Urine Lipoarabinomannan as a Marker for Low-risk of NTM Infection in the CF Airway

Autor: Katie R. Poch, Kenneth C. Malcolm, Marion C. Jones, Prithwiraj De, Delphi Chatterjee, Jerry A. Nick, Stacey L. Martiniano, Silvia M. Caceres, Anita G. Amin, Barbara Graham, Milene T. Saavedra
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Pulmonary and Respiratory Medicine
Adult
Lipopolysaccharides
Male
Adolescent
Cystic Fibrosis
Population
Mycobacterium Infections
Nontuberculous
Pilot Projects
Urine
Cystic fibrosis
Article
Sputum culture
Mycobacterium tuberculosis
Cohort Studies
03 medical and health sciences
Young Adult
0302 clinical medicine
Predictive Value of Tests
hemic and lymphatic diseases
Medicine
Humans
education
Child
education.field_of_study
Lipoarabinomannan
medicine.diagnostic_test
biology
business.industry
Sputum
Middle Aged
biology.organism_classification
medicine.disease
bacterial infections and mycoses
030104 developmental biology
030228 respiratory system
Pediatrics
Perinatology and Child Health
Immunology
Nontuberculous mycobacteria
lipids (amino acids
peptides
and proteins)
Female
medicine.symptom
business
Biomarkers
Zdroj: J Cyst Fibros
Popis: Background Individuals with Cystic fibrosis (CF) are the most vulnerable population for pulmonary infection with nontuberculous mycobacteria (NTM). Screening, diagnosis, and assessment of treatment response currently depend on traditional culture techniques, but sputum analysis for NTM in CF is challenging, and associated with a low sensitivity. The cell wall lipoarabinomannan (LAM), a lipoglycan found in all mycobacterial species, and has been validated as a biomarker in urine for active Mycobacterium tuberculosis infection. Methods Urine from a CF cohort (n = 44) well-characterized for NTM infection status by airway cultures was analyzed for LAM by gas chromatography/mass spectrometry. All subjects with positive sputum cultures for NTM had varying amounts of LAM in their urine. No LAM was detected in subjects who never had a positive culture (14/45). One individual initially classified as NTM sputum negative subsequently developed NTM disease 657 days after the initial urine LAM testing. Repeat urine LAM testing turned positive, correlating to her positive NTM status. Subjects infected with subspecies of M. abscessus had greater LAM quantities than those infected with M. avium complex (MAC). There was no correlation with disease activity or treatment status and LAM quantity. A TB Capture ELISA using anti-LAM antibodies demonstrated very poor sensitivity in identifying individuals with positive NTM sputum cultures. Conclusion These findings support the conclusion that urine LAM related to NTM infection may be a useful screening test to determine patients at low risk for having a positive NTM sputum culture, as part of a lifetime screening strategy in the CF population.
Databáze: OpenAIRE
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