结核分枝杆菌重要诊断用抗原研究进展

血清学试验是结核诊断的重要依据。随着科学技术的进步,新的结核诊断用抗原不断被发现。我们简要综述了结核菌素蛋白衍生物、抗原85复合体、38kDa磷酸盐转运蛋白、6kDa早期分泌性蛋白、10kDa培养滤液蛋白、免疫性蛋白MPT64、主要分泌性免疫蛋白MPB70、表面脂蛋白MPB83等8种结核分枝杆菌重要抗原作为结核诊断用抗原的研究进展。     

结核病血清学诊断进展

结核病的细菌学检查目前是结核病实验室诊断的金标准.由于痰涂片阳性率较低,镜检需要经验,难以区分环境分枝杆菌造成的假阳性;痰培养需时太长,因此细菌学检查对结核病的诊断价值有限.随着分子生物学技术的迅速发展,用高度敏感的方法检测结核分枝杆菌(简称结核杆菌)及其特异性DNA片段,如聚合酶链反应(PCR)、生物探针和基因芯片等,需要相应的检测设备和检测费用高而未能广泛推广.血清学诊断技术有其固有的优势,如操作简便、快速、便于推广、无需特殊精密仪器,已有多种纯化的特异性抗原可采用,可以发展成自动化检测,尤其是对痰培养阴性和肺外结核病有较为重要的辅助诊断价值而受到广泛的重视.本文从靶抗原的选择和检测技术的改进等方面综述了结核病血清学诊断的现状和进展.     

结核分枝杆菌耐药性的分子生物学研究进展

结核病一直是世界性问题,我国其发病情况尤为严重,是亚洲的第二大结核病发病国家。结核病治疗方面常使用抗生素作为首选药物,随着抗菌药的滥用,结核杆菌对多种抗菌药产生耐药性,结核病耐药患者增多,治疗难度增加。因此,结核杆菌耐药分子机制的研究更加重要,新型抗结核药物研制更加迫切。结核分枝杆菌的基因突变是引起耐药的主要分子学依据,因此基于结核分枝杆菌耐药性相关基因的深入探索,对于预防结核病的传播及治疗皆具有深远影响。本文从分子生物学角度分析了近年来结核分枝杆菌耐药性产生的原因及相关研究进展。     

结核分枝杆菌抗原检测研究进展

结核病仍然是一个严重的全球性公共卫生问题,有效控制结核病的障碍在于缺乏早期、准确的诊断方法。机体受到结核分枝杆菌感染后,体内首先出现的是结核分枝杆菌特异性抗原。因此,结核分枝杆菌抗原检测作为结核病早期诊断的方法可能具有很高的诊断价值。我们简要综述了结核分枝杆菌抗原检测的相关研究进展。     

结核分枝杆菌重组38kD蛋白用于新疆南疆维吾尔族和湖南湘中汉族血清学诊断的研究

目的：对结核分枝杆菌38kD蛋白编码基因进行克隆表达及纯化,建立基于重组38kD蛋白的酶联免疫吸附法（EusA）检测结核病人血清标本,评价重组38kD蛋白用于结核病血清学诊断抗原的价值。并比较分析其在汉族和维吾尔族人群中的血清学诊断的差异。方法：用PCR方法扩增38kD蛋白的编码基因,构建重组质粒,转化到大肠杆菌BL21中,经IPTG诱导表达,得到纯化的38kD蛋白,建立以38kD蛋白为包被抗原的ELISA,并检测临床确诊的结核病人血清标本。结果：ELISA检测结核病患者血清标本的维吾尔族阳性率为34％（52／153）,汉族为52．4％（65／124）,两者对比有统计学差异（x2=9．538,P〈O．005）。在阴性对照中的维吾尔族特异度为96．4％（159／165）,汉族为98．8％（130／133）,结果无统计学意义（x2=0．111,P〉0．5）。结论：重组38kD蛋白用于血清学诊断的敏感度在维吾尔族和汉族中有差异,而其诊断特异度无差别。     

