Combination of anti-glycopeptidolipid-core IgA antibody and clinical features for diagnosing potential nontuberculous mycobacterium pulmonary disease in routine practice. (November 2022)

• Record Type: Journal Article
• Authors: Iwasaki, Takuya; Yamaguchi, Fumihiro; Hayashi, Makoto; Kobayashi, Hitoshi; Hirata, Kento; Miyo, Kenta; Kondo, Chika; Kanzaki, Mamiko; Tei, Kazusawa; Abe, Takashi; Sakakura, Shunsuke; Inoue, Daisuke; Yamazaki, Yohei; Tateno, Hidetsugu; Yokoe, Takuya; Shikama, Yusuke
• Is Part Of: Therapeutic advances in respiratory disease. Volume 16(2022)
• Publication Date: 2022-11
• Subjects: anti-glycopeptidolipid-core IgA antibody -- Mycobacterium abscessus complex -- Mycobacterium avium complex -- Mycobacterium gordonae -- nontuberculous mycobacterium pulmonary disease; Respiratory organs -- Diseases -- Periodicals; Respiratory agents -- Periodicals; Pulmonary pharmacology -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory System Agents -- therapeutic use -- Periodicals; Respiratory Tract Diseases -- drug therapy -- Periodicals; Lung Diseases -- drug therapy -- Periodicals; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Agents respiratoires -- Périodiques; Pharmacologie pulmonaire -- Périodiques; 616.2005
• DOI: 10.1177/17534666221138002
• Languages: English
• ISSNs: 1753-4658

Abstract

Background: The anti- Mycobacterium avium complex (MAC) antibody test measures levels of IgA antibody against the glycopeptidolipid (GPL) core in the bacterial cell walls and is a useful clinical indicator of nontuberculous mycobacterium pulmonary disease (NTM-PD). However, it is not currently possible to diagnose the disease using anti-MAC antibodies alone. Objectives: The study aim was to assess the efficacy of the combination of anti-MAC antibodies and clinical findings for diagnosing potential NTM-PD. Methods: This cross-sectional study included 938 patients tested using the anti-MAC antibody. NTM-PD was diagnosed by multiple positive cultures of the same species in sputum samples. Multivariate logistic regression models were used to identify the clinical factors related to NTM-PD. Results: Overall, 19.6% (184/938) of participants were diagnosed with NTM-PD. In multivariate analysis, positive anti-MAC antibodies, low body mass index, absence of malignancy, and cavity-forming lung lesions were significantly associated with NTM-PD at diagnosis. The positive rates of the anti-MAC antibody test were 79.4% (135/170) for MAC and 55.6% (5/9) for Mycobacterium abscessus complex, respectively. Conclusions: Bronchoscopic examinations should be performed especially in certain types of individuals from whom sputum samples cannot be obtained. Anti-MAC antibodies are also positive in patients other than those harboring MAC, but the rate may be low because of the different components in GPLs.