivity of the tests in HIV-negative TB patients was very low.

Citing Articles

A new rapid lipoarabinomannan urine assay for tuberculosis: a two-centre diagnostic accuracy evaluation in outpatients with and without HIV.

Hamasur B, Okunola A, Sserubiri J, Dube-Nwamba W, Nwamba W, Abdulgader S Res Sq. 2025; .

PMID: 40034451 PMC: 11875286. DOI: 10.21203/rs.3.rs-5386988/v2.

Diagnostic accuracy of a sequence-specific -DNA hybridization assay in urine: a case-control study including subclinical TB cases.

Tschan Y, Sasamalo M, Hiza H, Fellay J, Gagneux S, Reither K Microbiol Spectr. 2024; 12(6):e0042624.

PMID: 38717151 PMC: 11237410. DOI: 10.1128/spectrum.00426-24.

Urinary lipoarabinomannan in individuals with sputum-negative pulmonary tuberculosis.

Ajantha P, Puri M, Tayal D, Khalid U Indian J Med Res. 2024; 159(2):206-212.

PMID: 38577859 PMC: 11050756. DOI: 10.4103/ijmr.ijmr_2074_22.

Lipoarabinomannan-based tuberculosis diagnosis using a fiber cavity ring down biosensor.

Ullah U, Saleem S, Farooq M, Yameen B, Cheema M Biomed Opt Express. 2024; 15(3):1428-1436.

PMID: 38495702 PMC: 10942700. DOI: 10.1364/BOE.516892.

New Insights into Biomarkers for Evaluating Therapy Efficacy in Pulmonary Tuberculosis: A Narrative Review.

Zhang F, Zhang F, Dong Y, Li L, Pang Y Infect Dis Ther. 2023; 12(12):2665-2689.

PMID: 37938418 PMC: 10746651. DOI: 10.1007/s40121-023-00887-x.

References

Shah M, Martinson N, Chaisson R, Martin D, Variava E, Dorman S . Quantitative analysis of a urine-based assay for detection of lipoarabinomannan in patients with tuberculosis. J Clin Microbiol. 2010; 48(8):2972-4. PMC: 2916614. DOI: 10.1128/JCM.00363-10. View

Chatterjee D, Khoo K . Mycobacterial lipoarabinomannan: an extraordinary lipoheteroglycan with profound physiological effects. Glycobiology. 1998; 8(2):113-20. DOI: 10.1093/glycob/8.2.113. View

Steingart K, Flores L, Dendukuri N, Schiller I, Laal S, Ramsay A . Commercial serological tests for the diagnosis of active pulmonary and extrapulmonary tuberculosis: an updated systematic review and meta-analysis. PLoS Med. 2011; 8(8):e1001062. PMC: 3153457. DOI: 10.1371/journal.pmed.1001062. View

Conesa-Botella A, Massinga Loembe M, Manabe Y, Worodria W, Mazakpwe D, Luzinda K . Urinary lipoarabinomannan as predictor for the tuberculosis immune reconstitution inflammatory syndrome. J Acquir Immune Defic Syndr. 2011; 58(5):463-8. DOI: 10.1097/QAI.0b013e31823801de. View

Minion J, Leung E, Talbot E, Dheda K, Pai M, Menzies D . Diagnosing tuberculosis with urine lipoarabinomannan: systematic review and meta-analysis. Eur Respir J. 2011; 38(6):1398-405. DOI: 10.1183/09031936.00025711. View

Pai N, Pai M . Point-of-care diagnostics for HIV and tuberculosis: landscape, pipeline, and unmet needs. Discov Med. 2012; 13(68):35-45. View

Mazurek J, Ignatowicz L, Kallenius G, Svenson S, Pawlowski A, Hamasur B . Divergent effects of mycobacterial cell wall glycolipids on maturation and function of human monocyte-derived dendritic cells. PLoS One. 2012; 7(8):e42515. PMC: 3411746. DOI: 10.1371/journal.pone.0042515. View

Kerkhoff A, Wood R, Vogt M, Lawn S . Prognostic value of a quantitative analysis of lipoarabinomannan in urine from patients with HIV-associated tuberculosis. PLoS One. 2014; 9(7):e103285. PMC: 4116167. DOI: 10.1371/journal.pone.0103285. View

Hamasur B, Bruchfeld J, Haile M, Pawlowski A, Bjorvatn B, Kallenius G . Rapid diagnosis of tuberculosis by detection of mycobacterial lipoarabinomannan in urine. J Microbiol Methods. 2001; 45(1):41-52. DOI: 10.1016/s0167-7012(01)00239-1. View

10.

