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1.
Nat Commun ; 15(1): 3173, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38609390

RESUMO

Semaphorin-3A (SEMA3A) functions as a chemorepulsive signal during development and can affect T cells by altering their filamentous actin (F-actin) cytoskeleton. The exact extent of these effects on tumour-specific T cells are not completely understood. Here we demonstrate that Neuropilin-1 (NRP1) and Plexin-A1 and Plexin-A4 are upregulated on stimulated CD8+ T cells, allowing tumour-derived SEMA3A to inhibit T cell migration and assembly of the immunological synapse. Deletion of NRP1 in both CD4+ and CD8+ T cells enhance CD8+ T-cell infiltration into tumours and restricted tumour growth in animal models. Conversely, over-expression of SEMA3A inhibit CD8+ T-cell infiltration. We further show that SEMA3A affects CD8+ T cell F-actin, leading to inhibition of immune synapse formation and motility. Examining a clear cell renal cell carcinoma patient cohort, we find that SEMA3A expression is associated with reduced survival, and that T-cells appear trapped in SEMA3A rich regions. Our study establishes SEMA3A as an inhibitor of effector CD8+ T cell tumour infiltration, suggesting that blocking NRP1 could improve T cell function in tumours.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Animais , Humanos , Actinas , Linfócitos T CD8-Positivos , Citoesqueleto , Semaforina-3A/genética
3.
Structure ; 28(5): 507-515.e5, 2020 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-32187531

RESUMO

The transmembrane protein OTK plays an essential role in plexin and Wnt signaling during Drosophila development. We have determined a crystal structure of the last three domains of the OTK ectodomain and found that OTK shows high conformational flexibility resulting from mobility at the interdomain interfaces. We failed to detect direct binding between Drosophila Plexin A (PlexA) and OTK, which was suggested previously. We found that, instead of PlexA, OTK directly binds semaphorin 1a. Our binding analyses further revealed that glycosaminoglycans, heparin and heparan sulfate, are ligands for OTK and thus may play a role in the Sema1a-PlexA axon guidance system.


Assuntos
Proteínas de Drosophila/química , Proteínas de Drosophila/metabolismo , Receptores Proteína Tirosina Quinases/química , Receptores Proteína Tirosina Quinases/metabolismo , Animais , Células CHO , Células COS , Membrana Celular/metabolismo , Chlorocebus aethiops , Cricetulus , Cristalografia por Raios X , Proteínas de Drosophila/genética , Transferência Ressonante de Energia de Fluorescência , Glicosaminoglicanos/metabolismo , Células HEK293 , Heparina/metabolismo , Heparitina Sulfato/metabolismo , Humanos , Proteínas do Tecido Nervoso/metabolismo , Conformação Proteica , Domínios Proteicos , Mapas de Interação de Proteínas , Receptores Proteína Tirosina Quinases/genética , Receptores de Superfície Celular/metabolismo , Semaforinas/metabolismo
4.
J Biomol Struct Dyn ; 38(6): 1575-1589, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31084346

RESUMO

Aminoacyl-tRNA synthetases (aaRSs) are considered as important components in protein translation as they facilitate the attachment of specific transfer RNA (tRNA) to form aminoacyl-tRNAs. Our study focused on understanding the crystal structure of Glutaminyl-tRNA synthetase (GlnRS) from Thermus thermophilus HB8 (PDB ID:5ZDO) and mechanism of formation of enzyme-substrate complex using substrates and its analogs by applying molecular dynamics simulation (MDS) to investigate the conformational changes. Least energy structure of TtGlnRS was considered to dock the enzyme substrates such as glutamine (Gln), glutamic acid (Glu), adenosine monophosphate (AMP), adenosine triphosphate (ATP), QSI and various substrate analogs (2MA, 4SU and 5MU) onto the active site of the enzyme. We focused on comparative analysis of binding specificity between Gln and Glu; similarly, ATP and AMP. Active site organization as observed by MDS analysis showed interactive changes associated with substrate and catalytically important loops. Study found that when tRNAGln specific for GlnRS was docked into the active site of the TtGlnRS enzyme it interacts with 2' OH on the ribose acceptor end of the tRNA. Upon validation with 50 ns MDS, the maximum deviations and conformational changes of secondary structural elements were observed to be high in the loop regions of enzyme-substrate complexes. Binding affinity of ATP to TtGlnRS was further proved by isothermal titration calorimetry. AbbreviationsaaRSsaminoacyl-tRNA synthetasesAMPadenosine monophosphateATPadenosine triphosphateGlideGrid-based LIgand Docking with EnergeticGlnRSglutaminyl-tRNA synthetaseGRAVYGRand AVerage of hydropathicitYGROMACSGROingen Machine for Chemical SimulationsHADDOCKHigh Ambiguity Driven protein-protein DOCKingITCisothermal titration calorimetry2MA2-methyladenosine 5'-(dihydrogen phosphate)MDSmolecular dynamics simulation5MU5-methyluridine 5'-monophosphateNPTnumber of particles, pressure and temperatureNVTnumber of particles, volume and temperatureOPLS-AAoptimized potential for liquid simulation all atomPDBBrookhaven Protein DatabankPMEParticle-Mesh EwaldQSI5'-o-[n-(l-Glutaminyl)-sulfamoyl]adenosineRgradius of gyrationRMSDroot mean square deviationRMSFroot mean square fluctuation4SU4-thiouracil 5'-monophosphateSPCsimple point chargetRNAtransfer ribo nucleic acidTtThermus thermophilusXPextra precisionCommunicated by Ramaswamy H. Sarma.


