Objective: The diagnosis of tuberculosis (TB) ascites is problematic. Delay in the diagnosis and treatment of TB ascites are considered

to be major factors that contribute to the high mortality of TB. This study identifies specific protein markers in ascitic fluid which will

be useful in diagnosis of TB ascites.

Methods: We used Two-Dimensional Electrophoresis, liquid chromatography-mass spectrometry/mass spectrometry, immunoblot

analysis and Enzyme Linked Immunosorbent assay (ELISA) as a comprehensive quantitative proteomic screening system for the diagnosis

of TB ascites.

Results: The screen identified several antigens of interest: a 30-kilodalton (kDa) protein that demonstrated significant homology to the

antigen 85B and 85C (Ag 85) complex; a 65-kDa protein that corresponded to Mycobacterium tuberculosis (MTB) heat shock protein

65 (65-kDa HSP), Rv0440; a 14-kDa protein and 71-kDa protein that exhibits an amino acid sequence identical to that of MTB heat

shock protein 14 (14-kDa HSP), GroES; and MTB heat shock protein 71 (71-kDa HSP), Rv0350 respectively. ELISA confirmed that

TB ascites patients were consistently positive for these antigens at higher rates than non-TB ascites patients.

Conclusion: The 65-kDa HSP, 71-kDa HSP, 14-kDa HSP and Ag 85 complex proteins may serve as very useful diagnostic markers for

TB ascites.

Keywords: TB ascites, heat shock proteins, M. tuberculosis antigens