Tessema T, Hamasur B, Bjun G, Svenson S, Bjorvatn B . Diagnostic evaluation of urinary lipoarabinomannan at an Ethiopian tuberculosis centre. Scand J Infect Dis. 2001; 33(4):279-84. DOI: 10.1080/003655401300077306. View

11.

Boehme C, Molokova E, Minja F, Geis S, Loscher T, Maboko L . Detection of mycobacterial lipoarabinomannan with an antigen-capture ELISA in unprocessed urine of Tanzanian patients with suspected tuberculosis. Trans R Soc Trop Med Hyg. 2005; 99(12):893-900. DOI: 10.1016/j.trstmh.2005.04.014. View

12.

Reither K, Saathoff E, Jung J, Minja L, Kroidl I, Saad E . Low sensitivity of a urine LAM-ELISA in the diagnosis of pulmonary tuberculosis. BMC Infect Dis. 2009; 9:141. PMC: 2741465. DOI: 10.1186/1471-2334-9-141. View

13.

Mutetwa R, Boehme C, Dimairo M, Bandason T, Munyati S, Mangwanya D . Diagnostic accuracy of commercial urinary lipoarabinomannan detection in African tuberculosis suspects and patients. Int J Tuberc Lung Dis. 2009; 13(10):1253-9. PMC: 3373957. View

14.

Lawn S, Edwards D, Kranzer K, Vogt M, Bekker L, Wood R . Urine lipoarabinomannan assay for tuberculosis screening before antiretroviral therapy diagnostic yield and association with immune reconstitution disease. AIDS. 2010; 23(14):1875-80. DOI: 10.1097/qad.0b013e32832e05c8. View

15.

Dheda K, Davids V, Lenders L, Roberts T, Meldau R, Ling D . Clinical utility of a commercial LAM-ELISA assay for TB diagnosis in HIV-infected patients using urine and sputum samples. PLoS One. 2010; 5(3):e9848. PMC: 2844421. DOI: 10.1371/journal.pone.0009848. View

16.

Tessema T, Bjune G, Assefa G, Svenson S, Hamasur B, Bjorvatn B . Clinical and radiological features in relation to urinary excretion of lipoarabinomannan in Ethiopian tuberculosis patients. Scand J Infect Dis. 2002; 34(3):167-71. DOI: 10.1080/00365540110077254. View

17.

Hamasur B, Haile M, Pawlowski A, Schroder U, Kallenius G, Svenson S . A mycobacterial lipoarabinomannan specific monoclonal antibody and its F(ab') fragment prolong survival of mice infected with Mycobacterium tuberculosis. Clin Exp Immunol. 2004; 138(1):30-8. PMC: 1809178. DOI: 10.1111/j.1365-2249.2004.02593.x. View

18.

Hunter S, Gaylord H, Brennan P . Structure and antigenicity of the phosphorylated lipopolysaccharide antigens from the leprosy and tubercle bacilli. J Biol Chem. 1986; 261(26):12345-51. View

19.

Chan J, Fan X, Hunter S, Brennan P, Bloom B . Lipoarabinomannan, a possible virulence factor involved in persistence of Mycobacterium tuberculosis within macrophages. Infect Immun. 1991; 59(5):1755-61. PMC: 257912. DOI: 10.1128/iai.59.5.1755-1761.1991. View

20.

Chatterjee D, Bozic C, McNeil M, Brennan P . Structural features of the arabinan component of the lipoarabinomannan of Mycobacterium tuberculosis. J Biol Chem. 1991; 266(15):9652-60. View