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The assessment of host and bacterial proteins in sputum from active pulmonary tuberculosis
Hsin-Chih Lai , Yu-Tze Horng , Pen-Fang Yeh , Jann-Yuan Wang , Chin-Chung Shu , Jang-Jih Lu , Jen-Jyh Lee , Po-Chi Soo
J. Microbiol. 2016;54(11):761-767.   Published online October 29, 2016
DOI: https://doi.org/10.1007/s12275-016-6201-x
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AbstractAbstract
Pulmonary tuberculosis (TB) is caused by Mycobacterium tuberculosis. The protein composition of sputum may reflect the immune status of the lung. This study aimed to evaluate the protein profiles in spontaneous sputum samples from patients with active pulmonary TB. Sputum samples were collected from patients with pulmonary TB and healthy controls. Western blotting was used to analyze the amount of interleukin 10 (IL-10), interferon-gamma (IFN-γ), IL-25, IL- 17, perforin-1, urease, albumin, transferrin, lactoferrin, adenosine deaminase (also known as adenosine aminohydrolase, or ADA), ADA-2, granzyme B, granulysin, and caspase- 1 in sputum. Results of detection of IL-10, IFN-γ, perforin- 1, urease, ADA2, and caspase-1, showed relatively high specificity in distinguishing patients with TB from healthy controls, although sensitivities varied from 13.3% to 66.1%. By defining a positive result as the detection of any two proteins in sputum samples, combined use of transferrin and urease as markers increased sensitivity to 73.2% and specificity to 71.1%. Furthermore, we observed that the concentration of transferrin was proportional to the number of acidfast bacilli detected in sputum specimens. Detection of sputum transferrin and urease was highly associated with pulmonary TB infection. In addition, a high concentration of transferrin detected in sputum might correlate with active TB infection. This data on sputum proteins in patients with TB may aid in the development of biomarkers to assess the severity of pulmonary TB.
The Value of Submitting Multiple Sputum Specimens for Accurate Diagnosis of Pulmonary Tuberculosis
Ozgul Kisa , Ali Albay , Orhan Baylan , Levent Doganci
J. Microbiol. 2002;40(4):301-304.
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AbstractAbstract
Is a multiple number of sputum specimens necessary for the diagnosis of pulmonary tuberculosis? To answer this question, 6844 respiratory specimens obtained from previously untreated patients suspected of having pulmonary tuberculosis between 1998 and 2001 were evaluated retrospectively. All of the specimens were evaluated by acid fast bacilli smear and BACTEC 460 TB culture system. A total of 785 (11%) specimens from 353 patients were positive for Mycobacterium tuberculosis complex. For 76% (270/353) of these patients the organism was detected from sputum specimens collected sequentially for daily basis. Mycobacterium tuberculosis was isolated in the first, second and third samples of the majority (98%, 195/199) of patients who had three or more sputum samples sent to the laboratory. Our results indicate that, we could carry out Mycobacterium tuberculosis isolation in the first, second and third sputum samples of the overwhelming majority of the patients and the diagnostic value of four or more sputum specimens submitted to the laboratory was very low (2%). We recommend that, for definitive and cost-effective diagnosis of pulmonary tuberculosis at least three sequential sputum specimens be collected for all patients suspected pulmonary tuberculosis.

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