结核分枝杆菌重组38kD蛋白用于新疆南疆维吾尔族和 湖南湘中汉族血清学诊断的研究

目的：对结核分枝杆菌38kD 蛋白编码基因进行克隆表达及纯化,建立基于重组38 kD 蛋白的酶联免疫吸附法(ELISA)检测 结核病人血清标本,评价重组38 kD蛋白用于结核病血清学诊断抗原的价值。并比较分析其在汉族和维吾尔族人群中的血清学 诊断的差异。方法：用PCR方法扩增38 kD 蛋白的编码基因, 构建重组质粒, 转化到大肠杆菌BL21 中,经IPTG诱导表达, 得到纯 化的38 kD 蛋白,建立以38 kD蛋白为包被抗原的ELISA,并检测临床确诊的结核病人血清标本。结果：ELISA 检测结核病患者 血清标本的维吾尔族阳性率为34%（52/153）,汉族为52.4%（65/124）,两者对比有统计学差异（X2＝9.538,P＜0.005）。在阴性对照 中的维吾尔族特异度为96.4%（159/165）,汉族为98. 8%（130/133）,结果无统计学意义（X2＝0.111,P＞0.5）。结论：重组38kD 蛋白 用于血清学诊断的敏感度在维吾尔族和汉族中有差异,而其诊断特异度无差别。     

结核分枝杆菌潜伏感染诊断方法的新进展

每年有超过8百万人感染结核,其中绝大部分没有发展为活动性结核病,而是表现为潜伏性结核感染。大多数活动性结核病是潜伏感染的结核杆菌重新被激活所致,因此结核潜伏感染者成为结核患者的重要来源。及早诊断和治疗结核潜伏感染者是控制结核传播的最有效手段之一。我们较要综述了目前国内外结核潜伏感染的诊断方法及其新进展。     

结核分枝杆菌Rv3425蛋白的原核表达纯化及其血清学诊断价值

目的：用原核系统表达结核分枝杆菌Rv3425蛋白并纯化,评价该重组蛋白在结核病血清学诊断方面的价值。方法：以结核分枝杆菌H37Rv株基因组为模板,PCR扩增得到Rv3425基因序列,克隆至表达载体pET-28a中,转入大肠杆菌BL21（DE3）进行诱导、表达后纯化,用Western印迹和ELISA法进行抗原性初步评价。结果：在原核系统内经IPTG诱导表达后,Rv3425蛋白主要以包涵体形式存在,经复性和镍柱层析纯化后,纯度达95%以上;Western印迹和ELISA结果证明重组Rv3425具有较强的抗原活性;用纯化的Rv3425蛋白做抗原,临床诊断结核病人血清,阳性率达50%。结论：高纯度的Rv3425蛋白在结核病诊断方面具有很高的应用价值,可作为结核病诊断的备选抗原。     

结核分枝杆菌多表位诊断抗原的制备

将结核分枝杆菌(Mycobacterium tuberculosis,Mtb)多个B细胞预测表位串联表达(命名为B102),并初步评价其作为诊断抗原的血清学诊断价值。将MtbPstS1、ESAT6、CFP10、Ag85B、Ag85A及PPE54等6个蛋白的11个B细胞预测表位串联,加入合适的连接臂后全基因合成;将多表位片段插入带有TRX标签的表达质粒中,在大肠杆菌BL21(DE3)中诱导表达,并利用Ni~(2+)-Chelating亲和层析和DEAE阴离子交换层析纯化目的蛋白;利用Western blotting (WB)技术对目的蛋白抗原性进行鉴定,并建立Mtb抗体检测竞争法ELISA技术,初步评价此方法对阴阳血清样本的鉴别能力。目的蛋白以包涵体形式存在,其表达量约占菌体总蛋白的31.25%,经纯化及复性后蛋白B102可溶性存在,浓度为3.124mg/mL,纯度为96.71%;WB实验表明目的蛋白能与Mtb阳性血清相应抗体发生反应。对60份Mtb阳性血清及60份Mtb阴性血清进行检测得出其灵敏度为90.00%,特异性为93.33%,阳性预测值为93.10%,阴性预测值为90.32%,符合率为91.67%,McNemer检验的结果提示与"金标准"诊断结果无差异,Kappa=0.833,提示两种方法诊断结果一致性优异。原核表达与层析纯化可以获取抗原性优异的Mtb多表位诊断抗原,作为诊断抗原可以应用于Mtb的血清学检测中。     

