Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, South Korea.
Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, South Korea.
Chest. 2014 Aug;146(2):283-291. doi: 10.1378/chest.13-1855.
The ligands for CXC chemokine receptor 3 (CXCR3) recruit T-helper type 1 cells, which play a major role in cell-mediated immunity in TB.
A total of 409 subjects were enrolled. The study population comprised 186 patients with active TB, 58 patients with non-TB pulmonary diseases, 50 control subjects with a positive interferon (IFN)-γ release assay (IGRA) result, and 115 control subjects with a negative IGRA result. Whole-blood samples were collected using IGRA methodology. After incubation, plasma IFN-γ levels and two CXCR3 ligands, IFN-inducible T-cell α-chemoattractant (I-TAC, CXCL11) and monokine induced by IFN-γ (MIG, CXCL9), were measured by enzyme-linked immunosorbent assay. Receiver operating characteristic (ROC) analysis was performed. Sensitivity and specificity were based on cutoff values selected to maximize the Youden index.
The TB antigen-stimulated levels of IFN-γ, I-TAC, and MIG were significantly increased in the active pulmonary TB group compared with all other groups. From ROC analysis, for the diagnosis of active TB, I-TAC and MIG outperformed IFN-γ in all comparisons with the IGRA-positive and -negative control groups and the non-TB pulmonary disease group. The areas under the curve (95% CI) for differentiating active pulmonary TB from all other groups were 0.893 (0.864-0.924) for IFN-γ, 0.962 (0.946-0.978) for I-TAC, and 0.944 (0.922-0.965) for MIG. Sensitivity and specificity were 90.3% and 90.7%, respectively, for I-TAC; 92.5% and 85.2% for MIG; and 84.9% and 79.8% for IFN-γ.
TB antigen-stimulated assays of I-TAC and MIG may be useful surrogate markers in the diagnosis of active pulmonary TB.
CXC 趋化因子受体 3（CXCR3）的配体募集 T 辅助型 1 细胞，在结核病中的细胞介导免疫中发挥主要作用。
共纳入 409 名受试者。研究人群包括 186 例活动性结核病患者、58 例非结核病肺部疾病患者、50 例干扰素（IFN）-γ释放试验（IGRA）阳性的对照受试者和 115 例 IGRA 阴性的对照受试者。使用 IGRA 方法采集全血样本。孵育后，通过酶联免疫吸附试验测定血浆 IFN-γ 水平和两个 CXCR3 配体，干扰素诱导的 T 细胞α趋化因子（I-TAC，CXCL11）和 IFN-γ 诱导的单核细胞趋化蛋白（MIG，CXCL9）。进行接收者操作特征（ROC）分析。基于选择最大化约登指数的截断值确定敏感性和特异性。
与所有其他组相比，TB 抗原刺激的 IFN-γ、I-TAC 和 MIG 水平在活动性肺结核组中显著增加。从 ROC 分析来看，对于活动性结核病的诊断，I-TAC 和 MIG 在与 IGRA 阳性和阴性对照组以及非结核病肺部疾病组的所有比较中均优于 IFN-γ。区分活动性肺结核与所有其他组的曲线下面积（95%CI）分别为 IFN-γ为 0.893（0.864-0.924）、I-TAC 为 0.962（0.946-0.978）和 MIG 为 0.944（0.922-0.965）。I-TAC 的敏感性和特异性分别为 90.3%和 90.7%；MIG 为 92.5%和 85.2%；IFN-γ 为 84.9%和 79.8%。
TB 抗原刺激的 I-TAC 和 MIG 测定可能是活动性肺结核诊断的有用替代标志物。
