Current Science

Open Access Open Access  Restricted Access Subscription Access

Antigens of Mycobacterium tuberculosis with Reference to Diseases Diagnosis and Special Emphasis on Lipoarabinomannan


Affiliations
1 Department of Zoology, Dayalbagh Educational Institute (Deemed to be University), Agra 282 001, India
2 Department of Immunology, National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Indian Council of Medical Research, Agra 282 005, India
3 Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru 560 029, India
 

Tuberculosis (TB) is a contagious and notorious disease globally. There are several tests available for the detection of TB, but they have severe limitations. There is no reliable test present that quickly can detect TB at an early stage and also discern between different stages of the disease. Detection of TB is the major problem. Resolving it may lead to initiation of early treatment and thus controlling further spread. Methods to detect TB are continuously evolving to achieve rapid, cheaper, sensitive, and specific results. Here, we review Mycobacterium tuberculosis lipoarabinomannan (LAM) as a diagnostic marker, which is present in the sputum and body fluids, including urine and blood. Thus, it could be an innovative approach in the diagnosis of childhood TB using urine as a sample. There is a need for developing better diagnostic tools to detect TB and using LAM as a diagnostic marker, we can overcome the shortcomings of the present tools and techniques. The application of rapid LAM test has the potential to evolve with innovative approaches being attempted to increase the sensitivity of TB detection.

Keywords

Antigens, Diagnostic Marker, Lipoarabinomannan, Mycobacterium tuberculosis, Tuberculosis.
User
Notifications
Font Size

  • Riley, R. L. and Moodie, A. S., Infectivity of patients with pulmonary tuberculosis in inner city homes. Am. Rev. Respirat. Dis., 1974, 110(6P1), 810–812.

  • Vynnycky, E. and Fine, P. E., Lifetime risks, incubation period, and serial interval of tuberculosis. Am. J. Epidemiol., 2000, 152(3), 247–263.

  • Houben, R. M. G. J. and Dodd, P. J., The global burden of latent tuberculosis infection: a re-estimation using mathematical modelling. PLOS Med., 2016, 13(10), e1002152.

  • MacLean, E. and Pai, M., Urine lipoarabinomannan for tuberculosis diagnosis: evolution and prospects. Clin. Chem., 2018, 64(8), 1133–1135.

  • Murray, C. J. and Lopez, A. D., Mortality by cause for eight regions of the world: global burden of disease study. Lancet, 1997, 349(9061), 1269–1276.

  • WHO, Global tuberculosis report, World Health Organization, Geneva, Switzerland, 2020; https://www.who.int/publications/i/item/9789240013131 (accessed on 1 March 2022).

  • WHO, End TB Strategy, World Health Organization, Geneva, Switzerland; http://www.who.int/tb/post2015_strategy/en/ (accessed on 18 March 2022).

  • Collins, C. H., Grange, J. M. and Yates, M. D., Tuberculosis Bacteriology: Organization and Practice, Butterworth Heinemann, Oxford, UK, 1997, 2nd edn.

  • Cole, S. et al., Deciphering the biology of Mycobacterium tuberculosis from the complete genome sequence. Nature, 1998, 393(6685), 537–544.

  • Fu, L. M. and Fu-Liu, C. S., Is Mycobacterium tuberculosis a closer relative to Gram-positive or Gram-negative bacteria pathogens? Tuberculosis, 2002, 82(2–3), 85–90.

  • Dannenberg Jr, A. M., Roles of cytotoxic delayed-type hypersensitivity and macrophage-activating cell-mediated immunity in the pathogenesis of tuberculosis. Immunobiology, 1994, 191(4–5), 461–473.

  • Cardona, P. J., A dynamic reinfection hypothesis of latent tuberculosis infection. Infection, 2009, 37(2), 80–86.

  • Alderwick, L. J., Birch, H. L., Mishra, A. K., Eggeling, L. and Besra, G. S., Structure, function, and biosynthesis of the Mycobacterium tuberculosis cell wall: arabinogalactan and lipoarabinomannan assembly with a view to discovering new drug targets. Biochem. Soc. Trans., 2007, 35(5), 1325–1328.

