Novel monoclonal antibodies to ESAT-6 and CFP-10 antigens for ELISA-based diagnosis of pleural tuberculosis

OBJECTIVE: To elucidate the potential of monoclonal antibodies (mAbs) of culture filtrate protein 10 (CFP-10) and early secretory antigenic target 6 (ESAT-6) in tuberculosis (TB) diagnosis.DESIGN: We generated and characterised monoclonal and polyclonal antibodies against Mycobacterium tuberculosis-...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The international journal of tuberculosis and lung disease 2011-06, Vol.15 (6), p.804-810
Hauptverfasser: FENG, T.-T, SHOU, C.-M, YAO, H.-P, SHEN, L, QIAN, Y, WU, Z.-G, FAN, J, ZHANG, Y.-Z, TANG, Y.-W, WU, N.-P, LU, H.-Z
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 810
container_issue 6
container_start_page 804
container_title The international journal of tuberculosis and lung disease
container_volume 15
creator FENG, T.-T
SHOU, C.-M
YAO, H.-P
SHEN, L
QIAN, Y
WU, Z.-G
FAN, J
ZHANG, Y.-Z
TANG, Y.-W
WU, N.-P
LU, H.-Z
description OBJECTIVE: To elucidate the potential of monoclonal antibodies (mAbs) of culture filtrate protein 10 (CFP-10) and early secretory antigenic target 6 (ESAT-6) in tuberculosis (TB) diagnosis.DESIGN: We generated and characterised monoclonal and polyclonal antibodies against Mycobacterium tuberculosis-specific antigens ESAT-6 and CFP-10 by immunising BALB/c mice with an ESAT-6/CFP-10 fusion protein. Stable hybridoma cell lines were established and mAbs were specifically identified by immunoblotting and immunoprecipitation. The mouse mAbs were used to coat plates, and biotin-labelled polyclonal antibodies were used to detect the antigens. One hundred and seventy-three samples of sputum culture supernatants and pleural effusion aspirates have been tested.RESULTS: The ESAT-6 enzyme-linked immunosorbent assay (ELISA) detected the culture supernatants and pleural effusion specimens that were positive for M. tuberculosis, but failed to identify M. tuberculosis-positive specimens in the non-M. tuberculosis culture supernatants or control specimens. This yielded a sensitivity of 95.4% and a specificity of 100% for the ESAT-6-specific ELISA. The CFP-10 ELISA presented less satisfactory sensitivity and specificity, of respectively 81.6% and 92.2%. Results showed positive detection rates of ESAT-6 and CFP-10 of 86.8% (33/38) and 76.3% (29/38) for the diagnosis of tuberculous pleural effusion in patients bacteriologically negative for M. tuberculosis culture.CONCLUSION: The ESAT-6 and CFP-10 ELISAs incorporating mAbs generated in this study serve as potential tools in the laboratory diagnosis of TB.
doi_str_mv 10.5588/ijtld.10.0393
format Article
fullrecord <record><control><sourceid>pubtec_pubme</sourceid><recordid>TN_cdi_pubmed_primary_21575303</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ingid>iuatld/ijtld/2011/00000015/00000006/art00018</ingid><sourcerecordid>iuatld/ijtld/2011/00000015/00000006/art00018</sourcerecordid><originalsourceid>FETCH-LOGICAL-c457t-502e53e8159f7502961942d663c4289aa1bb88d8b6e744a769af342f4a7dbb713</originalsourceid><addsrcrecordid>eNp1kk1vEzEQhlcIREvhyBX5gjht8efae4xCCpUiaNVytmbX3sjBWQfbW6n99XiTFE744pnxq2fs11NV7wm-FEKpz26bvbksGWYte1GdE0VELVuKX5YYU1kzSdqz6k1KW4wpIUS-rs4oEVIwzM6rX9_Dg_VoF8bQ-zCCRzBm1wXjbEI5oNXd4r5uStGg5dVNTfDhfGPHhIYQ0Wp9fbeoO0jWIONgM4bkEgoD2ns7xULLU2djP_m5_rZ6NYBP9t1pv6h-Xq3ul9_q9Y-v18vFuu65kLkWmFrBbHlHO8iStA1pOTVNw3pOVQtAuk4po7rGSs5BNi0MjNOhhKbrJGEX1acjdx_D78mmrHcu9dZ7GG2YklaN5FIxxouyPir7GFKKdtD76HYQHzXBerZXH-yds9neov9wIk_dzpq_6mc_i-DjSQCpBz9EGHuX_ul4-R7Wzlf8ctS5sXiZQW_DFIv7SbsJ5o7HvhQTovFhEXEKcKMh5rmiCub2f5j-mTQPwTwD-oGIsSlISrCiQhMumDZ2gMlnnSHqzZNOhfkHl2azAw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>867478334</pqid></control><display><type>article</type><title>Novel monoclonal antibodies to ESAT-6 and CFP-10 antigens for ELISA-based diagnosis of pleural tuberculosis</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>FENG, T.