Feske Marsha, Nudelman Rodolfo J, Medina Miguel, Lew Justin, Singh Manisha, Couturier Jacob, Graviss Edward A, Lewis Dorothy E
University of Texas School of Public Health, Galveston, TX 77555-0567, USA.
Clin Vaccine Immunol. 2008 Oct;15(10):1616-22. doi: 10.1128/CVI.00185-08. Epub 2008 Aug 27.
Children and immunocompromised adults are at an increased risk of tuberculosis (TB), but diagnosis is more challenging. Recently developed gamma interferon (IFN-gamma) release assays provide increased sensitivity and specificity for diagnosis of latent TB, but their use is not FDA approved in immunocompromised or pediatric populations. Both populations have reduced numbers of T cells, which are major producers of IFN-gamma. Interleukin 7 (IL-7), a survival cytokine, stabilizes IFN-gamma message and increases protein production. IL-7 was added to antigen-stimulated lymphocytes to improve IFN-gamma responses as measured by enzyme-linked immunosorbent assay (ELISA) and enzyme-linked immunospot (ELISPOT) assay. Antigens used were tetanus toxoid (n = 10), p24 (from human immunodeficiency virus [HIV], n = 9), and TB peptides (n = 15). Keyhole limpet hemocyanin was used as a negative control, and phytohemagglutinin was the positive control. IL-7 improved antigen-specific responses to all antigens tested including tetanus toxoid, HIV type 1 p24, and TB peptides (ESAT-6 and CFP-10) with up to a 14-fold increase (mean = 3.8), as measured by ELISA. Increased IFN-gamma responses from controls, HIV-positive patients, and TB patients were statistically significant, with P values of <0.05, 0.01, and 0.05, respectively. ELISPOT assay results confirmed ELISA findings (P values of <0.01, 0.02, and 0.03, respectively), with a strong correlation between the two tests (R(2) = 0.82 to 0.99). Based on average background levels, IL-7 increased detection of IFN-gamma by 39% compared to the level with antigen alone. Increased production of IFN-gamma induced by IL-7 improves sensitivity of ELISA and ELISPOT assays for all antigens tested. Further enhancement of IFN-gamma-based assays might improve TB diagnosis in those populations at highest risk for TB.
儿童和免疫功能低下的成年人患结核病(TB)的风险增加,但诊断更具挑战性。最近开发的γ干扰素(IFN-γ)释放试验提高了潜伏性结核病诊断的敏感性和特异性,但其在免疫功能低下或儿科人群中的使用尚未获得美国食品药品监督管理局(FDA)的批准。这两类人群中作为IFN-γ主要产生者的T细胞数量均减少。白细胞介素7(IL-7)作为一种存活细胞因子,可稳定IFN-γ信息并增加蛋白质产量。将IL-7添加到抗原刺激的淋巴细胞中,以通过酶联免疫吸附测定(ELISA)和酶联免疫斑点(ELISPOT)测定来改善IFN-γ反应。使用的抗原为破伤风类毒素(n = 10)、p24(来自人类免疫缺陷病毒[HIV],n = 9)和结核肽(n = 15)。血蓝蛋白用作阴性对照,植物血凝素用作阳性对照。通过ELISA测定,IL-7改善了对所有测试抗原(包括破伤风类毒素、1型HIV p24和结核肽)的抗原特异性反应,增幅高达14倍(平均值 = 3.8)。对照、HIV阳性患者和结核病患者的IFN-γ反应增加具有统计学意义,P值分别<0.05、0.01和0.05。ELISPOT测定结果证实了ELISA的结果(P值分别<0.01、0.02和0.03),两种测试之间具有很强的相关性(R² = 从0.82至0.99)。基于平均背景水平,与仅使用抗原时相比,IL-7使IFN-γ的检测增加了39%。IL-7诱导的IFN-γ产量增加提高了ELISA和ELISPOT测定对所有测试抗原的敏感性。基于IFN-γ的检测方法的进一步改进可能会改善结核病高危人群的结核病诊断。