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Raised PPD antibodies in active pulmonary tuberculosis.

C O'Mahony1, L Clancy, P Kelly

  • 1Department of Immunology, St. James's Hospital, Dublin.

Irish Medical Journal
|September 1, 1990
PubMed
Summary

Measuring IgG antibodies to purified protein derivative (PPD) can aid tuberculosis diagnosis. This enzyme-linked immunosorbent assay showed 65% sensitivity and 98% specificity for active tuberculosis detection.

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Area of Science:

  • Immunology
  • Infectious Diseases
  • Medical Diagnostics

Background:

  • Tuberculosis (TB) diagnosis relies on microbiological and clinical methods, which can be slow or inconclusive.
  • Accurate and rapid diagnostic tools for TB are crucial for effective patient management and public health.

Purpose of the Study:

  • To evaluate the diagnostic utility of measuring IgG antibodies to purified protein derivative (PPD) in patients with active pulmonary tuberculosis.
  • To determine the sensitivity and specificity of this antibody assay in distinguishing TB patients from healthy individuals and those with other diseases.

Main Methods:

  • An enzyme-linked immunosorbent assay (ELISA) was employed to quantify IgG anti-PPD antibodies.
  • The assay was performed on serum samples from 47 patients with active pulmonary TB, 28 patients with non-tuberculous diseases, and 49 healthy controls.

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  • Antibody levels were also assessed in patients with suspected TB lacking microbiological confirmation.

    • Main Results:

    • Elevated IgG anti-PPD antibodies were detected in 65% (30/47) of active TB patients.
    • The assay demonstrated high specificity (98%), with only one false positive in non-TB disease patients and one in healthy controls.
    • In patients with suspected TB, raised antibodies correlated with subsequent clinical validation of TB (6/8 patients).
    • Antibody levels decreased over one year of successful TB therapy.
    • Tuberculin skin testing and BCG vaccination did not induce a rise in antibodies in healthy subjects.

    Conclusions:

    • Measurement of IgG anti-PPD antibodies is a potentially valuable adjunctive test for diagnosing active pulmonary tuberculosis.
    • The assay shows promise in identifying TB in cases where microbiological evidence is initially absent.
    • Further validation may establish this immunoassay as a useful tool in TB diagnostics, complementing existing methods.