-T ; SHOU, C.-M ; YAO, H.-P ; SHEN, L ; QIAN, Y ; WU, Z.-G ; FAN, J ; ZHANG, Y.-Z ; TANG, Y.-W ; WU, N.-P ; LU, H.-Z</creator><creatorcontrib>FENG, T.-T ; SHOU, C.-M ; YAO, H.-P ; SHEN, L ; QIAN, Y ; WU, Z.-G ; FAN, J ; ZHANG, Y.-Z ; TANG, Y.-W ; WU, N.-P ; LU, H.-Z</creatorcontrib><description>OBJECTIVE: To elucidate the potential of monoclonal antibodies (mAbs) of culture filtrate protein 10 (CFP-10) and early secretory antigenic target 6 (ESAT-6) in tuberculosis (TB) diagnosis.DESIGN: We generated and characterised monoclonal and polyclonal antibodies against Mycobacterium tuberculosis-specific antigens ESAT-6 and CFP-10 by immunising BALB/c mice with an ESAT-6/CFP-10 fusion protein. Stable hybridoma cell lines were established and mAbs were specifically identified by immunoblotting and immunoprecipitation. The mouse mAbs were used to coat plates, and biotin-labelled polyclonal antibodies were used to detect the antigens. One hundred and seventy-three samples of sputum culture supernatants and pleural effusion aspirates have been tested.RESULTS: The ESAT-6 enzyme-linked immunosorbent assay (ELISA) detected the culture supernatants and pleural effusion specimens that were positive for M. tuberculosis, but failed to identify M. tuberculosis-positive specimens in the non-M. tuberculosis culture supernatants or control specimens. This yielded a sensitivity of 95.4% and a specificity of 100% for the ESAT-6-specific ELISA. The CFP-10 ELISA presented less satisfactory sensitivity and specificity, of respectively 81.6% and 92.2%. Results showed positive detection rates of ESAT-6 and CFP-10 of 86.8% (33/38) and 76.3% (29/38) for the diagnosis of tuberculous pleural effusion in patients bacteriologically negative for M. tuberculosis culture.CONCLUSION: The ESAT-6 and CFP-10 ELISAs incorporating mAbs generated in this study serve as potential tools in the laboratory diagnosis of TB.</description><identifier>ISSN: 1027-3719</identifier><identifier>EISSN: 1815-7920</identifier><identifier>DOI: 10.5588/ijtld.10.0393</identifier><identifier>PMID: 21575303</identifier><language>eng</language><publisher>Paris, France: IUATLD</publisher><subject>Animals ; Antibodies, Monoclonal ; Antigens, Bacterial - immunology ; Bacterial diseases ; Bacterial diseases of the respiratory system ; Bacterial Proteins - immunology ; Biological and medical sciences ; Cfp-10 ; Databases, Nucleic Acid ; Disease Models, Animal ; DNA Primers ; Enzyme-Linked Immunosorbent Assay - methods ; Esat-6 ; Human bacterial diseases ; Humans ; Immunoblotting ; Immunological Diagnosis ; Immunoprecipitation ; Infectious diseases ; Medical sciences ; Mice ; Mice, Inbred BALB C ; Monoclonal Antibody ; Mycobacterium tuberculosis - immunology ; Mycobacterium tuberculosis - isolation &amp; purification ; Pneumology ; Respiratory system : syndromes and miscellaneous diseases ; Sensitivity and Specificity ; Sputum - microbiology ; Tuberculin - immunology ; Tuberculosis ; Tuberculosis and atypical mycobacterial infections ; Tuberculosis, Pleural - diagnosis</subject><ispartof>The international journal of tuberculosis and lung disease, 2011-06, Vol.15 (6), p.804-810</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c457t-502e53e8159f7502961942d663c4289aa1bb88d8b6e744a769af342f4a7dbb713</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=24181391$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21575303$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>FENG, T.-T</creatorcontrib><creatorcontrib>SHOU, C.-M</creatorcontrib><creatorcontrib>YAO, H.-P</creatorcontrib><creatorcontrib>SHEN, L</creatorcontrib><creatorcontrib>QIAN, Y</creatorcontrib><creatorcontrib>WU, Z.