Department of Medical Microbiology & Infectious Diseases, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.
Eur J Clin Microbiol Infect Dis. 2012 Jun;31(6):1195-201. doi: 10.1007/s10096-011-1428-2. Epub 2011 Oct 9.
There are limitations on diagnostic methods to differentiate between active and latent tuberculosis (TB), and the prediction of latent progression to TB disease is yet complex. Traditionally, tuberculosis-specific host immune response was visualized using the tuberculin skin test. Nowadays, IFN-γ release assays (IGRA) provide a more specific and sensitive tool, by which exposure to Mtb could be determined. However, the merit of IGRA aids in diagnosing active TB is yet unclear. We adapted IGRA for use in mice, and quantifying bead-based flow cytometry techniques were used to assess cytokine profiles during the course of untreated infection and to investigate the value of IGRA and cytokines as biomarkers for therapy response. High variability of IGRA results during progression of active TB infection related to various phases of infection was obtained. However, a significant decrease in IGRA results and in levels of IFN-γ, IL-17, IP-10 or MIG was observed and appeared to be associated with successful therapy. This outcome does not support the value of IGRA to accurately diagnose active TB or to monitor infection progression. However, IGRA proved to be a useful biomarker to monitor therapy success. In addition, different cytokines might serve as biomarkers.
用于区分活动性和潜伏性结核病(TB)的诊断方法存在局限性,预测潜伏性结核病进展为结核病也很复杂。传统上,使用结核菌素皮肤试验来观察针对结核分枝杆菌的宿主免疫应答。如今,IFN-γ 释放试验(IGRA)提供了一种更具特异性和敏感性的工具,通过它可以确定对 Mtb 的暴露。然而,IGRA 有助于诊断活动性结核病的优点尚不清楚。我们将 IGRA 应用于小鼠,并使用基于珠的流式细胞术技术来评估未经治疗感染过程中的细胞因子谱,并研究 IGRA 和细胞因子作为治疗反应生物标志物的价值。在与感染各个阶段相关的活动性 TB 感染进展过程中,IGRA 结果的高度变异性得到了证实。然而,我们观察到 IGRA 结果以及 IFN-γ、IL-17、IP-10 或 MIG 水平显著下降,且似乎与成功治疗相关。这一结果不支持使用 IGRA 来准确诊断活动性结核病或监测感染进展。然而,IGRA 被证明是监测治疗成功的有用生物标志物。此外,不同的细胞因子可能作为生物标志物。