항결핵항체 검사와 인터페론감마 분비능 측정법을 조합한 결핵 진단 방법의 임상적 유용성
Clinical Usefulness of Combined Anti-tuberculosis Antibody Test and Interferon-γ Release Assay for the Diagnosis of Tuberculosis
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Background: For the diagnosis of tuberculosis (TB), a variety of tests based on the patients’ immune response has been introduced. We evaluated the clinical usefulness of combined anti-tuberculosis antibody (anti-TB Ab) test and Interferon-γ release assay (IGRA), evaluating humoral and cellular immune response to Mycobacterium tuberculosis, respectively. Methods: Among patients tested for IGRA, 78 patients diagnosed as TB and treated with anti-TB drug and 80 non-TB patients were included in this study. We used QuantiFERON-TB GOLD (QFT, Cellestis limited, Australia) for IGRA and an immunochromatographic assay, Easy Test TB (ASAN PHARM, Korea), for anti-TB Ab test. Results: The sensitivity, specificity, and positive and negative predictive values of Easy Test TB were 23.1%, 98.8%, 94.7% and 56.8%, respectively. QFT had a significantly higher sensitivity than Easy Test TB (67.9% vs. 23.1%; P <0.05). The agreement between the two assays was poor (69.6%, k=0.190). Of the 18 cases with positive Easy Test TB, six (33%) showed negative QFT results. The combination of Easy Test TB and QFT had a significantly higher sensitivity than single QFT (75.6%, vs. 67.9%; P =0.031). Conclusions: The combination of Easy Test TB and QFT could be used to aid in a rapid diagnosis and early treatment of TB.
Abstract
Background: For the diagnosis of tuberculosis (TB), a variety of tests based on the patients’ immune response has been introduced. We evaluated the clinical usefulness of combined anti-tuberculosis antibody (anti-TB Ab) test and Interferon-γ release assay (IGRA), evaluating humoral and cellular immune response to Mycobacterium tuberculosis, respectively. Methods: Among patients tested for IGRA, 78 patients diagnosed as TB and treated with anti-TB drug and 80 non-TB patients were included in this study. We used QuantiFERON-TB GOLD (QFT, Cellestis limited, Australia) for IGRA and an immunochromatographic assay, Easy Test TB (ASAN PHARM, Korea), for anti-TB Ab test. Results: The sensitivity, specificity, and positive and negative predictive values of Easy Test TB were 23.1%, 98.8%, 94.7% and 56.8%, respectively. QFT had a significantly higher sensitivity than Easy Test TB (67.9% vs. 23.1%; P <0.05). The agreement between the two assays was poor (69.6%, k=0.190). Of the 18 cases with positive Easy Test TB, six (33%) showed negative QFT results. The combination of Easy Test TB and QFT had a significantly higher sensitivity than single QFT (75.6%, vs. 67.9%; P =0.031). Conclusions: The combination of Easy Test TB and QFT could be used to aid in a rapid diagnosis and early treatment of TB.
