Diagnostic significance of humoral immune responses to recombinant antigens of Mycobacterium tuberculosis in patients with pleural tuberculosis

J Clin Lab Anal. 2010;24(5):283-8. doi: 10.1002/jcla.20401.


Mycobacterium tuberculosis bacilli are seldom demonstrated in tuberculous pleural effusion (TPE) by conventional bacteriological methods. In this study, an indirect enzyme-linked immunosorbent assay (ELISA) was developed to detect IgG against four mycobacterial recombinant antigens (ESAT-6, PlcA, HspX and Tb8.4) in 69 pleural fluids of patients with TPE and 71 patients with malignant pleural effusion. To increase the sensitivity of the assay, a multi-antigen cocktail containing all the above antigens were also used. IgG positivity in ELISA for PlcA, HspX, Tb8.4, ESAT-6 antigens and multi-antigen complex were 49.3, 60.8, 49.3, 53.6 and 75.4% respectively. Each one of the above four antigens and their multi-antigen cocktail were highly specific in distinguishing tuberculous and malignant pleural effusion. This new generation immunoassay will serve as a useful marker for the diagnosis of pleural tuberculosis patients in whom M. tuberculosis bacilli were not demonstrated by bacteriological methods.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Bacterial / blood*
  • Antigens, Bacterial / immunology*
  • Bacterial Proteins / immunology
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Immunoglobulin G / immunology
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / immunology*
  • Pleural Effusion, Malignant / immunology*
  • Recombinant Proteins / immunology
  • Tuberculosis, Pleural / diagnosis*
  • Tuberculosis, Pleural / immunology
  • Type C Phospholipases / immunology
  • Young Adult


  • Antibodies, Bacterial
  • Antigens, Bacterial
  • Bacterial Proteins
  • ESAT-6 protein, Mycobacterium tuberculosis
  • HspX protein, Mycobacterium tuberculosis
  • Immunoglobulin G
  • Recombinant Proteins
  • Type C Phospholipases
  • MpcA protein, Mycobacterium tuberculosis