BACKGROUND A previous study demonstrated pleural fluid (PF) IgA immunodominance for the fused MT10.3:MPT64 protein in pleural tuberculosis (PLTB) cases. However, no clue on the role of IgA and IgG against this and other antigens in PF and serum concerning improved diagnosis is available. Thus, the aim of the present study was to validate PF IgA-MT10.3:MPT64 and evaluate PF and serum IgA and IgG reactivity against this protein, its peptides (F2) and single MPT64, MT10.3 and the PPE59 mycobacterial specific antigens. IgA and IgG ELISA were measured against the antigen in PLTB (n = 29) and other non-TB pleurisy (n = 39) patient samples. RESULTS The immunodominance of PF IgA-MT10.3:MPT64 was confirmed in PLTB (86.2%) followed by PPE59 (62%), while serum IgA-F2 exhibited 51.7% sensitivity. PF and serum IgG-MT10.3:MPT64 led to 65.5 and 51.7% sensitivity, respectively. However, MT10.3 and MPT64 displayed overall lower sensitivity (≤34.5) for both antibodies. All results at 95% fixed specificity. Combinatory results indicated 93.1% sensitivity for PF IgA-MT10.3:MPT64/-PPE59 and IgA/IgG-MT10.3:MPT64 at 92.3% specificity, followed by IgA-MT10.3:MPT64/-MPT64 or /-F2 (89.6%) without jeopardizing specificity (94.9%). The combinatory results of the PF adenosine deaminase test (ADA) and IgA-MT10.3:MPT64/-F2 demonstrated the highest sensitivity (96.6%), with a specificity of 92.3%. CONCLUSIONS The PF IgA-MT10:MPT64 immune dominance was validated in PLTB, and its combinatory results with PPE59 or MPT64 or F2 antigens as well as with IgG, are reported herein for the first time, improving their potential to assist diagnosis. Combining PF-ADA and IgA-MT10.3:MPT64/-F2 results achieved better accuracy. Moreover, serum IgG, although less accurate, displays potential beyond microbiological tests.

中文翻译：

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胸膜结核患者胸水和血清中分枝杆菌抗原的IgA和IgG抗体检测。

背景技术先前的研究表明，胸膜结核（PLTB）病例中，胸膜积液（PF）IgA对融合的MT10.3：MPT64蛋白具有免疫力。然而，尚无关于改善诊断的IgA和IgG抵抗PF和血清中的此抗原和其他抗原的作用的线索。因此，本研究的目的是验证PF IgA-MT10.3：MPT64并评估PF和血清IgA和IgG对这种蛋白质，其肽（F2）和单个MPT64，MT10.3和PPE59分枝杆菌特异性抗原的反应性。针对PLTB（n = 29）和其他非TB胸膜炎（n = 39）患者样品中的抗原测量了IgA和IgG ELISA。结果PF IgA-MT10.3：MPT64的免疫优势在PLTB中得到证实（86.2％），其次是PPE59（62％），而血清IgA-F2表现出51.7％的敏感性。PF和血清IgG-MT10.3：MPT64分别为65.5和51。灵敏度分别为7％。但是，MT10.3和MPT64对这两种抗体的总体敏感性较低（≤34.5）。所有结果均为95％固定特异性。组合结果表明，PF IgA-MT10.3：MPT64 / -PPE59和IgA / IgG-MT10.3：MPT64的敏感性为92.3％，特异性为92.3％，其次是IgA-MT10.3：MPT64 / -MPT64或-F2（ 89.6％）而不会损害特异性（94.9％）。PF腺苷脱氨酶试验（ADA）和IgA-MT10.3：MPT64 / -F2的组合结果显示最高的敏感性（96.6％），特异性为92.3％。结论PF IgA-MT10：MPT64的免疫优势已在PLTB中得到验证，并且首次报道了其与PPE59或MPT64或F2抗原以及IgG的组合结果，从而提高了其辅助诊断的潜力。结合PF-ADA和IgA-MT10.3：MPT64 / -F2结果获得了更好的精度。此外，血清IgG尽管准确性较差，但仍具有超越微生物学检测的潜力。