Assuntos
Aminoacil-tRNA Sintetases , Simulação de Dinâmica Molecular , Aminoacil-tRNA Sintetases/metabolismo , Sítios de Ligação , Simulação de Acoplamento Molecular , RNA de Transferência , RNA de Transferência de Glutamina
5.
Nat Commun ; 10(1): 3691, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-31417095

RESUMO

Semaphorin ligands and their plexin receptors are one of the major cell guidance factors that trigger localised changes in the cytoskeleton. Binding of semaphorin homodimer to plexin brings two plexins in close proximity which is a prerequisite for plexin signalling. This model appears to be too simplistic to explain the complexity and functional versatility of these molecules. Here, we determine crystal structures for all members of Drosophila class 1 and 2 semaphorins. Unlike previously reported semaphorin structures, Sema1a, Sema2a and Sema2b show stabilisation of sema domain dimer formation via a disulfide bond. Unexpectedly, our structural and biophysical data show Sema1b is a monomer suggesting that semaphorin function may not be restricted to dimers. We demonstrate that semaphorins can form heterodimers with members of the same semaphorin class. This heterodimerization provides a potential mechanism for cross-talk between different plexins and co-receptors to allow fine-tuning of cell signalling.


Assuntos
Semaforinas/metabolismo , Animais , Cristalografia por Raios X , Dimerização , Proteínas de Drosophila/metabolismo , Drosophila melanogaster , Modelos Moleculares , Simulação de Dinâmica Molecular , Proteínas do Tecido Nervoso/metabolismo , Polimerização , Receptores de Superfície Celular/metabolismo
6.
Nat Commun ; 9(1): 4833, 2018 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-30420666

RESUMO

The original version of this Article contained an error in the spelling of the author Jonah B Sacha, which was incorrectly given as Jonah Sacha. These errors have now been corrected in both the PDF and HTML versions of the Article.

7.
Int J Biol Macromol ; 120(Pt B): 1379-1386, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30248426

RESUMO

Aminoacyl-tRNA synthetases (AaRSs) are vital enzymes for translation of proteins in cells. AaRSs catalyse the esterification of a specific amino acid to corresponding tRNAs to form an aminoacyl-tRNA that is used in ribosome-based protein synthesis. We focused on Glutaminyl tRNA synthetase (GlnRS) enzyme from the extreme thermophile Thermus thermophilus for structural studies. Our thermal shift assays show binding of enzyme substrates L-Gln and ATP as well as of various metals including cesium. We resolved crystal structures of apo-GlnRS as well as those in complex with AMP and ATP at 2.8 Å, 2.4 Šand 2.6 Šrespectively. The bound cesium was found at the site of magnesium that typically binds to GlnRS. High structural conservation was evident in the Thermus thermophilus GlnRS when compared to those from Escherichia coli GlnRS.