  • Rajni Rao, N. and Meena, L. S., Biosynthesis and virulent behaviour of lipids produced by Mycobacterium tuberculosis: LAM and cord factor: an overview. Biotechnol. Res. Int., 2011, 1–7; doi: 10.4061/2011/274693.

  • Riley, L. W., Of mice, men, and elephants: Mycobacterium tuberculosis cell envelope lipids and pathogenesis. J. Clin. Invest., 2006, 116(6), 1475–1478.

  • Riley, R. L. et al., Aerial dissemination of pulmonary tuberculosis. A two-year study of contagion in a tuberculosis ward. Am. J. Hygiene, 1959, 70(2), 185–196.

  • Kallenius, G., Correia-Neves, M., Buteme, H., Hamasur, B. and Svenson, S. V., Lipoarabinomannan, and its related glycolipids, induce divergent and opposing immune responses to Mycobacterium tuberculosis depending on structural diversity and experimental variations. Tuberculosis, 2016, 96, 120–130.

  • Cooper, A. M., Cell-mediated immune responses in tuberculosis. Annu. Rev. Immunol., 2009, 27(1), 393–422.

  • Kozakiewicz, L., Phuah, J., Flynn, J. and Chan, J., The role of B cells and humoral immunity in Mycobacterium tuberculosis infection. In The New Paradigm of Immunity Tuberculosis, Springer, New York, 2013, vol. 783, pp. 225–250; doi:10.1007/978-1-4614-6111-1_12.

  • Achkar, J. M., Chan, J. and Casadevall, A., B cells and antibodies in the defence against Mycobacterium tuberculosis infection. Immunol. Rev., 2015, 264(1), 167–181.

  • Cotran, R. S., Kumar, V. and Robbins, S. L., Pathologic Basis of Disease, Elsevier, 1989, vol. 4, p. 1519.

  • Saleh, M., Longhi, G., Hanifi-Moghaddam, P. and Toubassy, R., Macrophage infection by mycobacteria. Mycobacterial Dis., 2016, 6(01), 1–11.

  • Petruccioli, E. et al., Correlates of tuberculosis risk: predictive bio-markers for progression to active tuberculosis. Euro. Respirat. J., 2016, 48(6), 1751–1763.

  • Auguste, P., Tsertsvadze, A., Pink, J., Court, R., McCarthy, N., Sutcliffe, P. and Clarke, A., Comparing interferon-gamma release assays with tuberculin skin test for identifying latent tuberculosis infection that progresses to active tuberculosis: systematic review and meta-analysis. BMC Inf. Dis., 2017, 17(1), 200.

  • Lagrange, P. H. et al., A toolbox for tuberculosis diagnosis: an Indian multicentric study (2006–2008): microbiological results. PLoS ONE, 2012, 7(8), e43739.

  • Goletti, D., Petruccioli, E., Joosten, S. A. and Ottenhoff, T. H. M., Tuberculosis biomarkers: from diagnosis to protection. Infect. Dis. Rep., 2016, 8(2), 24–32.

  • Salgame, P., Geadas, C., Collins, L., Jones-López, E. and Ellner, J. J., Latent tuberculosis infection–revisiting and revising concepts. Tuberculosis, 2015, 95(4), 373–384.

  • Kik, S. V., Denkinger, C. M., Casenghi, M., Vadnais, C. and Pai, M., Tuberculosis diagnostics: which target product profiles should be prioritised? Eur. Respir. J., 2014, 44(2), 537–540.

  • Ottenhoff, T. H., Ellner, J. J. and Kaufmann, S. H., Ten challenges for TB biomarkers. Tuberculosis, 2012, 92(1), S17–S20.

  • Choudhary, A. et al., Characterization of the antigenic heterogeneity of lipoarabinomannan, the major surface glycolipid of Mycobacterium tuberculosis, and complexity of antibody specificities toward this antigen. J. Immunol., 2018, 200(9), 3053–3066.