참고문헌 (31)
- Dye C, "Consensus statement. Global burden of tuberculosis: estimated incidence, prevalence, and mortality by country", JAMA, 282, pp.677~686 (1999), WHO Global Surveillance and Monitoring Project
- Global tuberculosis control: a short update to the 2009 report, "World Health Organization (WHO)", World Health Organization, ~, pp.WHO (2009), HTM[DOI]
- Bartoloni A, "Evaluation of a rapid immunochromatographic test for the serologic diagnosis of tuberculosis in Italy", Clin Microbiol Infect, 9, pp.632~639 (2003)
- Pfaller MA, "Application of new technology to the detection, identification, and antimicrobial susceptibility testing of mycobacteria", Am J Clin Pathol, 101, pp.329~337 (1994)
- 장호은, "실시간-중합효소연쇄반응을 이용한 결핵균의 검출", Annals of Laboratory Medicine, 28(2), pp.103~108 (2008), 대한진단검사의학회
- Bothamley GH, "Serological diagnosis of tuberculosis", Eur Respir J Suppl, 20, pp.676~688 (1995)
- Chan ED, "Immunologic diagnosis of tuberculosis: a review", Tuber Lung Dis, 80, pp.131~140 (2000)
- Steingart KR, "A systematic review of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis", Postgrad Med J, 83, pp.705~712 (2007)
- Steingart KR, "Commercial serological antibody detection tests for the diagnosis of pulmonary tuberculosis: a systematic review", PLoS Med, 4, pp.202~ (2007)
- Pai M, "New tools and emerging technologies for the diagnosis of tuberculosis: part I. Latent tuberculosis", Expert Rev Mol Diagn, 6, pp.413~422 (2006)
- Zellweger JP, "Contact tracing using a new T-cell based test: better correlation with tuberculosis exposure than the tuberculin skin test", Int J Tuberc Lung Dis, 9, pp.1242~1247 (2005)
- Raja A, "Immunology of tuberculosis", Indian J Med Res, 120, pp.213~232 (2004)
- Glatman-Freedman A, "Serum therapy for tuberculosis revisited: reappraisal of the role of antibody-mediated immunity against Mycobacterium tuberculosis", Clin Microbiol Rev, 11, pp.514~532 (1998)
- Doherty TM, "Vaccines for tuberculosis: novel concepts and recent progress", Clin Microbiol, 18, pp.687~702 (2005)
- Torres M, "Comparison of the immune response against Mycobacterium tuberculosis antigens between a group of patients with active pulmonary tuberculosis and healthy household contacts", Clin Exp Immunol, 96, pp.75~78 (1994)
- Del Prete R, "Detection of anti-lipoarabinomannan antibodies for the diagnosis of active tuberculosis", Int J Tuberc Lung Dis, 2, pp.160~163 (1998)
- Harboe M, "The 38-kDa protein of Mycobacterium tuberculosis:a review", J Infect Dis, 166, pp.874~884 (1992)
- Nagai S, "Isolation and partial characterization of major protein antigens in the culture fluid of Mycobacterium tuberculosis", Infect Immun, 59, pp.372~382 (1991)
- Kox LF, "Tests for detection and identification of mycobacteria. How should they be used", Respir Med, 89, pp.399~408 (1995)
- Yoshikawa M, "Diagnosis of mycobacterial disease by biochemical and immunological parameters", Nippon Rinsho, 56, pp.3057~3061 (1998)
- Steingart KR, "Commercial serological tests for the diagnosis of tuberculosis: do they work", Future Microbiol, 2, pp.355~359 (2007)
- Ongut G, "Evaluation of the ICT Tuberculosis test for the routine diagnosis of tu berculosis", BMC Infect Dis, 6, pp.37~ (2006)
- Cole RA, "Clinical evaluation of a rapid immunochromatographic assay based on the 38 kDa antigen of Mycobacterium on patients with pulmonary tuberculosis in China", Tuber Lung Dis, 77, pp.363~368 (1996)
- Kim MY, "Clinical Usefulness of An Immunochromatographic Assay Based on 38 kDa Antigen for The Diagnosis of Active Tuberculosis", Korean J Clin Pathol, 19, pp.647~656 (1999)
- Senol G, "Humoral immune response against 38-kDa and 16-kDa mycobacterial antigens in tuberculosis", Eur Respir J, 29, pp.143~148 (2007)
- Okuda Y, "Rapid serodiagnosis of active pulmonary Mycobacterium tuberculosis by analysis of results from multiple antigen-specific tests", J Clin Microbiol, 42, pp.1136~1141 (2004)
- Miller RA, "The aging immune system: primer and prospectus", Science, 273, pp.70~74 (1996)
- Thybo S, "Humoral response to Mycobacterium tuberculosis-specific antigens in African tuberculosis patients with high prevalence of human immunodeficiency virus infection", Tuber Lung Dis, 76, pp.149~155 (1995)
- World Health Organization (WHO), "product development guidelines, Workshop report", WHO tuberculosis diagnositcs workshop, pp.1~27 (1997), World Health Organization
- Pottumarthy S, "A comparison of seven tests for serological diagnosis of tuberculosis", J Clin Microbiol, 38, pp.2227~2231 (2000)
- Freeman R, "Rapid immunochromatographic assay for diagnosis of tuberculosis: antibodies detected may not be specific", J Clin Microbiol, 37, pp.2111~2112 (1999)