Assuntos
Aminoacil-tRNA Sintetases/química , Aminoacil-tRNA Sintetases/metabolismo , Thermus thermophilus/enzimologia , Sequência de Aminoácidos , Domínio Catalítico , Estabilidade Enzimática , Modelos Moleculares
8.
Nat Commun ; 9(1): 3137, 2018 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-30087334

RESUMO

Through major histocompatibility complex class Ia leader sequence-derived (VL9) peptide binding and CD94/NKG2 receptor engagement, human leucocyte antigen E (HLA-E) reports cellular health to NK cells. Previous studies demonstrated a strong bias for VL9 binding by HLA-E, a preference subsequently supported by structural analyses. However, Mycobacteria tuberculosis (Mtb) infection and Rhesus cytomegalovirus-vectored SIV vaccinations revealed contexts where HLA-E and the rhesus homologue, Mamu-E, presented diverse pathogen-derived peptides to CD8+ T cells, respectively. Here we present crystal structures of HLA-E in complex with HIV and Mtb-derived peptides. We show that despite the presence of preferred primary anchor residues, HLA-E-bound peptides can adopt alternative conformations within the peptide binding groove. Furthermore, combined structural and mutagenesis analyses illustrate a greater tolerance for hydrophobic and polar residues in the primary pockets than previously appreciated. Finally, biochemical studies reveal HLA-E peptide binding and exchange characteristics with potential relevance to its alternative antigen presenting function in vivo.


Assuntos
Epitopos , Antígenos de Histocompatibilidade Classe I/imunologia , Peptídeos/imunologia , Animais , Apresentação de Antígeno , Linfócitos T CD8-Positivos/citologia , Linfócitos T CD8-Positivos/imunologia , Citomegalovirus , Ensaio de Imunoadsorção Enzimática , Células HEK293 , Humanos , Células Matadoras Naturais/imunologia , Macaca mulatta , Mycobacterium tuberculosis , Ligação Proteica , Conformação Proteica , Vírus da Imunodeficiência Símia/imunologia , Antígenos HLA-E
9.
J Biol Chem ; 293(39): 14962-14972, 2018 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-30104413

RESUMO

The genomes of the malaria-causing Plasmodium parasites encode a protein fused of 6-hydroxymethyl-7,8-dihydropterin pyrophosphokinase (HPPK) and dihydropteroate synthase (DHPS) domains that catalyze sequential reactions in the folate biosynthetic pathway. Whereas higher organisms derive folate from their diet and lack the enzymes for its synthesis, most eubacteria and a number of lower eukaryotes including malaria parasites synthesize tetrahydrofolate via DHPS. Plasmodium falciparum (Pf) and Plasmodium vivax (Pv) HPPK-DHPSs are currently targets of drugs like sulfadoxine (SDX). The SDX effectiveness as an antimalarial drug is increasingly diminished by the rise and spread of drug-resistant mutations. Here, we present the crystal structure of PvHPPK-DHPS in complex with four substrates/analogs, revealing the bifunctional PvHPPK-DHPS architecture in an unprecedented state of enzymatic activation. SDX's effect on HPPK-DHPS is due to 4-amino benzoic acid (pABA) mimicry, and the PvHPPK-DHPS structure sheds light on the SDX-binding cavity, as well as on mutations that effect SDX potency. We mapped five dominant drug resistance mutations in PvHPPK-DHPS: S382A, A383G, K512E/D, A553G, and V585A, most of which occur individually or in clusters proximal to the pABA-binding site. We found that these resistance mutations subtly alter the intricate enzyme/pABA/SDX interactions such that DHPS affinity for pABA is diminished only moderately, but its affinity for SDX is changed substantially. In conclusion, the PvHPPK-DHPS structure rationalizes and unravels the structural bases for SDX resistance mutations and highlights architectural features in HPPK-DHPSs from malaria parasites that can form the basis for developing next-generation anti-folate agents to combat malaria parasites.


Assuntos
Di-Hidropteroato Sintase/química , Difosfotransferases/química , Malária Vivax/tratamento farmacológico , Plasmodium vivax/química , Sulfadoxina/química , Aminoácidos/química , Aminoácidos/genética , Cristalografia por Raios X , Di-Hidropteroato Sintase/genética , Difosfotransferases/genética , Resistência a Medicamentos/genética , Humanos , Malária Vivax/parasitologia , Mutação , Plasmodium falciparum , Plasmodium vivax/genética , Plasmodium vivax/patogenicidade , Sulfadoxina/uso terapêutico , Tetra-Hidrofolatos/química
10.
Drug Discov Today ; 23(6): 1233-1240, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29408369

RESUMO

Malaria remains a major infectious disease and, despite incidence reduction, it threatens resurgence in drug-resistant forms. Antimalarial drugs remain the mainstay of therapeutic options and hence there is a constant need to identify and validate new druggable targets. Plasmodium falciparum aminoacyl-tRNA synthetases (Pf-aaRSs) drive protein translation and are potent targets for development of next-generation antimalarials. Here, we detail advances made in structural-biology-based investigations in Pf-aaRSs and discuss their distribution of druggable pockets. This review establishes a platform for systematic experimental dissection of malarial parasite aaRSs as a new focus for sustained drug development efforts against malaria.