  • Patil, S. A., Ramu, G. and Patil, M., Lipoarabinomannan antigen and anti-lipoarabinomannan antibody profile in the serum of patients with mycobacterial infections and their significance in disease process. Serodiagn. Immunother. Infect. Dis., 1995, 7(2), 59–63.

  • Venisse, A., Berjeaud, J. M., Chaurand, P., Gilleron, M. and Puzo, G., Structural features of lipoarabinomannan from Mycobacterium bovis BCG. Determination of molecular mass by laser desorption mass spectrometry. J. Biol. Chem., 1993, 268(17), 12401–12411.

  • Nigou, J., Gilleron, M. and Puzo, G., Lipoarabinomannans: from structure to biosynthesis. Biochimie, 2003, 85(1–2), 153–166.

  • Torrelles, J. B. and Schlesinger, L. S., Diversity in Mycobacterium tuberculosis mannosylated cell wall determinants impact adaptation to the host. Tuberculosis, 2010, 90(2), 84–93.

  • Gilleron, M., Himoudi, N., Adam, O., Constant, P., Venisse, A., Rivière, M. and Puzo, G., Mycobacterium smegmatis sphosphoinositols-glyceroarabinomannans: structure and localization of alkali-labile and alkali-stable phosphoinositides. J. Biol. Chem., 1997, 272(1–3), 117–124.

  • Besra, G. S., Morehouse, C. B., Rittner, C. M., Waechter, C. J. and Brennan, P. J., Biosynthesis of mycobacterial lipoarabinomannan. J. Biol. Chem., 1997, 272(29), 18460–18466.

  • Turnbull, W. B. and Stalford, S. A., Methylthioxylose – a jewel in the mycobacterial crown? Org. Biomol. Chem., 2012, 10(30), 5698–5706.

  • Gupta-Wright, A., Peters, J. A., Flach, C. and Lawn, S. D., Detection of lipoarabinomannan (LAM) in urine is an independent predictor of mortality risk in patients receiving treatment for HIV-associated tuberculosis in sub-Saharan Africa: a systematic review and meta-analysis. BMC Med., 2016, 14(1), 1–11.

  • MacLean, E., Broger, T., Yerlikaya, S., Fernandez-Carballo, B. L., Pai, M. and Denkinger, C. M., A systematic review of biomarkers to detect active tuberculosis. Nature Microbiol., 2019, 4(5), 748–758.

  • WHO, High priority target product profiles for new tuberculosis diagnostics: report of a consensus meeting, World Organization, Geneva, Switzerland, 2014; http://apps.who.int/iris/bitstream/10665/135617/1/WHO_HTM_TB_2014.18_eng.pdf?ua=1 (accessed on 4 April 2022).

  • Graham, S. M. et al., Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel. J. Inf. Dis., 2012, 205(Suppl. 2), S199–S208.

  • Batz, H. G., Cooke, G. S. and Reid, S. D., Towards lab-free tuberculosis diagnosis. Treatment Action Group, the TB/HIV Working Group of the Stop TB Partnership, Imperial College, London, UK, and the MSF Access Campaign, 2011.

  • Denkinger, C. M., Kampmann, B., Ahmed, S. and Dowdy, D. W., Modelling the impact of novel diagnostic tests on pediatric and extrapulmonary tuberculosis. BMC Infect. Dis., 2014, 14(1), 1–10.

  • Wells, W. A. et al., Alignment of new tuberculosis drug regimens and drug susceptibility testing: a framework for action. Lancet Infect. Dis., 2013, 13(5), 449–458.

  • Bulterys, M. A. et al., Point-of-care urine LAM tests for tuberculosis diagnosis: a status update. J. Clin. Med., 2020, 9(1), 111.

  • Denkinger, C. M. et al., Guidance for the evaluation of tuberculosis diagnostics that meet the World Health Organization (WHO) target product profiles: an introduction to WHO process and study design principles. J. Infect. Dis., 2019, 220(Suppl. 3), S91–S98.

