Antigens of the Mycobacterium avium, Mycobacterium intracellulare complex

In the past decade, the clinical significance of the Mycobacterium avium, Myobacterium intracellulare complex (MAC) has increased dramatically primarily because of the association between the MAC and the acquired immunodeficiency syndrome (AIDS). Recent hospital reports have suggested that about one-half of AIDS patients in the United States are infected with the MAC. The resulting myobacteremia is a primary cause of mortality in 5-10% of these patients. This increased clinical importance of the MAC has generated renewed interest in MAC immunobiology. In this review, recent immunological and biochemical characterizations of four classes of dominant myobacterial antigens - glycopeptidolipids, arabinogalactan, lipoarabinomannan and MAC proteins - is examined. In addition, future prospects for improved diagnosis of MAC disease using defined monospecific antigens is discussed.