Utility of Th1-cell immune responses for distinguishing active tuberculosis from non-active tuberculosis: A case-control studyReport as inadecuate




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Currently available Interferon-γ release assay IGRA cannot reliably differentiate active TB ATB from non-active TB non-ATB. A study was performed to evaluate the value of Mycobacterium tuberculosis MTB specific Th1 cell immune responses which test IFN-γ and IL-2 simultaneous for differentiating ATB from non-ATB. Forty-nine newly diagnosed inpatients with ATB 26 pulmonary TB and 23 extrapulmonary TB were enrolled as the ATB group. Forty-five volunteers with latent tuberculosis infection LTBI and twenty with evidence of previous TB were enrolled during the same period as the non-ATB group. Clinical examination and MTB specific Th1 cell immune responses were performed for all participants. After being stimulated with ESAT-6 and CFP-10, the median frequencies of single IL-2-, single IFN-γ-, and dual IFN-γ-IL-2-secreting T-cells were all higher in the ATB group than in the non-ATB group 208–45 vs. 73–13, P<0.001;13144–308 vs. 106–27, P<0.001;259–74 vs. 73–23, P = 0.001, respectively. Evaluation of the diagnostic performance of detecting single IFN-γ-secreting T cells for pulmonary TB employed a cutoff value of 35 iSFCs-250,000 PBMC. The sensitivity, specificity, positive predictive value PPV, negative predictive value NPV, positive likelihood ratio PLR, and negative likelihood ratio NLR were 92.3%, 80.0%, 64.9%, 96.3%, 4.62, and 0.10, respectively. For extrapulmonary TB, using a cutoff value of 23 iSFCs- 250,000 PBMC, the sensitivity, specificity, PPV, NPV, PLR, and NLR were 91.3%, 76.9%, 58.3%, 96.2%, 3.96, and 0.11, respectively. When combining frequencies and proportion of single IFN-γ-secreting T cells, the test sensitivity was 100% in parallel tests and the specificity was 87.7% in serial tests for pulmonary TB. MTB specific Th1 cell immune responses FluoroSpot had value for the differentiation of ATB and non-ATB. Further confirmatory studies are indicated.



Author: Lifan Zhang, Xinhe Cheng, Sainan Bian, Yanhua Song, Qiang Li, Mengqiu Gao, Yueqiu Zhang, Xiaochun Shi, Xiaoqing Liu

Source: http://plos.srce.hr/



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