Ferrara G, Losi M, D'Amico R, Cagarelli R, Pezzi A M, Meacci M, Meccugni B, Marchetti Dori I, Rumpianesi F, Roversi P, Casali L, Fabbri L M, Richeldi L
Section of Respiratory Disease, Department of Oncology, Hematology and Respiratory Disease, University of Modena, and Policlinico Hospital of Modena, Modena, Italy.
Int J Immunopathol Pharmacol. 2009 Jul-Sep;22(3):669-77. doi: 10.1177/039463200902200312.
The tuberculin skin test (TST) does not discriminate between recent and remote latent tuberculosis infection (LTBI). This study was carried out to test two interferon-gamma-based blood assays in recent contacts with high prevalence of remote LTBI. We performed a contact tracing investigation in a nursing home for the elderly, where elderly patients were exposed to a case of pulmonary tuberculosis. TST, QuantiFERON-TB Gold (QFT-G) and T-SPOT.TB (TS.TB) were performed 8 weeks after the end of potential exposure. IFN-gamma measurements were recorded and correlation with exposure was evaluated. Twenty-seven (37.5%), 32 (44.4%) and 16 (22.2%) subjects were TST, TS.TB and QFT-G positive, respectively; agreement between TS.TB and QFT-G was good among exposed subjects only (K=0.915, 0.218 in unexposed, p<0.001). When amounts of IFN-gamma were corrected for the number of producing T cells, specific IFN-gamma production was significantly different between exposed and unexposed individuals (16.75+/-5.40 vs 2.33+/-0.71 IFN-gamma IU/1000 SFC, p=0.0001). QFT-G and TS.TB provided discordant results among elderly contacts. Unlike TST, the specific IFN-gamma response might discriminate between recent and long-lasting tuberculosis infection.
结核菌素皮肤试验（TST）无法区分近期和既往潜伏性结核感染（LTBI）。本研究旨在对近期接触过既往LTBI高流行率人群的两种基于干扰素-γ的血液检测方法进行测试。我们在一家养老院开展了一项接触者追踪调查，该养老院中的老年患者接触过一例肺结核病例。在潜在接触结束8周后进行TST、结核感染T细胞检测（QFT-G）和结核感染斑点试验（T-SPOT.TB，TS.TB）。记录干扰素-γ测量值并评估其与接触情况的相关性。分别有27名（37.5%）、32名（44.4%）和16名（22.2%）受试者TST、TS.TB和QFT-G呈阳性；仅在接触者中TS.TB和QFT-G之间的一致性良好（K = 0.915，未接触者中为0.218，p<0.001）。当根据产生干扰素-γ的T细胞数量校正干扰素-γ量时，接触者和未接触者之间的特异性干扰素-γ产生存在显著差异（16.75±5.40对2.33±0.71干扰素-γ IU/1000 SFC，p = 0.0001）。在老年接触者中QFT-G和TS.TB得出了不一致的结果。与TST不同，特异性干扰素-γ反应可能能够区分近期和长期结核感染。