结核分枝杆菌毒力的研究进展

结核分枝杆菌可以在人体内缓慢增殖,释放代谢产物,造成细胞损伤,引起结核病。其致病机制可能与其复杂的细胞壁成分密切相关。结核分枝杆菌细胞壁中的脂质、糖类及蛋白类物质在构成屏障结构,保护并辅助结核分枝杆菌在细胞内的生长及迁移,调节宿主免疫应答,造成宿主组织细胞损伤等方面发挥重要生物学作用。其表达受众多基因的精细调控。本文将对结核分枝杆菌细胞壁中的脂质阿拉伯甘露聚糖和分枝菌酸在其毒力中的作用,以及sig基因对毒力的调节作用作一综述。     

结核分枝杆菌融合抗原Rv3914-6His的原核表达、纯化与抗原性检测

血清学诊断是目前临床诊断中应用最为广泛的方法之一,用原核表达并鉴定了系列结核分枝杆菌抗原融合蛋白Rv1908c-6His、Rv0733-6His、Rv0899-6His、Rv1411c-6His和Rv3914-6His,并以此包被酶标板,以Rv2031c-6His为阳性对照,采用间接ELISA方法比较了34例活动性结核病患者与35例健康体检者血清中抗结核分枝杆菌抗原的IgG水平。结果显示,活动性结核病患者中针对Rv1411c-6His、Rv3914-6His和Rv2031c-6His的IgG水平明显高于健康体检者,其中Rv3914-6His的AUC值(0.786 7)略高于目前临床应用的类似于16 ku的抗原Rv2031c-6His(AUCRv2031c=0.754),提示Rv3914抗原可能是结核病血清诊断的新的候选标志物。     

Molecular detection, identification and drug resistance detection in Mycobacterium tuberculosis

This minireview presents recent developments in molecular methods for the diagnosis of tuberculosis, including detection, identification and determination of drug resistance of Mycobacterium tuberculosis . Tuberculosis remains one of the major causes of global death from a single infectious agent. This situation is worsened by the HIV/AIDS pandemic because one-third of HIV/AIDS patients are coinfected with M. tuberculosis . Also of great concern is the emergence of drug-resistant tuberculosis because there are almost no treatment options available for patients affected by highly resistant strains of M. tuberculosis . Advances in molecular biology techniques and a better knowledge of the molecular mechanisms of drug resistance have provided new tools for the rapid diagnosis of tuberculosis. Several nucleic acid amplification technologies have been developed and evaluated. New molecular approaches are being introduced continuously. This minireview will also comment on the future perspectives for the molecular diagnosis of tuberculosis and the feasibility for the implementation of these newer techniques in the clinical diagnostic laboratory.     

细胞因子和microRNA与结核分枝杆菌感染的研究进展

细胞因子是由免疫细胞和某些非免疫细胞经刺激而合成、分泌的一类具有广泛生物学活性的小分子蛋白质,其作为细胞间信号传递分子,主要参与调节免疫应答、免疫细胞分化发育、组织修复、介导炎症反应、刺激造血功能等。micro RNA(mi RNA)是存在于真核细胞内的一种非编码小RNA,可以调控基因转录后的表达,同时还可作为不同生理和病理状态的分子标记。许多研究表明,细胞因子相关基因的多态性与结核感染、肺结核发病易感性密切相关,而mi RNA在肺部疾病的正负调节功能与肺部疾病感染的发生、发展、转化与治疗有关。我们简要叙述了细胞因子、mi RNA与结核分枝杆菌感染三者之间的关联,以期有利于及时筛查潜伏结核感染和肺结核患者,降低结核感染率和发病率。     

Tuberculosis patients co-infected with Mycobacterium bovis and Mycobacterium tuberculosis in an urban area of Brazil