Assuntos
Aminoacil-tRNA Sintetases/metabolismo , Plasmodium falciparum/enzimologia , Animais , Citoplasma/enzimologia , Humanos , Malária/tratamento farmacológico , Terapia de Alvo Molecular
11.
Structure ; 25(10): 1495-1505.e6, 2017 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-28867614

RESUMO

Developing anti-parasitic lead compounds that act on key vulnerabilities are necessary for new anti-infectives. Malaria, leishmaniasis, toxoplasmosis, cryptosporidiosis and coccidiosis together kill >500,000 humans annually. Their causative parasites Plasmodium, Leishmania, Toxoplasma, Cryptosporidium and Eimeria display high conservation in many housekeeping genes, suggesting that these parasites can be attacked by targeting invariant essential proteins. Here, we describe selective and potent inhibition of prolyl-tRNA synthetases (PRSs) from the above parasites using a series of quinazolinone-scaffold compounds. Our PRS-drug co-crystal structures reveal remarkable active site plasticity that accommodates diversely substituted compounds, an enzymatic feature that can be leveraged for refining drug-like properties of quinazolinones on a per parasite basis. A compound we termed In-5 exhibited a unique double conformation, enhanced drug-like properties, and cleared malaria in mice. It thus represents a new lead for optimization. Collectively, our data offer insights into the structure-guided optimization of quinazolinone-based compounds for drug development against multiple human eukaryotic pathogens.


Assuntos
Aminoacil-tRNA Sintetases/química , Inibidores Enzimáticos/administração & dosagem , Infecções por Protozoários/tratamento farmacológico , Quinazolinonas/administração & dosagem , Aminoacil-tRNA Sintetases/antagonistas & inibidores , Animais , Domínio Catalítico/efeitos dos fármacos , Coccidiose/tratamento farmacológico , Criptosporidiose/tratamento farmacológico , Descoberta de Drogas , Inibidores Enzimáticos/química , Inibidores Enzimáticos/farmacologia , Humanos , Leishmaniose/tratamento farmacológico , Malária/tratamento farmacológico , Camundongos , Modelos Moleculares , Proteínas de Protozoários/antagonistas & inibidores , Proteínas de Protozoários/química , Quinazolinonas/química , Quinazolinonas/farmacologia , Relação Estrutura-Atividade , Toxoplasmose/tratamento farmacológico
12.
ACS Infect Dis ; 3(4): 281-292, 2017 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-28195698

RESUMO

Parasitic diseases caused by eukaryotic pathogens impose significant health and economic burden worldwide. The level of research funding available for many parasitic diseases is insufficient in relation to their adverse social and economic impact. In this article, we discuss that extant 3D structural data on protein-inhibitor complexes can be harnessed to accelerate drug discovery against many related pathogens. Assessment of sequence conservation within drug/inhibitor-binding residues in enzyme-inhibitor complexes can be leveraged to predict and validate both new lead compounds and their molecular targets in multiple parasitic diseases. Hence, structure-based targeting of orthologous pathogen proteins accelerates the discovery of new antiparasitic drugs. This approach offers significant benefits for jumpstarting the discovery of new lead compounds and their molecular targets in diverse human, livestock, and plant pathogens.


Assuntos
Antiparasitários/química , Inibidores Enzimáticos/química , Animais , Antiparasitários/farmacologia , Bases de Dados de Compostos Químicos , Desenho de Fármacos , Inibidores Enzimáticos/farmacologia , Humanos , Modelos Moleculares , Doenças Parasitárias/tratamento farmacológico , Relação Estrutura-Atividade
13.
Trends Parasitol ; 33(3): 158-161, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28081985

RESUMO

Parasite-directed drug discovery efforts require sustained and substantial scientific resources. Many eukaryotic parasites share similarities in metabolic pathways and housekeeping genes, as evident from their underlying protein sequences. Their subsequent structural congruence within enzyme active sites can thus be leveraged for multiparasite targeting using similar or identical drug probes. This bodes well for delivering new anti-infectives.


