Many of H. pylori strains causing gastroduodenal diseases have a cagA gene encoding CagA protein, a virulence factor of these bacteria. Anti-CagA antibodies produced by majority of people infected with CagA(+) strains can indicate such infection. In this study the efficacy of three immunoenzymatic tests: immunoblot (MileniaID Blot H. pylori IgG, DPC Biermann GmbH, Germany) (MB) and ELISA, conducted with a recombinant immunodominant fragment of CagA (rCagA) and full length CagA molecule (flCagA), in detecting CagA(+) and CagA(-) infections, was compared. The 13C urea breath test (13C-UBT) was used for establishing H. pylori status. The serum samples from 157 individuals were used for serodiagnosis. The H. pylori CagA(+) infection was detected in H. pylori infected individuals with similar frequency by MB (64%) and flCagA-ELISA (60%) and little less frequently by rCagA-ELISA (53%). There was a high coincidence between the negative results of these three tests for H. pylori uninfected individuals with no anti-CagA IgG in the serum (96-100%). The results show that rCagA-ELISA and especially flCagA-ELISA are easy, inexpensive and useful noninvasive assays for discrimination of CagA(+) and CagA(-) H. pylori infections in the subjects examined by urea breath test.
Elimination of tuberculosis (TB) largely depends upon definitive rapid diagnosis and treatment. Widely used diagnostic tests do not qualify for use in a developing country due to lack of either desired accuracy or their cost. In the present study an enzyme-linked immunosorbent assay was used to evaluate the diagnostic potential of an immuno-dominant 30/32-kDa mycolyl transferase complex (Ag85 complex) and Mycobacterium tuberculosis-specific proteins (ESAT-6 and CFP-10) of the RD1 region. Higher sensitivity (84.1%) with Ag85 complex was observed compared with ESAT-6 (64.9%) and CFP-10 (66%), with almost similar specificity (Ag85: 85.2%, ESAT-6: 88.9%, CFP-10: 85.2%), whereas the individual components of Ag85 complex, i.e. Ag85A, Ag85B, and Ag85C, showed sensitivities of 44.6, 34, and 80.9% and specificities of 55.6, 74.1, and 40.7% respectively. A cocktail of Ag85 complex, ESAT-6, CFP-10, Ag85A, Ag85B, and Ag85C antigens also could not help in increasing either sensitivity (51.1%) or specificity (85.2%). Furthermore, immunoblot analysis using clinical isolates as well as a standard strain (H37Rv) of M. tuberculosis also showed strong reactivity of sera from TB patients to Ag85 complex and, to a lesser extent, also to ESAT-6. To conclude, use of Ag85 complex along with ESAT-6 and CFP-10 seems to be promising in minimizing the heterogeneous sero-responses of adult TB cases.
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