Clinical evaluation of MPT-64 and MPT-59, two proteins secreted from Mycobacterium tuberculosis, for skin test reagents

• Published in: Tubercle and lung disease 1996-06, Vol.77 (3), p.250-256
• Main Authors: Wilcke, J.T.R., Jensen, B.Nybo, Ravi, P., Andersen, Å.B., Hasløv, K.
• Format: Article
• Language: English
• Subjects: Adult; Antigens, Bacterial; Bacterial Proteins; BCG Vaccine; Cell Culture Techniques; Cell Division - immunology; Humans; Hypersensitivity, Delayed - immunology; Interferon-gamma - biosynthesis; Intradermal Tests - methods; Lymphocytes - immunology; Mycobacterium tuberculosis; Mycobacterium tuberculosis - immunology; Tuberculin Test; Tuberculosis - diagnosis
• ISSN: 0962-8479; 1532-219X
• DOI: 10.1016/S0962-8479(96)90009-X

Setting: Department of Pulmonary Medicine P, Bispebjerg Hospital, Copenhagen, Denmark. Objective: To study the ability of two proteins secreted from Mycobacterium tuberculosis, MPT-64 and MPT-59 to induce delayed type hypersensitivity (DTH) reactions following intradermal administration. Design: In a small scale clinical investigation, skin reactions to these antigens were compared to reactions to tuberculin PPD RT23 in 1) patients with active tuberculosis, 2) BCG vaccinated healthy subjects with close contact with tuberculous patients, and 3) BCG vaccinated healthy subjects without contact with tuberculous patients. Tests for in vitro reactivity to these antigens were carried out in similar groups. Results: All subjects gave positive reaction to tuberculin PPD RT23, whereas approximately half of the subjects in each of the three groups reacted to MPT-59. Two subjects (one patient with tuberculosis and one healthy bacille Calmette-Guérin vaccinated subject without patient contact) reacted to MPT-64. The studies of cell proliferation and induction of interferon-γ (IFN-γ) following stimulation with tuberculin PPD and MPT-64 supported this profile of reactivity. Conclusion: None of the experimental skin test antigens had properties superior to tuberculin PPD RT23 in humans. The failure of MPT-64 to induce delayed type hypersensitivity reactions in the majority of tuberculosis patients is discussed, in view of the potent reactivity to MPT-64 in tuberculous guinea pigs. Cadre: Département de Médecine Pulmonaire P, Hôpital Bispebjerg, Copenhague, Danemark. Objectif: Etudier la capacité de deux protéines sécrétées par Mycobacterium tuberculosis, MPT-64 et MPT-59, á induire une hypersensibilité de type retardé après administration intradermique. Schéma: Au cours d'une investigation clinique á petite échelle, les réactions cutanées á ces antigènes ont été comparées aux réactions á la tuberculine PPD RT23 chez 1) des patients atteints d'une tuberculose active, 2) des sujets sains vaccinés au BCG ayant eu des contacts étroits avec des malades tuberculeux, et 3) des sujets sains vaccinés au BCG sans contact avec des tuberculeux. Des tests de réactivité in vitro ont été pratiqués á l'égard de ces antigènes dans des groupes similaires de patients. Résultats: Tous les sujets ont eu des réactions positives á la tuberculine PPD RT23 alors qu'environ la moitié d'entre eux dans chacun des trois groupes réagissait á MPT-59. Deux sujets (l'un du groupe 1 et l'autre du groupe 3