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.     

牛分支杆菌与肺结核分支杆菌基因组的比较

通过比较基因组学的方法研究发现,牛分支杆菌与肺结核杆菌基因组的同源性为99．95％,但在牛分枝杆菌基因组中有11个缺失区,大小从1kb到12．7kb,遗传信息的缺失引起牛分枝杆菌的基因组减小;牛分枝杆菌与肺结核分枝杆菌H37Rv间存在着2437个单核苷酸多态性（SNPs）,与肺结核分枝杆菌CDC1551间存在着2423个单核苷酸多态性（SNPs）,牛分支杆菌与肺结核分枝杆菌在编码细胞壁和分泌蛋白上变异程度也是巨大的。研究结果揭示了牛分支杆菌与肺结核分枝杆菌的遗传关系,为研究分支杆菌疫苗和诊断试剂提供理论依据,对牛肺结核病的防治有着非常重要的意义。     

结核分枝杆菌分泌蛋白TB10.4的功能和应用

近年来,结核的发病率又呈上升趋势,传统的结核疫苗已无法起到有效的保护作用。结核分枝杆菌分泌蛋白由于具有良好的免疫保护性因而备受关注。结核分泌蛋白TB10.4是免疫主导的蛋白,能够激发有效的免疫反应,因而成为研究结核新疫苗靶抗原之一。本文就近几年结核分枝杆菌TB10.4的相关研究作一综述。     

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。     

应用PCR技术检测结核分枝杆菌的临床分析

采用聚合酶链反应（Ｐｏｌｙｍｅｒａｎｓｅ Ｃｈｉａｎ Ｒｅａｔｉｏｎ,即ＰＣＲ）技术检测结核分枝杆菌Ｍｙｃｏｂａｃｔｅｒｉｕｍ ｔｕｂｅｒｃｕｌｏｓｉｓ,一年多来共检测了１００例结核（肺、肾结核）患者的痰和尿液标本,结果ＰＣＲ检出阳性率为８１％,对照用储菌涂片抗酸染色法,阳性率为５８％,用常规培养法阳性率为２０％。而对５０例非结核患者的痰和尿液标本的检测,ＰＣＲ法仍有６％的阳性率,而用涂片或常规培     

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.     

Direct detection of Mycobacterium tuberculosis lipid antigens by thin-layer chromatography

Abstract Free lipids were extracted from Mycobacterium tuberculosis H37Rv, and their antigenicity was assessed directly on thin-layer chromatograms (TLC) by an immunostaining technique. A family of glycolipids, composed of trehalose acylated with multimethyl branched long-chain fatty acids, was investigated. The most polar of these glycolipids was identified as a possible specific surface antigen. A pair of novel polar glycolipids also showed positive antigenic reactions.     

快速方法检测结核分枝杆菌耐药基因突变

快速准确地鉴定结核分枝杆菌与结核分枝杆菌对利福平和异烟肼耐药基因突变的快速检测,对结核病人的诊断与治疗具有重要指导意义。本次根据结核分枝杆菌标准株H37RV序列,利用覆盖rpoB、katG、inhA基因突变区的系列寡核苷酸探针,并检测临床样品中结核分枝杆菌的基因突变情况,以此来判断耐药结果,并对其进行方法学评价。     

Polymorphisms of 20 regulatory proteins between Mycobacterium tuberculosis and Mycobacterium bovis

Mycobacterium tuberculosis and Mycobacterium bovis are responsible for tuberculosis in humans and animals, respectively. Both species are closely related and belong to the Mycobacterium tuberculosis complex (MTC). M. tuberculosis is the most ancient species from which M. bovis and other members of the MTC evolved. The genome of M. bovis is over >99.95% identical to that of M. tuberculosis but with seven deletions ranging in size from 1 to 12.7 kb. In addition, 1200 single nucleotide mutations in coding regions distinguish M. bovis from M. tuberculosis. In the present study, we assessed 75 M. tuberculosis genomes and 23 M. bovis genomes to identify non‐synonymous mutations in 202 coding sequences of regulatory genes between both species. We identified species‐specific variants in 20 regulatory proteins and confirmed differential expression of hypoxia‐related genes between M. bovis and M. tuberculosis.     

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.     

结核杆菌融合蛋白DNA疫苗构建及免疫保护研究

目的:评价结核DNA疫苗免疫鼠产生细胞因子和抵抗结核分枝杆菌攻击的能力。方法:将结核菌Mtb8.4基因和谷胱甘肽S转移酶基因插入pVAX1载体,构建表达Mtb8.4和GST融合蛋白的DNA疫苗pVS8.4G。小鼠分成5组,用pVS8.4G、pVAX1、pIL2S 100μg和PBS 0.1mL各免疫3次,间隔2w。另一组用BCG免疫1次。每组10只鼠在加强后,无菌取脾培养。另外10只小鼠用H37Rv攻击,2w后取脾、肝和肺培养结核菌并计数。结果:pVS8.4G免疫鼠脾细胞培养上清mIL-2和mIFN-γ平均为380.9和422.1pg/mL,显著高于阴性对照组,与BCG组无显著差异。5个组的平均mIL-6和mIL-10无显著差异。pVS8.4G免疫小鼠脾、肝和肺的平均结核菌载量分别为42 093.2、43 264.1和37 264.8CFU/g,低于pVAX1、pIL2S和PBS组相应器官的载量。结论:DNA疫苗pVS8.4G能刺激产生Th1型免疫应答,免疫鼠抵抗H37Rv攻击的能力增强。     