  • Drain, P. K. et al., Guidance for studies evaluating the accuracy of biomarker-based non sputum tests to diagnose tuberculosis. J. Infect. Dis., 2019, 220(Suppl. 3), S108–S115.

  • Marais, B. J. and Graham, S. M., Childhood tuberculosis: a roadmap towards zero deaths. J. Paediatr. Child Health, 2016, 52(3), 258–261.

  • Iskandar, A., Nursiloningrum, E., Arthamin, M. Z., Olivianto, E. and Chandrakusuma, M. S., The diagnostic value of urine lipoarabinomannan (LAM) antigen in childhood tuberculosis. J. Clin. Diagnostic Res., 2017, 11(3), EC32–EC35.

  • Correia-Neves, M. et al., Biomarkers for tuberculosis: the case for lipoarabinomannan. ERJ Open Res., 2019, 5(1), 00115-2018.

  • Suwanpimolkul, G. et al., Utility of urine lipoarabinomannan (LAM) in diagnosing tuberculosis and predicting mortality with and without HIV: prospective TB cohort from the Thailand Big City TB Research Network. Int. J. Infect. Dis., 2017, 59, 96–102.

  • Hamasur, B., Bruchfeld, J., Haile, M., Pawlowski, A., Bjorvatn, B., Källenius, G. and Svenson, S. B., Rapid diagnosis of tuberculosis by detection of mycobacterial lipoarabinomannan in urine. J. Microbiol. Meth., 2001, 45(1), 41–52.

  • Kawasaki, M. et al., Lipoarabinomannan in sputum to detect bacterial load and treatment response in patients with pulmonary tuberculosis: analytic validation and evaluation in two cohorts. PLoS Med., 2019, 16(4), e1002780.

  • Sarkar, P., Biswas, D., Sindhwani, G., Rawat, J., Kotwal, A. and Kakati, B., Application of lipoarabinomannan antigen in tuberculosis diagnostics: current evidence. Postgr. Med. J., 2014, 90(1061), 155–163.

  • Chan, E. D., Reves, R., Belisle, J. T., Brennan, P. J. and Hahn, W. E., Diagnosis of tuberculosis by a visually detectable immunoassay for lipoarabinomannan. Am. J. Respirat. Crit. Care Med., 2000, 161(5), 1713–1719.

  • Pai, M., Nicol, M. P. and Boehme, C. C., Tuberculosis diagnostics: state-of-the-art and future directions. Microbiol Spectr., 2016, 4(5); doi:10.1128/microbiolspec.TBTB2-0019-2016.

  • Gautam, H., Singla, M., Jain, R., Lodha, R., Kabra, S. K. and Singh, U. B., Point-of-care urine lipoarabinomannan antigen detection for diagnosis of tuberculosis in children. Int. J. Tubercul. Lung Dis., 2019, 23(6), 714–719.

  • Barry, C. E. et al., The spectrum of latent tuberculosis: rethinking the biology and intervention strategies. Nature Rev. Microbiol., 2009, 7(12), 845–855.

  • Denkinger, C. M. et al., Defining the needs for next generation assays for tuberculosis. J. Infecti. Dis., 2015, 211(2), S29–S38.

  • Pai, M., Innovations in tuberculosis diagnostics: progress and translational challenges. E BioMedicine, 2015, 2, 182–183.

  • Gounder, C. R. et al., Diagnostic accuracy of a urine lipoarabinomannan enzyme-linked immunosorbent assay for screening ambulatory HIV-infected persons for TB. J. Acquir. Immune Def. Syndr., 2011, 58(2), 219–223.

  • Sarkar, S., Tang, X. L., Das, D., Spencer, J. S., Lowary, T. L. and Suresh, M. R., A bispecific antibody-based assay shows potential for detecting tuberculosis in resource constrained laboratory settings. PLoS ONE, 2012, 7(2), e32340.