Assuntos
Antiparasitários/uso terapêutico , Reposicionamento de Medicamentos , Doenças Parasitárias/tratamento farmacológico , Animais , Descoberta de Drogas , Eucariotos , Humanos , Parasitos
14.
Structure ; 24(9): 1476-87, 2016 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-27502052

RESUMO

Excess cellular heme is toxic, and malaria parasites regulate its levels during hemoglobin digestion. Aminoacyl-tRNA synthetases are ubiquitous enzymes, and of these, arginyl-tRNA synthetase (RRS) is unique as its enzymatic product of charged tRNA is required for protein synthesis and degradation. We show that Plasmodium falciparum arginyl-tRNA synthetase (PfRRS) is an active, cytosolic, and monomeric enzyme. Its high-resolution crystal structure highlights critical structural differences with the human enzyme. We further show that hemin binds to and inhibits the aminoacylation activity of PfRRS. Hemin induces a dimeric form of PfRRS that is thus rendered enzymatically dead as it is unable to recognize its cognate tRNA(arg). Excessive hemin in chloroquine-treated malaria parasites results in significantly reduced charged tRNA(arg) levels, thus suggesting deceleration of protein synthesis. These data together suggest that the inhibition of Plasmodium falciparum arginyl-tRNA synthetase can now be synergized with existing antimalarials for more potent drug cocktails against malaria parasites.


Assuntos
Arginina-tRNA Ligase/química , Arginina/química , Heme/química , Hemina/química , Plasmodium falciparum/efeitos dos fármacos , Proteínas de Protozoários/química , RNA de Transferência de Arginina/química , Sequência de Aminoácidos , Antimaláricos/química , Antimaláricos/farmacologia , Arginina/metabolismo , Arginina-tRNA Ligase/genética , Arginina-tRNA Ligase/metabolismo , Sítios de Ligação , Cloroquina/química , Cloroquina/farmacologia , Cristalografia por Raios X , Expressão Gênica , Heme/farmacologia , Hemina/farmacologia , Humanos , Modelos Moleculares , Plasmodium falciparum/enzimologia , Plasmodium falciparum/genética , Plasmodium falciparum/crescimento & desenvolvimento , Ligação Proteica , Biossíntese de Proteínas/efeitos dos fármacos , Domínios e Motivos de Interação entre Proteínas , Multimerização Proteica , Estrutura Secundária de Proteína , Proteínas de Protozoários/genética , Proteínas de Protozoários/metabolismo , RNA de Transferência de Arginina/metabolismo , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Alinhamento de Sequência , Homologia de Sequência de Aminoácidos , Especificidade da Espécie , Especificidade por Substrato
15.
Structure ; 23(5): 819-829, 2015 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-25817387

RESUMO

The Chinese herb Dichroa febrifuga has traditionally treated malaria-associated fever. Its active component febrifugine (FF) and derivatives such as halofuginone (HF) are potent anti-malarials. Here, we show that FF-based derivatives arrest parasite growth by direct interaction with and inhibition of the protein translation enzyme prolyl-tRNA synthetase (PRS). Dual administration of inhibitors that target different tRNA synthetases suggests high utility of these drug targets. We reveal the ternary complex structure of PRS-HF and adenosine 5'-(ß,γ-imido)triphosphate where the latter facilitates HF integration into the PRS active site. Structural analyses also highlight spaces within the PRS architecture for HF derivatization of its quinazolinone, but not piperidine, moiety. We also show a remarkable ability of HF to kill the related human parasite Toxoplasma gondii, suggesting wider HF efficacy against parasitic PRSs. Hence, our cell-, enzyme-, and structure-based data on FF-based inhibitors strengthen the case for their inclusion in anti-malarial and anti-toxoplasmosis drug development efforts.


Assuntos
Aminoacil-tRNA Sintetases/química , Antimaláricos/farmacologia , Piperidinas/farmacologia , Plasmodium falciparum/efeitos dos fármacos , Quinazolinonas/farmacologia , Aminoacil-tRNA Sintetases/metabolismo , Antimaláricos/química , Domínio Catalítico/efeitos dos fármacos , Cristalografia , Humanos , Modelos Moleculares , Complexos Multiproteicos/química , Piperidinas/química , Plasmodium falciparum/química , Plasmodium falciparum/enzimologia , Proteínas de Protozoários/química , Proteínas de Protozoários/metabolismo , Quinazolinonas/química , Relação Estrutura-Atividade , Toxoplasma/química , Toxoplasma/efeitos dos fármacos , Toxoplasma/enzimologia
16.
J Struct Funct Genomics ; 15(4): 181-90, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25047712