结核分枝杆菌诊断技术研究进展

近年来,结核病的诊断方法逐渐得到完善,将传统细菌学检验方法、免疫学方法和分子生物学的方法相结合,加速了对结核病的诊断研究。特别是分子生物学技术的发展,对于阐明分枝杆菌和结核分枝杆菌的遗传变异规律及分子进化等都有重要的意义。我们结合近年来结核分枝杆菌诊断在免疫学检测、PCR技术、基因技术等方面的进步,从细菌学检测、免疫学检测、分子生物学检测等3个方面做简要综述。     

结核分枝杆菌的致病机理

结核病仍是全球健康的主要威胁,其致病菌结核分枝杆菌的致闰机理与众不同。脂类代谢在致病中具有重要的作用。巨噬细胞被入侵的细菌修的机理也是研究细菌持续感染致病的重要突破点,研究细菌的致病机理可以为开发新的疫苗和治疗药物奠定坚实的基础。     

荧光定量PCR检测结核分枝杆菌Meta分析

目的系统评价荧光定量PCR(FQ-PCR)方法检测结核分枝杆菌的效果。方法按照系统评价的要求检索CBM、VIP、CNKI以及万方数据库等,获得20篇符合纳入标准的文献,对其进行Meta分析,并评价Meta分析结果的稳定性和发表偏倚。结果 FQ-PCR对照涂片染色、培养鉴定以及总数据的异质性检验P0.00001,采用随机效应模型进行Meta分析,其余的采用固定效应模型分析。FQ-PCR与涂片染色、培养鉴定、抗体检测等的总体效应Z值分别为7.76、5.00和7.34,P值均小于0.00001,差异具有统计学意义。总数据分析结果的合并OR=2.78,95%CI为1.93-4.01,总体效应检验,Z=5.49,P0.00001,差异具有统计学意义,固定效应模型OR值和95%CI(2.52[2.35-2.70])与随机效应模型比较接近,剔除小样本报道后的合并OR=2.93,95%CI为1.98-4.31,与剔除前的结果也比较接近。结论从现有的临床证据来看,FQ-PCR是检测结核分枝杆菌的有效方法,可推广应用与临床结核病辅助检测。     

Mass-spectrometry based minisequencing method for the rapid detection of drug resistance in Mycobacterium tuberculosis

A MALDI TOF MS based minisequencing method has been developed and applied for the analysis of rifampin (RIF)- and isoniazid (INH)-resistant M. tuberculosis strains. Eight genetic markers of RIF resistance-nucleotide polymorphisms located in RRDR of rpoB gene, and three of INH resistance including codon 315 of katG gene and − 8 and − 15 positions of the promoter region of fabG1-inhA operon were worked out. Based on the analysis of 100 M. tuberculosis strains collected from the Moscow region in 1997–2005 we deduced that 91% of RIF-resistant and 94% of INH-resistant strains can be identified using the technique suggested. The approach is rapid, reliable and allows to reveal the drug resistance of M. tuberculosis strains within 12 h after sample isolation.     

结核分枝杆菌与巨噬细胞相互作用的研究进展

结核分枝杆菌（Mycobacterium tuberculosis,MTB）是一种典型的胞内致病菌,巨噬细胞是MTB在体内的主要宿主细胞。巨噬细胞具有强大的吞噬功能,在机体固有免疫和适应性免疫中均发挥着重要作用,可有效保护宿主免受结核分枝杆菌的感染。MTB在与宿主巨噬细胞的长期相互作用过程中,逐渐形成多种逃避杀灭的有效策略,得以在宿主体内存活并增殖。该文从巨噬细胞抗MTB感染及MTB逃避巨噬细胞杀灭两个方面综述国内外的研究进展。     

结核分枝杆菌脂阿拉伯甘露聚糖的提纯及活性初步鉴定

目的:提取纯化结核分枝杆菌(MTB)脂阿拉伯甘露聚糖(LAM)。方法:MTB菌体彻底破碎后,去脂,去蛋白,上清液经苯酚萃取,酒精沉淀,得到LAM;以提取的LAM作为包被抗原检测血清中的LAM抗体。结果和结论:提取到LAM抗原,免疫印迹表明,LAM迁移范围相对分子质量为25×103~40×103,主要集中在35×103处。在64例肺结核患者中,有43例LAM-ELISA检测阳性(敏感性为67.19%);在67例健康志愿者中,有64例LAM-ELISA检测阴性(特异性为95.52%)。     

结核疫苗保护力评价用感染菌液的制备和保藏研究

实验研究中对结合分枝杆菌感染菌液进行活菌数量与毒力的稳定性观察。以活菌计数与感染豚鼠后的肝、脾、肺病变指数为评判指标进行观察,结果显示低温保藏菌液在32个月内,其活菌数量处于6.7～18×105CFU/ml之间,感染豚鼠的肝、脾、肺病变指数处于42～51之间。说明低温保藏菌液具有很好的稳定性,可作为结核分枝杆菌感染豚鼠模型标准化用菌液。     

Revised structure of a trehalose-containing immunoreactive glycolipid of Mycobacterium tuberculosis

Nuclear magnetic resonance spectroscopy, fast-atom bombardment mass spectrometry as well as various chemical degradations and chromatographic techniques were used to re-examine the structure of a highly immunoreactive glycolipid previously described in Mycobacterium tuberculosis (strain Canetti) as a 2,3-diacyl trehalose 2'-sulfate (labelled SL-IV). Ion exchange chromatography allowed the recognition of a neutral and an acidic glycolipid, indistinguishable on conventional silica gel. The neutral glycolipid was shown to be serologically identical to SL-IV and its structure was established as 2,3-diacyl trehalose. It corresponded to the non-chemically defined highly observed immunoreactive lipid previously recognized by others in M. tuberculosis (H37Rv).