Mycobacterium tuberculosis Lipolytic Enzymes as Potential Biomarkers for the Diagnosis of Active Tuberculosis

BACKGROUND: New diagnosis tests are urgently needed to address the global tuberculosis (TB) burden and to improve control programs especially in resource-limited settings. An effective in vitro diagnostic of TB based on serological methods would be regarded as an attractive progress because immunoassays are simple, rapid, inexpensive, and may offer the possibility to detect cases missed by standard sputum smear microscopy. However, currently available serology tests for TB are highly variable in sensitivity and specificity. Lipolytic enzymes have recently emerged as key factors in lipid metabolization during dormancy and/or exit of the non-replicating growth phase, a prerequisite step of TB reactivation. The focus of this study was to analyze and compare the potential of four Mycobacterium tuberculosis lipolytic enzymes (LipY, Rv0183, Rv1984c and Rv3452) as new markers in the serodiagnosis of active TB. METHODS: Recombinant proteins were produced and used in optimized ELISA aimed to detect IgG and IgM serum antibodies against the four lipolytic enzymes. The capacity of the assays to identify infection was evaluated in patients with either active TB or latent TB and compared with two distinct control groups consisting of BCG-vaccinated blood donors and hospitalized non-TB individuals. RESULTS: A robust humoral response was detected in patients with active TB whereas antibodies against lipolytic enzymes were infrequently detected in either uninfected groups or in subjects with latent infection. High specifity levels, ranging from 93.9% to 97.5%, were obtained for all four antigens with sensitivity values ranging from 73.4% to 90.5%, with Rv3452 displaying the highest performances. Patients with active TB usually exhibited strong IgG responses but poor IgM responses. CONCLUSION: These results clearly indicate that the lipolytic enzymes tested are strongly immunogenic allowing to distinguish active from latent TB infections. They appear as potent biomarkers providing high sensitivity and specificity levels for the immunodiagnosis of active TB

Study and validation of new biomarkers for the diagnosis of pulmonary tuberculosis

La tuberculose (TB) est une maladie infectieuse causée par M. tuberculosis. En 2009, la mortalité était élevée avec 1,7 millions de décès enregistrés dans le monde. La co-infection par le VIH, notamment en Afrique, et les tuberculoses à bacilles multi-résistants aux antibiotiques, rendent la maîtrise de la pandémie encore plus complexe. Les tests actuels de diagnostic présentent des lacunes notamment en terme de sensibilité pour la microscopie qui est le test le plus utilisé, ou en terme de praticité, en ce qui concerne la culture qui est le test de référence. Le développement de nouveaux tests pour le diagnostic de la TB active représente un enjeu majeur de nos sociétés modernes. Les tests immunologiques, en particulier les tests sérologiques actuellement disponibles, présentent une alternative aux tests bactériologiques couramment utilisés mais leurs performances restent faibles. Pour cela, il est indispensable de cibler de nouveaux biomarqueurs pour développer un test efficace, sensible, rapide et peu onéreux. C'est dans de cadre que s'inscrit ce travail de thèse.Nous rapportons dans ce mémoire, la recherche de marqueurs innovants dans le cadre de la mise au point d'un test de diagnostic de la tuberculose. Nous avons ciblé plusieurs marqueurs protéiques (OmpATb, LipY, Rv0183, Rv1984c et Rv3452) et un marqueur glycolipide, le tréhalose-6,6'-dimycolate (TDM). Parmi ces candidats, plusieurs présentent de réelles performances sur le plan diagnostique. Parallèlement à cette étude, nous avons mis au point une technique de séparation des différentes formes de TDM. La séparation des différentes formes de TDM devrait permettre de déterminer de façon précise les fonctions de ces composants majeurs de la paroi de M. tuberculosis et d'évaluer leur potentiel en terme de diagnostic.Tuberculosis (TB) is an infectious disease caused by M. tuberculosis. In 2009, mortality was high with 1,7 million of recorded deaths in the world. The co-infection by the HIV, in particular in Africa, and tuberculosis with multi-resistant bacilli to antibiotics, make the control of pandemia more complex. The current tests of diagnosis present gaps, in particular, in term of sensitivity for microscopy, which is currently the used test, or in term of praticity, for the culture which is considered as the gold standard.The development of new tests for the diagnosis of TB active represents a major challenge of our modern societies. The immunological tests, in particular the serologic tests available, can present an alternative to the currently bacteriological tests. However, their performances are not sufficient. That's why, it is essential to target new biomarkers which permit to establish an effective, sensitive, fast and cheap test. It is in this context that my study takes place.We report in this memory, the research of innovating markers for the development of a diagnostic test of tuberculosis. We targeted several protenic markers (OmpATb, LipY, Rv0183, Rv1984c and for Rv3452) and a glycolipid marker, the trehalose-6,6'-dimycolate (TDM). Among these candidates, several shown good performances for active TB diagnosis. In parallel to this study, a technique of separation of the various forms of TDM was developed. The separation of the various forms of TDM will permit to study their role on the biological activities and evaluate their potential in term of diagnosis