RESUMO

Aminoacyl-tRNA synthetases (aaRSs) drive protein translation in cells and hence these are essential enzymes across life. Inhibition of these enzymes can halt growth of an organism by stalling protein translation. Therefore, small molecule targeting of aaRS active sites is an attractive avenue from the perspective of developing anti-infectives. Febrifugine and its derivatives like halofuginone (HF) are known to inhibit prolyl-tRNA synthetase of malaria parasite Plasmodium falciparum. Here, we present functional and crystallographic data on P. falciparum prolyl-tRNA synthetase (PfPRS). Using immunofluorescence data, we show that PfPRS is exclusively resident in the parasite cytoplasm within asexual blood stage parasites. The inhibitor HF interacts strongly with PfPRS in a non-competitive binding mode in presence or absence of ATP analog. Intriguingly, the two monomers that constitute dimeric PfPRS display significantly different conformations in their active site regions. The structural analyses presented here provide a framework for development of febrifugine derivatives that can seed development of new anti-malarials.


Assuntos
Aminoacil-tRNA Sintetases , Antimaláricos/química , Inibidores Enzimáticos/química , Piperidinas/química , Plasmodium falciparum/enzimologia , Proteínas de Protozoários , Quinazolinas/química , Aminoacil-tRNA Sintetases/antagonistas & inibidores , Aminoacil-tRNA Sintetases/química , Domínio Catalítico , Cristalografia por Raios X , Malária Falciparum/tratamento farmacológico , Malária Falciparum/enzimologia , Proteínas de Protozoários/antagonistas & inibidores , Proteínas de Protozoários/química
17.
PLoS One ; 7(9): e44630, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22984534

RESUMO

BACKGROUND: Tuberculous meningitis (TBM) is the most common form of neurotuberculosis and the fifth most common form of extrapulmonary TB. Early diagnosis and prompt treatment are the cornerstones of effective disease management. The accurate diagnosis of TBM poses a challenge due to an extensive differential diagnosis, low bacterial load and paucity of cerebrospinal fluid (CSF) especially in children. METHODOLOGY/PRINCIPAL FINDINGS: We describe the utility of ELISA and qPCR for the detection of Mycobacterium tuberculosis (M. tb) proteins (GlcB, HspX, MPT51, Ag85B and PstS1) and DNA for the rapid diagnosis of TBM. CSF filtrates (n = 532) derived from children were classified as 'Definite' TBM (M. tb culture positive, n = 29), 'Probable and Possible' TBM (n = 165) and 'Not-TBM' including other cases of meningitis or neurological disorders (n = 338). ROC curves were generated from ELISA and qPCR data of 'Definite' TBM and Non-Tuberculous infectious meningitis (NTIM) samples and cut-off values were derived to provide ≥ 95% specificity. devR qPCR, GlcB, HspX and PstS1 ELISAs showed 100% (88;100) sensitivity and 96-97% specificity in 'Definite' TBM samples. The application of these cut-offs to 'Probable and Possible' TBM groups yielded excellent sensitivity (98%, 94;99) and specificity (98%, 96;99) for qPCR and for GlcB, HspX and MPT51 antigen ELISAs (sensitivity 92-95% and specificity 93-96%). A test combination of qPCR with GlcB and HspX ELISAs accurately detected all TBM samples at a specificity of ~90%. Logistic regression analysis indicated that these tests significantly added value to the currently used algorithms for TBM diagnosis. CONCLUSIONS: The detection of M. tb GlcB/HspX antigens/devR DNA in CSF is likely to improve the utility of existing algorithms for TBM diagnosis and also hasten the speed of diagnosis.


Assuntos
Antígenos de Bactérias/imunologia , Proteínas de Bactérias/imunologia , Malato Sintase/imunologia , Mycobacterium tuberculosis/metabolismo , Tuberculose Meníngea/microbiologia , Algoritmos , Antígenos de Bactérias/metabolismo , Proteínas de Bactérias/metabolismo , Líquido Cefalorraquidiano/metabolismo , Criança , Diagnóstico Diferencial , Ensaio de Imunoadsorção Enzimática/métodos , Humanos , Malato Sintase/metabolismo , Reação em Cadeia da Polimerase/métodos , Valor Preditivo dos Testes , Curva ROC , Proteínas Recombinantes/metabolismo , Reprodutibilidade dos Testes , Inquéritos e Questionários , Tuberculose Meníngea/diagnóstico
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