-G</creatorcontrib><creatorcontrib>FAN, J</creatorcontrib><creatorcontrib>ZHANG, Y.-Z</creatorcontrib><creatorcontrib>TANG, Y.-W</creatorcontrib><creatorcontrib>WU, N.-P</creatorcontrib><creatorcontrib>LU, H.-Z</creatorcontrib><title>Novel monoclonal antibodies to ESAT-6 and CFP-10 antigens for ELISA-based diagnosis of pleural tuberculosis</title><title>The international journal of tuberculosis and lung disease</title><addtitle>Int J Tuberc Lung Dis</addtitle><description>OBJECTIVE: To elucidate the potential of monoclonal antibodies (mAbs) of culture filtrate protein 10 (CFP-10) and early secretory antigenic target 6 (ESAT-6) in tuberculosis (TB) diagnosis.DESIGN: We generated and characterised monoclonal and polyclonal antibodies against Mycobacterium tuberculosis-specific antigens ESAT-6 and CFP-10 by immunising BALB/c mice with an ESAT-6/CFP-10 fusion protein. Stable hybridoma cell lines were established and mAbs were specifically identified by immunoblotting and immunoprecipitation. The mouse mAbs were used to coat plates, and biotin-labelled polyclonal antibodies were used to detect the antigens. One hundred and seventy-three samples of sputum culture supernatants and pleural effusion aspirates have been tested.RESULTS: The ESAT-6 enzyme-linked immunosorbent assay (ELISA) detected the culture supernatants and pleural effusion specimens that were positive for M. tuberculosis, but failed to identify M. tuberculosis-positive specimens in the non-M. tuberculosis culture supernatants or control specimens. This yielded a sensitivity of 95.4% and a specificity of 100% for the ESAT-6-specific ELISA. The CFP-10 ELISA presented less satisfactory sensitivity and specificity, of respectively 81.6% and 92.2%. Results showed positive detection rates of ESAT-6 and CFP-10 of 86.8% (33/38) and 76.3% (29/38) for the diagnosis of tuberculous pleural effusion in patients bacteriologically negative for M. tuberculosis culture.CONCLUSION: The ESAT-6 and CFP-10 ELISAs incorporating mAbs generated in this study serve as potential tools in the laboratory diagnosis of TB.</description><subject>Animals</subject><subject>Antibodies, Monoclonal</subject><subject>Antigens, Bacterial - immunology</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the respiratory system</subject><subject>Bacterial Proteins - immunology</subject><subject>Biological and medical sciences</subject><subject>Cfp-10</subject><subject>Databases, Nucleic Acid</subject><subject>Disease Models, Animal</subject><subject>DNA Primers</subject><subject>Enzyme-Linked Immunosorbent Assay - methods</subject><subject>Esat-6</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Immunoblotting</subject><subject>Immunological Diagnosis</subject><subject>Immunoprecipitation</subject><subject>Infectious diseases</subject><subject>Medical sciences</subject><subject>Mice</subject><subject>Mice, Inbred BALB C</subject><subject>Monoclonal Antibody</subject><subject>Mycobacterium tuberculosis - immunology</subject><subject>Mycobacterium tuberculosis - isolation &amp; purification</subject><subject>Pneumology</subject><subject>Respiratory system : syndromes and miscellaneous diseases</subject><subject>Sensitivity and Specificity</subject><subject>Sputum - microbiology</subject><subject>Tuberculin - immunology</subject><subject>Tuberculosis</subject><subject>Tuberculosis and atypical mycobacterial infections</subject><subject>Tuberculosis, Pleural - diagnosis</subject><issn>1027-3719</issn><issn>1815-7920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kk1vEzEQhlcIREvhyBX5gjht8efae4xCCpUiaNVytmbX3sjBWQfbW6n99XiTFE744pnxq2fs11NV7wm-FEKpz26bvbksGWYte1GdE0VELVuKX5YYU1kzSdqz6k1KW4wpIUS-rs4oEVIwzM6rX9_Dg_VoF8bQ-zCCRzBm1wXjbEI5oNXd4r5uStGg5dVNTfDhfGPHhIYQ0Wp9fbeoO0jWIONgM4bkEgoD2ns7xULLU2djP_m5_rZ6NYBP9t1pv6h-Xq3ul9_q9Y-v18vFuu65kLkWmFrBbHlHO8iStA1pOTVNw3pOVQtAuk4po7rGSs5BNi0MjNOhhKbrJGEX1acjdx_D78mmrHcu9dZ7GG2YklaN5FIxxouyPir7GFKKdtD76HYQHzXBerZXH-yds9neov9wIk_dzpq_6mc_i-DjSQCpBz9EGHuX_ul4-R7Wzlf8ctS5sXiZQW_DFIv7SbsJ5o7HvhQTovFhEXEKcKMh5rmiCub2f5j-mTQPwTwD-oGIsSlISrCiQhMumDZ2gMlnnSHqzZNOhfkHl2azAw</recordid><startdate>20110601</startdate><enddate>20110601</enddate><creator>FENG, T.