Study and validation of new biomarkers for the diagnosis of pulmonary tuberculosis

La tuberculose (TB) est une maladie infectieuse causée par M. tuberculosis. En 2009, la mortalité était élevée avec 1,7 millions de décès enregistrés dans le monde. La co-infection par le VIH, notamment en Afrique, et les tuberculoses à bacilles multi-résistants aux antibiotiques, rendent la maîtrise de la pandémie encore plus complexe. Les tests actuels de diagnostic présentent des lacunes notamment en terme de sensibilité pour la microscopie qui est le test le plus utilisé, ou en terme de praticité, en ce qui concerne la culture qui est le test de référence. Le développement de nouveaux tests pour le diagnostic de la TB active représente un enjeu majeur de nos sociétés modernes. Les tests immunologiques, en particulier les tests sérologiques actuellement disponibles, présentent une alternative aux tests bactériologiques couramment utilisés mais leurs performances restent faibles. Pour cela, il est indispensable de cibler de nouveaux biomarqueurs pour développer un test efficace, sensible, rapide et peu onéreux. C'est dans de cadre que s'inscrit ce travail de thèse.Nous rapportons dans ce mémoire, la recherche de marqueurs innovants dans le cadre de la mise au point d'un test de diagnostic de la tuberculose. Nous avons ciblé plusieurs marqueurs protéiques (OmpATb, LipY, Rv0183, Rv1984c et Rv3452) et un marqueur glycolipide, le tréhalose-6,6'-dimycolate (TDM). Parmi ces candidats, plusieurs présentent de réelles performances sur le plan diagnostique. Parallèlement à cette étude, nous avons mis au point une technique de séparation des différentes formes de TDM. La séparation des différentes formes de TDM devrait permettre de déterminer de façon précise les fonctions de ces composants majeurs de la paroi de M. tuberculosis et d'évaluer leur potentiel en terme de diagnostic.Mots clés : tuberculose, sérodiagnostic, détection antigène, détection anticorps, enzymes lipolytiques, glycolipide.Tuberculosis (TB) is an infectious disease caused by M. tuberculosis. In 2009, mortality was high with 1,7 million of recorded deaths in the world. The co-infection by the HIV, in particular in Africa, and tuberculosis with multi-resistant bacilli to antibiotics, make the control of pandemia more complex. The current tests of diagnosis present gaps, in particular, in term of sensitivity for microscopy, which is currently the used test, or in term of praticity, for the culture which is considered as the gold standard.The development of new tests for the diagnosis of TB active represents a major challenge of our modern societies. The immunological tests, in particular the serologic tests available, can present an alternative to the currently bacteriological tests. However, their performances are not sufficient. That's why, it is essential to target new biomarkers which permit to establish an effective, sensitive, fast and cheap test. It is in this context that my study takes place.We report in this memory, the research of innovating markers for the development of a diagnostic test of tuberculosis. We targeted several protenic markers (OmpATb, LipY, Rv0183, Rv1984c and for Rv3452) and a glycolipid marker, the trehalose-6,6'-dimycolate (TDM). Among these candidates, several shown good performances for active TB diagnosis. In parallel to this study, a technique of separation of the various forms of TDM was developed. The separation of the various forms of TDM will permit to study their role on the biological activities and evaluate their potential in term of diagnosis.Key words: tuberculosis, serodiagnostic, antigen detection, antibody detection, lipolytic enzymes, glycolipid.MONTPELLIER-BU Sciences (341722106) / SudocSudocFranceF

Expression of OmpATb is dependent on small membrane proteins in Mycobacterium bovis BCG

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