title: A sensitive urinary lipoarabinomannan test for tuberculosis.
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.
authors.affiliation: Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Beston
authors.initials: B
authors.lastname: Hamasur
authors.affiliation: Unit of Infectious Diseases, Institution of Medicine, Karolinska Institutet Solna and, Karolinska University Hospital, Solna, Stockholm, Sweden.
authors.forename: Judith
authors.initials: J
authors.lastname: Bruchfeld
authors.affiliation: DST/NRF Centre of Excellence for Biomedical TB Research, US/MRC Centre for TB Research, Division of Molecular Biology and Human Genetics, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa.
authors.forename: Paul
authors.initials: P
authors.lastname: van Helden
authors.affiliation: Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Källenius
authors.affiliation: Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Svenson
mesh_terms: D000911:Antibodies, Monoclonal / Q000276:immunology; D015415:Biomarkers / Q000652:urine*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D008070:Lipopolysaccharides / Q000276:immunology / Q000652:urine*; D010865:Pilot Projects; D012680:Sensitivity and Specificity; D014376:Tuberculosis / Q000175:diagnosis* / Q000652:urine
chemical_list: D000911:Antibodies, Monoclonal; D015415:Biomarkers; D008070:Lipopolysaccharides; C050016:lipoarabinomannan