In this cross-sectional study, mycobacteria specimens from 189 tuberculosis (TB) patients living in an urban area in Brazil were characterised from 2008-2010 using phenotypic and molecular speciation methods (pncA gene and oxyR pseudogene analysis). Of these samples, 174 isolates simultaneously grew on Löwenstein-Jensen (LJ) and Stonebrink (SB)-containing media and presented phenotypic and molecular profiles of Mycobacterium tuberculosis, whereas 12 had molecular profiles of M. tuberculosis based on the DNA analysis of formalin-fixed paraffin wax-embedded tissue samples (paraffin blocks). One patient produced two sputum isolates, the first of which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, and the second of which only grew on SB media and presented phenotypic profiles of Mycobacterium bovis. One patient provided a bronchial lavage isolate, which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, but had molecular profiles of M. bovis from paraffin block DNA analysis, and one sample had molecular profiles of M. tuberculosis and M. bovis identified from two distinct paraffin blocks. Moreover, we found a low prevalence (1.6%) of M. bovis among these isolates, which suggests that local health service procedures likely underestimate its real frequency and that it deserves more attention from public health officials.     

Electrochemical-based biosensors for detection of Mycobacterium tuberculosis and tuberculosis biomarkers

Abstract

Early detection of tuberculosis (TB) reduces the interval between infection and the beginning of treatment. However, commercially available tests cannot discriminate between BCG-vaccinated healthy persons and patients. Also, they are not suitable to be used for immunocompromised persons. In recent years, biosensors have attracted great attention due to their simple utility, accessibility, and real-time outputs. These sensors are increasingly being considered as pioneering tools for point-of-care diagnostics in communities with a high burden of TB and limited accessibility to reference laboratories. Among other types of biosensors, the electrochemical sensors have the advantages of low-cost operation, fast processing, simultaneous multi-analyte analyzing, operating with turbid samples, comparable sensitivity and readily available miniaturization. Electrochemical biosensors are sub-divided into several categories including: amperometric, impedimetric, potentiometric, and conductometric biosensors. The biorecognition element in electrochemical biosensors is usually based on antibodies (immunosensors), DNAs or PNAs (genosensors), and aptamers (aptasensors). In either case, whether an interaction of the antigen–antibody/aptamer or the hybridization of probe with target mycobacterial DNA is detected, a change in the electrical current occurs that is recorded and displayed as a plot. Therefore, impedimetric-based methods evaluate resistance to electron transfer toward an electrode by a Nyquist plot and amperometric/voltammetric-based methods weigh the electrical current by means of cyclic voltammetry, square wave voltammetry, and differential pulse voltammetry. Electrochemical biosensors provide a promising scope for the new era of diagnostics. As a consequence, they can improve detection of Mycobacterium tuberculosis traces even in attomolar scales.     

Structural implications of lipoarabinomannan glycans from global clinical isolates in diagnosis of Mycobacterium tuberculosis infection

In Mycobacterium tuberculosis (Mtb), surface-exposed Lipoarabinomannan (LAM) is a key determinant of immunogenicity, yet its intrinsic heterogeneity confounds typical structure–function analysis. Recently, LAM gained a strong foothold as a validated marker for active tuberculosis (TB) infection and has shown great potential in new diagnostic efforts. However, no efforts have yet been made to model or evaluate the impact of mixed polyclonal Mtb infections (infection with multiple strains) on TB diagnostic procedures other than antibiotic susceptibility testing. Here, we selected three TB clinical isolates (HN878, EAI, and IO) and purified LAM from these strains to present an integrated analytical approach of one-dimensional and two-dimensional Nuclear Magnetic Resonance (NMR) spectroscopy, as well as enzymatic digestion and site-specific mass spectrometry (MS) to probe LAM structure and behavior at multiple levels. Overall, we found that the glycan was similar in all LAM preparations, albeit with subtle variations. Succinates, lactates, hydroxybutyrate, acetate, and the hallmark of Mtb LAM-methylthioxylose (MTX), adorned the nonreducing terminal arabinan of these LAM species. Newly identified acetoxy/hydroxybutyrate was present only in LAM from EAI and IO Mtb strains. Notably, detailed LC/MS-MS unambiguously showed that all acyl modifications and the lactyl ether in LAM are at the 3-OH position of the 2-linked arabinofuranose adjacent to the terminal β-arabinofuranose. Finally, after sequential enzymatic deglycosylation of LAM, the residual glycan that has ∼50% of α−arabinofuranose -(1→5) linked did not bind to monoclonal antibody CS35. These data clearly indicate the importance of the arabinan termini arrangements for the antigenicity of LAM.