Qualitative and quantitative results of interferon-γ release assays for monitoring the response to anti-tuberculosis treatment
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: The usefulness of interferon-γ release assays (IGRAs) in monitoring to responses to anti-tuberculosis (TB) treatment is controversial. We compared the results of two IGRAs before and after anti-TB treatment in same patients with active TB. Methods: From a retrospective review, we selected patients with active TB who underwent repeated QuantiFERON-TB Gold (QFN-Gold, Cellestis Limited) and T-SPOT.TB (Oxford Immunotec) assays before and after anti-TB treatment with first-line drugs. Both tests were performed prior to the start of anti-TB treatment or within 1 week after the start of anti-TB treatment and after completion of treatment. Results: A total of 33 active TB patients were included in the study. On the QFNGold test, at baseline, 23 cases (70%) were early secreted antigenic target 6-kDa protein 6 (ESAT-6) or culture filtrate protein 10 (CFP-10) positive. On the T-SPOT. TB test, at baseline, 31 cases (94%) were ESAT-6 or CFP-10 positive. Most of patients remained both test-positive after anti-TB treatment. Although changes in interferon-γ release responses over time were highly variable in both tests, there was a mean decline of 27 and 24 spot-forming counts for ESAT-6 and CFP-10, respectively on the T-SPOT.TB test (p < 0.05 for all). Conclusions: Although limited by the small number of patients and a short-term follow-up, there was significant decline in the quantitative result of the T-SPOT. TB test with treatment. However, both commercial IGRAs may not provide evidence regarding the cure of disease in Korea, a country where the prevalence of TB is within the intermediate range.
Abstract
Background/Aims: The usefulness of interferon-γ release assays (IGRAs) in monitoring to responses to anti-tuberculosis (TB) treatment is controversial. We compared the results of two IGRAs before and after anti-TB treatment in same patients with active TB. Methods: From a retrospective review, we selected patients with active TB who underwent repeated QuantiFERON-TB Gold (QFN-Gold, Cellestis Limited) and T-SPOT.TB (Oxford Immunotec) assays before and after anti-TB treatment with first-line drugs. Both tests were performed prior to the start of anti-TB treatment or within 1 week after the start of anti-TB treatment and after completion of treatment. Results: A total of 33 active TB patients were included in the study. On the QFNGold test, at baseline, 23 cases (70%) were early secreted antigenic target 6-kDa protein 6 (ESAT-6) or culture filtrate protein 10 (CFP-10) positive. On the T-SPOT. TB test, at baseline, 31 cases (94%) were ESAT-6 or CFP-10 positive. Most of patients remained both test-positive after anti-TB treatment. Although changes in interferon-γ release responses over time were highly variable in both tests, there was a mean decline of 27 and 24 spot-forming counts for ESAT-6 and CFP-10, respectively on the T-SPOT.TB test (p < 0.05 for all). Conclusions: Although limited by the small number of patients and a short-term follow-up, there was significant decline in the quantitative result of the T-SPOT. TB test with treatment. However, both commercial IGRAs may not provide evidence regarding the cure of disease in Korea, a country where the prevalence of TB is within the intermediate range.
참고문헌 (25)
- World Health Organization., "Global Tuberculosis Report 2015" (2015), World Health Organization
- World Health Organization., "Treatment of Tuberculosis:Guidelines for National Programmes" (2003), World Health Organization
- Mazurek GH, "Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection: United States, 2010", MMWR Recomm Rep, 59, pp.1~25 (2010)
- Liebeschuetz S, "Diagnosis of tuberculosis in South African children with a T-cell-based assay: a prospective cohort study", Lancet, 364, pp.2196~2203 (2004)
- Mazurek GH, "Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection, United States", MMWR Recomm Rep, 54, pp.49~55 (2005)
- Meier T, "Sensitivity of a new commercial enzyme-linked immunospot assay (T SPOT-TB) for diagnosis of tuberculosis in clinical practice", Eur J Clin Microbiol Infect Dis, 24, pp.529~536 (2005)
- Arend SM, "Comparison of two interferon-gamma assays and tuberculin skin test for tracing tuberculosis contacts", Am J Respir Crit Care Med, 175, pp.618~627 (2007)
- Lalvani A., "Counting antigen-specific T cells: a new approach for monitoring response to tuberculosis treatment?", Clin Infect Dis, 38, pp.757~759 (2004)
- Aiken AM, "Reversion of the ELISPOT test after treatment in Gambian tuberculosis cases", BMC Infect Dis, 6, pp.66~ (2006)
- Pai M, "Sensitivity of a whole-blood interferon-gamma assay among patients with pulmonary tuberculosis and variations in T-cell responses during anti-tuberculosis treatment", Infection, 35, pp.98~103 (2007)
- Ribeiro S, "T-SPOT.TB responses during treatment of pulmonary tuberculosis", BMC Infect Dis, 9, pp.23~ (2009)
- Lee SW, "Serial interferon-gamma release assays during treatment of active tuberculosis in young adults", BMC Infect Dis, 10, pp.300~ (2010)
- Chee CB, "Tuberculosis treatment effect on T-cell interferon-gamma responses to Mycobacterium tuberculosis-specific antigens", Eur Respir J, 36, pp.355~361 (2010)
- Chiappini E, "Utility of interferon-γ release assay results to monitor anti-tubercular treatment in adults and children", Clin Ther, 34, pp.1041~1048 (2012)
- Lee JY, "Comparison of two commercial interferon-gamma assays for diagnosing Mycobacterium tuberculosis infection", Eur Respir J, 28, pp.24~30 (2006)
- Lalvani A, "Rapid detection of Mycobacterium tuberculosis infection by enumeration of antigen-specific T cells", Am J Respir Crit Care Med, 163, pp.824~828 (2001)
- Mori T, "Specific detection of tuberculosis infection: an interferon-gamma-based assay using new antigens", Am J Respir Crit Care Med, 170, pp.59~64 (2004)
- "Tuberculosis" (2016)[URL]
- Ferrara G, "Use in routine clinical practice of two commercial blood tests for diagnosis of infection with Mycobacterium tuberculosis: a prospective study", Lancet, 367, pp.1328~1334 (2006)
- Kang YA, "Usefulness of wholeblood interferon-gamma assay and interferon-gamma enzyme-linked immunospot assay in the diagnosis of active pulmonary tuberculosis", Chest, 132, pp.959~965 (2007)
- Chee CB, "Comparison of sensitivities of two commercial gamma interferon release assays for pulmonary tuberculosis", J Clin Microbiol, 46, pp.1935~1940 (2008)
- Pathan AA, "Direct ex vivo analysis of antigen-specific IFN-gamma-secreting CD4 T cells in Mycobacterium tuberculosis-infected individuals: associations with clinical disease state and effect of treatment", J Immunol, 167, pp.5217~5225 (2001)
- Ferrand RA, "Interferon-gamma responses to ESAT-6 in tuberculosis patients early into and after anti-tuberculosis treatment", Int J Tuberc Lung Dis, 9, pp.1034~1039 (2005)
- Kobashi Y, "Clinical evaluation for diagnosing active TB disease and transitional change of two commercial blood tests", Scand J Infect Dis, 40, pp.629~634 (2008)
- Dyrhol-Riise AM, "Diagnosis and follow-up of treatment of latent tuberculosis; the utility of the QuantiFERON-TB Gold In-tube assay in outpatients from atuberculosis low-endemic country", BMC Infect Dis, 10, pp.57~ (2010)