Potential Role for Mycobacterium tuberculosis Specific IL-2 and IFN-γ Responses in Discriminating between Latent Infection and Active Disease after Long-Term StimulationReportar como inadecuado




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Interferon gamma release assays IGRAs could accurately diagnose Mycobacterium tuberculosis M.tuberculosis infection. However, these assays do not discriminate between latent tuberculosis infection LTBI and active tuberculosis disease ATB. Here, a total of 177 subjects, including 65 patients with ATB, 43 subjects with LTBI, and 69 TB-uninfected controls CON group were enrolled. The concentration of IFN-γ, IP-10, and IL-2 was determined in peripheral blood mononuclear cells PBMCs after short-term 24h or long-term 72h stimulation with TB antigens including ESAT-6-CFP-10 EC and purified protein derivative PPD.EC-stimulated IL-2 and gamma interferon-inducible protein 10 IP-10 release 24h and 72h showed a good diagnostic performance in distinguishing between TB-infected and TB-uninfected individuals, but failed to discriminate between ATB and LTBI. After 72h of incubation, the release of IL-2 was higher in LTBI patients after stimulation with EC and PPD. The PPD-stimulated IL-2-IFN-γ ratio after 72h incubation had the diagnostic potential to discriminate between ATB and LTBI, with a sensitivity of 90.8% and a specificity of 97.7%. In addition, these new biomarkers, combined with T-SPOT test in a two-step strategy, were validated with high levels of accuracy in a prospective clinical-based cohort. Collectively, the PPD-stimulated IL-2-IFN-γ ratio after long-term incubation may be an alternative diagnostic biomarker in distinguishing between active TB patients and subjects with latent infection.



Autor: Qin Sun, Wei Wei, Wei Sha

Fuente: http://plos.srce.hr/



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