Improved Alere Determine Lipoarabinomannan Antigen Detection Test for the Diagnosis of Human and Bovine Tuberculosis by Manipulating Urine and Milk

• Published in: Scientific reports Vol. 9; no. 1; pp. 18012 - 6
• Main Authors: García, Juan Ignacio, Kelley, Holden V, Meléndez, Johanna, de León, Rosa Alejandra Alvarez, Castillo, Alejandra, Sidiki, Sabeen, Yusoof, Kizil A, Nunes, Elizabete, Téllez, Cesar López, Mejía-Villatoro, Carlos Rodolfo, Ikeda, Janet, García-Basteiro, Alberto L, Wang, Shu-Hua, Torrelles, Jordi B
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 29.11.2019; Nature Publishing Group UK
• Subjects: Animals; Antigens, Bacterial - immunology; Antigens, Bacterial - isolation & purification; Cattle; CD4 antigen; Diagnosis; Diagnòstic immunològic; Female; HIV; Human immunodeficiency virus; Humans; Immunodiagnosis; Immunologic Tests - methods; Lactase; Lipopolysaccharides - immunology; Lipopolysaccharides - isolation & purification; Lymphocytes T; Mannosidase; Milk; Milk - microbiology; Mycobacterium bovis - immunology; Mycobacterium bovis - isolation & purification; Mycobacterium tuberculosis - immunology; Mycobacterium tuberculosis - isolation & purification; Point-of-Care Systems; Sensitivity and Specificity; Tuberculosi; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis - immunology; Tuberculosis - microbiology; Tuberculosis - urine; Tuberculosis, Bovine - diagnosis; Tuberculosis, Bovine - immunology; Tuberculosis, Bovine - microbiology; Urine; Urine - microbiology
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-54537-9

Tuberculosis (TB) disease still kills 1-person every 21-seconds. Few TB diagnostic tests are considered truly appropriate for point of care settings. The WHO-endorsed immunodiagnostic Alere Determine Lipoarabinomannan Ag-test (LAM-test) detects Mycobacterium tuberculosis complex LAM in urine, and its use is recommended for TB diagnosis among HIV co-infected individuals with low CD4 T-cell counts. Here we found that a simple 15-minute enzymatic treatment at room temperature of LAM-spiked urine with α-mannosidase (for human TB), and LAM-spiked milk with combined lactase and caseinase (for bovine TB), enhanced 10-fold the detection levels of the LAM-test and thus, improved the detection of LAM by the LAM-test in urine and milk that otherwise could be missed in the field. Future separate clinical research studies specifically designed to address the potential of these findings are required.