Translational Research Unit, Department of Epidemiology and Preclinical Research, L. Spallanzani National Institute for Infectious Diseases (INMI), Via Portuense 292, Rome, Italy.
J Infect. 2010 Jul;61(2):133-43. doi: 10.1016/j.jinf.2010.05.002. Epub 2010 May 12.
To evaluate whether in vitro response to Mycobacterium tuberculosis RD1 peptides selected by computational analysis, measured by IFN-gamma, IP-10, MCP-2 or IL-2 production, is associated with active tuberculosis (TB) in a country with a high incidence of TB.
129 individuals were prospectively enrolled, 41 with active-pulmonary TB and 88 without (household contacts and community controls). A whole blood assay based on RD1 selected peptides was performed. Soluble factors were evaluated by ELISA in plasma harvested at day1-post-culture. Enrolled individuals were also tested by QuantiFERON TB-Gold In tube (QFT-IT) and tuberculin skin tests (TST).
IFN-gamma response to RD1 selected peptides was significantly higher in active TB patients than in household contacts and community controls. IP-10 and MCP-2 response did not differ between active TB patients and household contacts, although it was higher in these groups compared to community controls; conversely IL-2 response did not differ among the three groups. When IFN-gamma response to RD1 selected peptides was scored based on receiver-operator-characteristic analysis, active TB was predicted with 68% sensitivity and 86% specificity. QFT-IT and TST showed a sensitivity for active TB of 90% and 68% and a specificity of 58% and 59%, respectively.
IFN-gamma (but not IP-10, MCP-2 and IL-2) response to RD1 selected peptides is associated with active TB with a higher specificity than QFT-IT and TST.
评估通过计算分析选择的结核分枝杆菌 RD1 肽的体外反应（通过 IFN-γ、IP-10、MCP-2 或 IL-2 产生来衡量）是否与高结核发病率国家的活动性肺结核（TB）有关。
前瞻性纳入 129 名个体，41 名患有活动性肺结核，88 名无肺结核（家庭接触者和社区对照者）。进行基于 RD1 选择肽的全血检测。通过在培养后第 1 天采集的血浆中进行 ELISA 评估可溶性因子。还对纳入的个体进行了 QuantiFERON TB-Gold In tube (QFT-IT) 和结核菌素皮肤试验 (TST) 检测。
RD1 选择肽的 IFN-γ反应在活动性肺结核患者中明显高于家庭接触者和社区对照者。IP-10 和 MCP-2 的反应在活动性肺结核患者和家庭接触者之间没有差异，尽管与社区对照者相比，这些群体的反应更高；相反，IL-2 的反应在三组之间没有差异。当根据接收者操作特征分析对 RD1 选择肽的 IFN-γ反应进行评分时，RD1 选择肽的 IFN-γ反应以 68%的敏感性和 86%的特异性预测活动性肺结核。QFT-IT 和 TST 对活动性肺结核的敏感性分别为 90%和 68%，特异性分别为 58%和 59%。
与 QFT-IT 和 TST 相比，RD1 选择肽的 IFN-γ（而非 IP-10、MCP-2 和 IL-2）反应与活动性肺结核有关，特异性更高。