-T</creator><creator>SHOU, C.-M</creator><creator>YAO, H.-P</creator><creator>SHEN, L</creator><creator>QIAN, Y</creator><creator>WU, Z.-G</creator><creator>FAN, J</creator><creator>ZHANG, Y.-Z</creator><creator>TANG, Y.-W</creator><creator>WU, N.-P</creator><creator>LU, H.-Z</creator><general>IUATLD</general><general>International Union against Tuberculosis and Lung Disease</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110601</creationdate><title>Novel monoclonal antibodies to ESAT-6 and CFP-10 antigens for ELISA-based diagnosis of pleural tuberculosis</title><author>FENG, T.-T ; SHOU, C.-M ; YAO, H.-P ; SHEN, L ; QIAN, Y ; WU, Z.-G ; FAN, J ; ZHANG, Y.-Z ; TANG, Y.-W ; WU, N.-P ; LU, H.-Z</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c457t-502e53e8159f7502961942d663c4289aa1bb88d8b6e744a769af342f4a7dbb713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Animals</topic><topic>Antibodies, Monoclonal</topic><topic>Antigens, Bacterial - immunology</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the respiratory system</topic><topic>Bacterial Proteins - immunology</topic><topic>Biological and medical sciences</topic><topic>Cfp-10</topic><topic>Databases, Nucleic Acid</topic><topic>Disease Models, Animal</topic><topic>DNA Primers</topic><topic>Enzyme-Linked Immunosorbent Assay - methods</topic><topic>Esat-6</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Immunoblotting</topic><topic>Immunological Diagnosis</topic><topic>Immunoprecipitation</topic><topic>Infectious diseases</topic><topic>Medical sciences</topic><topic>Mice</topic><topic>Mice, Inbred BALB C</topic><topic>Monoclonal Antibody</topic><topic>Mycobacterium tuberculosis - immunology</topic><topic>Mycobacterium tuberculosis - isolation &amp; purification</topic><topic>Pneumology</topic><topic>Respiratory system : syndromes and miscellaneous diseases</topic><topic>Sensitivity and Specificity</topic><topic>Sputum - microbiology</topic><topic>Tuberculin - immunology</topic><topic>Tuberculosis</topic><topic>Tuberculosis and atypical mycobacterial infections</topic><topic>Tuberculosis, Pleural - diagnosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>FENG, T.-T</creatorcontrib><creatorcontrib>SHOU, C.-M</creatorcontrib><creatorcontrib>YAO, H.-P</creatorcontrib><creatorcontrib>SHEN, L</creatorcontrib><creatorcontrib>QIAN, Y</creatorcontrib><creatorcontrib>WU, Z.-G</creatorcontrib><creatorcontrib>FAN, J</creatorcontrib><creatorcontrib>ZHANG, Y.-Z</creatorcontrib><creatorcontrib>TANG, Y.-W</creatorcontrib><creatorcontrib>WU, N.-P</creatorcontrib><creatorcontrib>LU, H.-Z</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The international journal of tuberculosis and lung disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>FENG, T.-T</au><au>SHOU, C.-M</au><au>YAO, H.-P</au><au>SHEN, L</au><au>QIAN, Y</au><au>WU, Z.-G</au><au>FAN, J</au><au>ZHANG, Y.-Z</au><au>TANG, Y.-W</au><au>WU, N.-P</au><au>LU, H.