Skip to main content
U.S. Department of Energy
Office of Scientific and Technical Information

Interaction of amphiphilic lipoarabinomannan with host carrier lipoproteins in tuberculosis patients: Implications for blood-based diagnostics

Journal Article · · PLoS ONE
 [1];  [2];  [3];  [4];  [2];  [2];  [5];  [4];  [6];  [7];  [2]
  1. Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Chemistry Division. Physical Chemistry and Applied Spectroscopy; OSTI
  2. Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Chemistry Division. Physical Chemistry and Applied Spectroscopy
  3. Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Chemistry Division. Physical Chemistry and Applied Spectroscopy; Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Chemistry Division. Actinide Analytical Chemistry
  4. Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Bioscience Division. Biosecurity and Public Health
  5. Los Alamos National Lab. (LANL), Los Alamos, NM (United States). Theory Division. Theoretical Biology and Biophysics
  6. Foundation for Innovative New Diagnostics, Geneva (Switzerland)
  7. Medical Univ. of South Carolina, Charleston, SC (United States). Dept. of Medicine

Lipoarabinomannan (LAM), an amphiphilic lipoglycan of the Mycobacterium tuberculosis cell wall, is a diagnostic target for tuberculosis. Previous work from our laboratory and others suggests that LAM is associated with host serum lipoproteins, which may in turn have implications for diagnostic assays. Our team has developed two serum assays for amphiphile detection: lipoprotein capture and membrane insertion. The lipoprotein capture assay relies on capture of the host lipoproteins, exploiting the biological association of host lipoprotein with microbial amphiphilic biomarkers to “concentrate” LAM. In contrast, the membrane insertion assay is independent of the association between pathogen amphiphiles and host lipoprotein association, and directly captures LAM based on its thermodynamic propensity for association with a supported lipid membrane, which forms the functional surface of an optical biosensor. In this manuscript, we explored the use of these assays for the detection of LAM in sera from adults whose tuberculosis status had been well-characterized using conventional microbiological tests, and endemic controls. Using the lipoprotein capture assay, LAM signal/noise ratios were >1.0 in 29/35 (83%) individuals with culture-confirmed active tuberculosis, 8/13 (62%) individuals with tuberculosis symptoms, but no positive culture for M. tuberculosis, and 0/6 (0%) symptom-free endemic controls. To evaluate serum LAM levels without bias associated with potential differences in circulating host lipoprotein concentrations between individuals, we subsequently processed available samples to liberate LAM from associated host lipoprotein assemblies followed by direct detection of the pathogen biomarker using the membrane insertion approach. Using the membrane insertion assay, signal/noise for detection of serum LAM was greater than that observed using the lipoprotein capture method for culture-confirmed TB patients (6/6), yet remained negative for controls (2/2). Taken together, these results suggest that detection of serum LAM is a promising TB diagnostic approach, but that further work is required to optimize assay performance and to decipher the implications of LAM/host lipoprotein associations for diagnostic assay performance and TB pathogenesis.

Research Organization:
Los Alamos National Laboratory (LANL), Los Alamos, NM (United States)
Sponsoring Organization:
USDOE National Nuclear Security Administration (NNSA); National Institutes of Health (NIH)
Grant/Contract Number:
89233218CNA000001
OSTI ID:
1815797
Alternate ID(s):
OSTI ID: 1846130
Journal Information:
PLoS ONE, Journal Name: PLoS ONE Journal Issue: 4 Vol. 16; ISSN 1932-6203
Publisher:
Public Library of ScienceCopyright Statement
Country of Publication:
United States
Language:
English

References (32)

Impact of HIV Infection and HAART on Serum Lipids in Men journal June 2003
Rapid diagnosis of tuberculosis by detection of mycobacterial lipoarabinomannan in urine journal May 2001
Approaches to tuberculosis screening and diagnosis in people with HIV in resource-limited settings journal March 2009
Novel lipoarabinomannan point-of-care tuberculosis test for people with HIV: a diagnostic accuracy study journal August 2019
Detection of the tuberculosis biomarker mannose-capped lipoarabinomannan in human serum: Impact of sample pretreatment with perchloric acid journal January 2019
HIV infection and high density lipoprotein metabolism journal July 2008
Lipoprotein particle subclasses, cardiovascular disease and HIV infection journal December 2009
Detection of stealthy small amphiphilic biomarkers journal August 2014
Planar optical waveguide-based biosensor for the quantitative detection of tumor markers journal May 2009
Rapid detection of Mycobacterium tuberculosis biomarkers in a sandwich immunoassay format using a waveguide-based optical biosensor journal September 2012
Association of lipoarabinomannan with high density lipoprotein in blood: Implications for diagnostics journal May 2013
Immunological biomarkers of tuberculosis journal April 2011
Direct detection of bacteremia by exploiting host-pathogen interactions of lipoteichoic acid and lipopolysaccharide journal April 2019
Pathogen detection using single mode planar optical waveguides journal January 2005
Diagnostic Accuracy of a Novel and Rapid Lipoarabinomannan Test for Diagnosing Tuberculosis Among People With Human Immunodeficiency Virus journal December 2019
Diagnostic Accuracy of a Rapid Urine Lipoarabinomannan Test for Tuberculosis in HIV-Infected Adults journal January 2014
The ongoing challenge of latent tuberculosis journal June 2014
Detection of lipopolysaccharides in serum using a waveguide-based optical biosensor
  • Noormohamed, Aneesa; Stromberg, Loreen R.; Anderson, Aaron S.
  • Optical Diagnostics and Sensing XVII: Toward Point-of-Care Diagnostics, Vol. 10072 https://doi.org/10.1117/12.2253506
conference February 2017
Incipient and Subclinical Tuberculosis: a Clinical Review of Early Stages and Progression of Infection journal July 2018
A Novel Sensitive Immunoassay Targeting the 5-Methylthio- d -Xylofuranose–Lipoarabinomannan Epitope Meets the WHO's Performance Target for Tuberculosis Diagnosis journal December 2018
A Rapid Method of Total Lipid Extraction and Purification journal August 1959
Innate Immune Recognition of Mycobacterium tuberculosis journal January 2011
HIV Disease Activity as a Modulator of Lipoprotein(a) and Allele-Specific Apolipoprotein(a) Levels journal February 2013
Detection of lipoarabinomannan (LAM) in urine is an independent predictor of mortality risk in patients receiving treatment for HIV-associated tuberculosis in sub-Saharan Africa: a systematic review and meta-analysis journal March 2016
Low HDL-cholesterol among HIV-1 infected and HIV-1 uninfected individuals in Nairobi, Kenya journal June 2017
A Sensitive Urinary Lipoarabinomannan Test for Tuberculosis journal April 2015
Sensitive electrochemiluminescence (ECL) immunoassays for detecting lipoarabinomannan (LAM) and ESAT-6 in urine and serum from tuberculosis patients journal April 2019
Pathogen-derived biomarkers for active tuberculosis diagnosis journal October 2014
Detection of Lipid and Amphiphilic Biomarkers for Disease Diagnostics journal July 2017
Waveguide-Based Biosensors for Pathogen Detection journal July 2009
Tuberculosis biomarkers: from diagnosis to protection journal June 2016
Detection of lipoarabinomannan (LAM) in urine is an independent predictor of mortality risk in patients receiving treatment for HIV-associated tuberculosis in sub-Saharan Africa: a systematic review and meta-analysis collection January 2016