  • Abd el-Atty, H. E. S., MohamadBakr, R., El-Helbawy, R., Fathyabbass, H. and El-kalashy, M. M., The value of serum lipoarabinomannan in the diagnosis of pulmonary tuberculosis. Menoufia Med. J., 2014, 27(4), 733–739.

  • Sabur, N. F., Esmail, A., Brar, M. S. and Dheda, K., Diagnosing tuberculosis in hospitalized HIV-infected individuals who cannot produce sputum: is urine lipoarabinomannan testing the answer? BMC Infect. Dis., 2017, 17(1), 1–6.

  • Amin, A. G. et al., Detection of lipoarabinomannan in urine and serum of HIV-positive and HIV-negative TB suspects using an improved capture-enzyme linked immuno absorbent assay and gas chromatography/mass spectrometry. Tuberculosis, 2018, 111, 178–187.

  • Younis, H. et al., Combining urine lipoarabinomannan with antibody detection as a simple non-sputum-based screening method for HIV-associated tuberculosis. PLoS ONE, 2019, 14(6), e0218606.

  • Songkhla, M. N., Tantipong, H., Tongsai, S. and Angkasekwinai, N., Lateral flow urine lipoarabinomannan assay for diagnosis of active tuberculosis in adults with human immunodeficiency virus infection: a prospective cohort study. Open Forum Infect. Dis., 2019, 6(4), ofz132.

  • Broger, T. et al., Novel lipoarabinomannan point-of-care tuberculosis test for people with HIV: a diagnostic accuracy study. Lancet Infect. Dis., 2019, 19(8), 852–861.

  • Brock, M., Hanlon, D., Zhao, M. and Pollock, N. R., Detection of mycobacterial lipoarabinomannan in serum for diagnosis of active tuberculosis. Diagn. Microbiol. Infect. Dis., 2020, 96(2), 114937.

  • Broger, T. et al., Diagnostic accuracy of 3 urine lipoarabinomannan tuberculosis assays in HIV-negative outpatients. J. Clin. Invest., 2020, 130(11), 5756–5764.

  • Reddy, K. P. et al., Cost-effectiveness of a novel lipoarabinomannan test for tuberculosis in patients with HIV. Clin. Infect. Dis., 2021, 73(7), e2077–e2085.


Abstract Views: 166

PDF Views: 81




  • Antigens of Mycobacterium tuberculosis with Reference to Diseases Diagnosis and Special Emphasis on Lipoarabinomannan

Abstract Views: 166  |  PDF Views: 81

Authors

Pooja Chaudhary
Department of Zoology, Dayalbagh Educational Institute (Deemed to be University), Agra 282 001, India
Arun P. Sikarwar
Department of Zoology, Dayalbagh Educational Institute (Deemed to be University), Agra 282 001, India
K. K. Mohanty
Department of Immunology, National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Indian Council of Medical Research, Agra 282 005, India
Shripad A. Patil
Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences, Hosur Road, Bengaluru 560 029, India

Abstract


Tuberculosis (TB) is a contagious and notorious disease globally. There are several tests available for the detection of TB, but they have severe limitations. There is no reliable test present that quickly can detect TB at an early stage and also discern between different stages of the disease. Detection of TB is the major problem. Resolving it may lead to initiation of early treatment and thus controlling further spread. Methods to detect TB are continuously evolving to achieve rapid, cheaper, sensitive, and specific results. Here, we review Mycobacterium tuberculosis lipoarabinomannan (LAM) as a diagnostic marker, which is present in the sputum and body fluids, including urine and blood. Thus, it could be an innovative approach in the diagnosis of childhood TB using urine as a sample. There is a need for developing better diagnostic tools to detect TB and using LAM as a diagnostic marker, we can overcome the shortcomings of the present tools and techniques. The application of rapid LAM test has the potential to evolve with innovative approaches being attempted to increase the sensitivity of TB detection.

Keywords


Antigens, Diagnostic Marker, Lipoarabinomannan, Mycobacterium tuberculosis, Tuberculosis.

References





DOI: https://doi.org/10.18520/cs%2Fv125%2Fi5%2F494-507