-Z</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Novel monoclonal antibodies to ESAT-6 and CFP-10 antigens for ELISA-based diagnosis of pleural tuberculosis</atitle><jtitle>The international journal of tuberculosis and lung disease</jtitle><addtitle>Int J Tuberc Lung Dis</addtitle><date>2011-06-01</date><risdate>2011</risdate><volume>15</volume><issue>6</issue><spage>804</spage><epage>810</epage><pages>804-810</pages><issn>1027-3719</issn><eissn>1815-7920</eissn><abstract>OBJECTIVE: To elucidate the potential of monoclonal antibodies (mAbs) of culture filtrate protein 10 (CFP-10) and early secretory antigenic target 6 (ESAT-6) in tuberculosis (TB) diagnosis.DESIGN: We generated and characterised monoclonal and polyclonal antibodies against Mycobacterium tuberculosis-specific antigens ESAT-6 and CFP-10 by immunising BALB/c mice with an ESAT-6/CFP-10 fusion protein. Stable hybridoma cell lines were established and mAbs were specifically identified by immunoblotting and immunoprecipitation. The mouse mAbs were used to coat plates, and biotin-labelled polyclonal antibodies were used to detect the antigens. One hundred and seventy-three samples of sputum culture supernatants and pleural effusion aspirates have been tested.RESULTS: The ESAT-6 enzyme-linked immunosorbent assay (ELISA) detected the culture supernatants and pleural effusion specimens that were positive for M. tuberculosis, but failed to identify M. tuberculosis-positive specimens in the non-M. tuberculosis culture supernatants or control specimens. This yielded a sensitivity of 95.4% and a specificity of 100% for the ESAT-6-specific ELISA. The CFP-10 ELISA presented less satisfactory sensitivity and specificity, of respectively 81.6% and 92.2%. Results showed positive detection rates of ESAT-6 and CFP-10 of 86.8% (33/38) and 76.3% (29/38) for the diagnosis of tuberculous pleural effusion in patients bacteriologically negative for M. tuberculosis culture.CONCLUSION: The ESAT-6 and CFP-10 ELISAs incorporating mAbs generated in this study serve as potential tools in the laboratory diagnosis of TB.</abstract><cop>Paris, France</cop><pub>IUATLD</pub><pmid>21575303</pmid><doi>10.5588/ijtld.10.0393</doi><tpages>7</tpages></addata></record>
fulltext fulltext
identifier ISSN: 1027-3719
ispartof The international journal of tuberculosis and lung disease, 2011-06, Vol.15 (6), p.804-810
issn 1027-3719
1815-7920
language eng
recordid cdi_pubmed_primary_21575303
source MEDLINE; Alma/SFX Local Collection
subjects Animals
Antibodies, Monoclonal
Antigens, Bacterial - immunology
Bacterial diseases
Bacterial diseases of the respiratory system
Bacterial Proteins - immunology
Biological and medical sciences
Cfp-10
Databases, Nucleic Acid
Disease Models, Animal
DNA Primers
Enzyme-Linked Immunosorbent Assay - methods
Esat-6
Human bacterial diseases
Humans
Immunoblotting
Immunological Diagnosis
Immunoprecipitation
Infectious diseases
Medical sciences
Mice
Mice, Inbred BALB C
Monoclonal Antibody
Mycobacterium tuberculosis - immunology
Mycobacterium tuberculosis - isolation & purification
Pneumology
Respiratory system : syndromes and miscellaneous diseases
Sensitivity and Specificity
Sputum - microbiology
Tuberculin - immunology
Tuberculosis
Tuberculosis and atypical mycobacterial infections
Tuberculosis, Pleural - diagnosis
title Novel monoclonal antibodies to ESAT-6 and CFP-10 antigens for ELISA-based diagnosis of pleural tuberculosis
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T15%3A36%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-pubtec_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Novel%20monoclonal%20antibodies%20to%20ESAT-6%20and%20CFP-10%20antigens%20for%20ELISA-based%20diagnosis%20of%20pleural%20tuberculosis&rft.jtitle=The%20international%20journal%20of%20tuberculosis%20and%20lung%20disease&rft.au=FENG,%20T.-T&rft.date=2011-06-01&rft.volume=15&rft.issue=6&rft.spage=804&rft.epage=810&rft.pages=804-810&rft.issn=1027-3719&rft.eissn=1815-7920&rft_id=info:doi/10.5588/ijtld.10.0393&rft_dat=%3Cpubtec_pubme%3Eiuatld/ijtld/2011/00000015/00000006/art00018%3C/pubtec_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=867478334&rft_id=info:pmid/21575303&rft_ingid=iuatld/ijtld/2011/00000015/00000006/art00018&rfr_iscdi=true