title: Evaluation of host Hsp(s) as potential biomarkers for the diagnosis of tuberculous meningitis.
abstract: OBJECTIVE
  Diagnosis of tuberculosis meningitis (TBM) remains challenging in tuberculosis (TB) endemic countries. The need for TB biomarkers arises, in part, from the difficulty of accurately diagnosing TBM with the available methods.
  
  
  METHODS
  To explore the potential of host Hsps (Hsp 25, Hsp 60, Hsp 70 and Hsp 90) as an alternative marker in TBM diagnosis, we evaluated cerebrospinal fluid (CSF) sample of TBM (n=49), Pyogenic Meningitis (PM) (n=20), Viral Meningitis (VM) (n=09), Fungal Meningitis (FM) (n=04) and non infectious control (n=79) patients using indirect ELISA.
  
  
  RESULTS
  Out of four Hsps, Hsp 70 and Hsp 90 yields 89% & 88% sensitivity and 82% & 89% specificity, respectively. The positive (PPV) and negative (NPV) predictive values yielded in TBM group for Hsp 70 was 86.27% (73.74-94.27) and 93.51% (85.48-97.83), respectively. For Hsp 90 the obtained PPV was 89.36% (76.88-96.41) and NPV was 91.36% (82.99-96.44). In 86% of TBM patients all the four Hsps were found to be positive and none of the patient was found to be negative for all Hsps in the same group.
  
  
  CONCLUSIONS
  The data presented in the study indicate that host Hsp 70 and Hsp 90 shows good sensitivity and specificity and have potential in the diagnosis of TBM disease. The combined use of all Hsps (Hsp 25, Hsp 60, Hsp 70 and Hsp 90) effectively distinguishes patients with TBM from other disease controls.
authors.affiliation: Biochemistry Research Laboratory, Central India Institute of Medical Sciences, Nagpur 440 010, India.
authors.forename: Seema D
authors.initials: SD
authors.lastname: Shekhawat
authors.affiliation: Environmental Genomics Unit, National Environmental Engineering Research Institute, Nehru Marg, Nagpur 440020, India.
authors.forename: Hemant J
authors.initials: HJ
authors.lastname: Purohit
authors.affiliation: Biochemistry Research Laboratory, Central India Institute of Medical Sciences, Nagpur 440 010, India.
authors.forename: Girdhar M
authors.initials: GM
authors.lastname: Taori
authors.affiliation: Biochemistry Research Laboratory, Central India Institute of Medical Sciences, Nagpur 440 010, India.
authors.forename: Hatim F
authors.initials: HF
authors.lastname: Daginawala
authors.affiliation: Biochemistry Research Laboratory, Central India Institute of Medical Sciences, Nagpur 440 010, India. Electronic address: raj_ciims@rediffmail.com.
authors.forename: Rajpal S
authors.initials: RS
authors.lastname: Kashyap
mesh_terms: D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000134:cerebrospinal fluid* / Q000302:isolation & purification; D015415:Biomarkers / Q000134:cerebrospinal fluid*; D003937:Diagnosis, Differential; D005260:Female; D006360:Heat-Shock Proteins / Q000134:cerebrospinal fluid*; D006801:Humans; D008297:Male; D008587:Meningitis, Viral / Q000134:cerebrospinal fluid / Q000175:diagnosis; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D012680:Sensitivity and Specificity; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid* / Q000175:diagnosis
chemical_list: D000942:Antigens, Bacterial; D015415:Biomarkers; D006360:Heat-Shock Proteins
keywords: Biomarker; Cerebrospinal fluid; Diagnosis; Heat shock protein; Mycobacterium tuberculosis; Tuberculous meningitis