尿-脂arabinmanmann -可能填补延迟诊断危及生命的肺结核的空白

S. Kant, Ankit Kumar, V. Niranjan, D. Bajaj, L. Devi
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引用次数: 1

摘要

结核分枝杆菌是结核病的一种致病微生物。肺部是最常见的感染器官,但它可以感染身体的任何重要器官。通过检测生物标本中的抗酸杆菌和快速分子检测,确定了具有结核病体征和症状的人。然而,早期结核病诊断的限制因素是诊断测试的运行成本。在低收入和中等收入国家,这是阻碍诊断实验室发展的常见原因。个人和社区都遭受了这种诊断延误。这种延迟导致患者显著的发病率和死亡率。可轻松获得的替代测试和替代样本将有助于防止这些诊断延迟问题。在尿样中检测脂arabinman聚糖(LAM)抗原就是一种很有前途的诊断试验。结核分枝杆菌的内层由糖脂组成。LAM来源于磷脂酰肌醇。LAM是一种热稳定的两亲性细胞壁成分。它是磷脂酰肌醇甘露糖酶和脂甘露聚糖的前体。一个额外的甘露糖帽是分枝杆菌毒力菌株的特征。LAM具有免疫原性和免疫调节特性。这是一种很有前途的诊断测试,因为它操作简单,可以在病人床边进行,而且需要一段时间。该检测灵敏度为56% ~ 85%,特异度大于88%。在HIV血清阳性患者中,使用LAM检测可降低8周死亡率。LAM检测也是一种很好的检测肾衰竭和播散性肺结核的方法。在尿液中检测脂arabinman聚糖是一种可能的测试,可以防止延误诊断。这是一个很有前途的测试,因为它很容易执行,测试可以在病人的床上进行卡片测试。它可用于艾滋病毒血清阳性患者和各种其他形式的肺外结核。对于诊断无法产生目标样本的危重病人来说,这是一个非常有用的测试。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Urine-lipoarabinomannan-might fill the gap in delayed diagnosis of life-threatening tuberculosis
Mycobacterium tuberculosis bacilli is a causative organism for tuberculosis disease. The lungs are the most commonly affected organ with this infection but it can infect any vital organ of the body. The person with signs and symptoms of tuberculosis disease was identified with detection of acid-fast bacilli in the biological specimen and with rapid molecular testing. However, the limiting factor for the early tuberculosis (Tb) diagnosis is the running cost of the diagnostic test. It is the common reason preventing the advancement of diagnostic laboratories in low and middle-income countries. The person and community both suffered from this diagnostic delay. This delay causes significant morbidity and mortality in the patient. An alternate test and an alternate sample that can be easily obtained would be beneficial to prevent these diagnostic delay issues. Lipoarabinomannan (LAM) antigen detection in the urine sample is one such promising diagnostic test. Mycobacterium tuberculosis’s inner layer is made up of glycolipids. LAM is derived from phosphatidylinositol. LAM is a heat-stable amphiphilic cell wall component. It is the precursor of phosphatidyl-inositol-mannosidase and lipomannan. An extra mannose cap is a characteristic feature of a virulent strain of Mycobacterium. LAM has immunogenic and immunomodulatory properties. It is a promising diagnostic test because it is simple to do, the assay can be performed at the patient’s bedside and takes a while to perform. This assay sensitivity varies from 56% to 85% and it has greater than 88% specificity. In HIV seropositive patients, use of LAM assay can reduce 8-week mortality. LAM detection is also a very good assay for the detection of tuberculosis in renal failure and disseminated tuberculosis patients.Lipoarabinomannan detection in the urine is a possible test that can prevent delay in diagnosis. This is a promising test because it's easy to perform, the test can be done with a card test besides the patient's bed. It can be used in HIV seropositive patients and various other forms of extra pulmonary tuberculosis. It can be a very useful test for diagnosing a critically ill patient who is not able to produce a target sample.
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