Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Spain.
Unidad de Neumología Infantil, Hospital Clínico Universitario Valencia, Universidad de Valencia, Spain.
J Infect. 2014 Dec;69(6):590-9. doi: 10.1016/j.jinf.2014.06.013. Epub 2014 Jun 27.
Performance of IFN-γ assays in children is compromised. Therefore, we investigated the utility of IP-10 for the detection of active tuberculosis (TB) and latent tuberculosis infection (LTBI) diagnosis in children; comparing its positivity with QuantiFERON-TB Gold In-Tube (QFN-G-IT) and T-SPOT.TB.
We studied 230 children from three groups: active TB, screening (healthy children without known exposure to active TB patient screened at school or by their paediatrician) and contact-tracing studies. IFN-γ release was determined by QFN-G-IT and T-SPOT.TB. IP-10 was detected in QFN-G-IT supernatants by ELISA.
When combining QFN-G-IT and IP-10 assays, positive results improved significantly from 38.3% in QFN-G-IT and 33.9% in IP-10 to 41.3%. Age and type of contact were significant risk factors associated with positive QFN-G-IT and IP-10 results. IP-10 levels after antigen-specific stimulation were significantly higher in comparison to IFN-γ levels. Correlation between the three assays was good (κ = 0.717-0.783).
IP-10 cytokine is expressed in response to TB specific-antigens used in QFN-G-IT. In conclusion, the use of IFN-γ T-cell based assays in combination with an additional IP-10 assay detection could be useful for diagnosing active TB and LTBI in children.
γ干扰素检测在儿童中表现不佳。因此，我们研究了 IP-10 在儿童活动性结核病（TB）和潜伏性结核感染（LTBI）诊断中的应用价值；并将其阳性率与 QuantiFERON-TB Gold In-Tube（QFN-G-IT）和 T-SPOT.TB 进行比较。
我们研究了三组共 230 名儿童：活动性 TB、筛查（在学校或由儿科医生筛查无已知活动性 TB 接触史的健康儿童）和接触者追踪研究。通过 QFN-G-IT 和 T-SPOT.TB 检测 IFN-γ 释放。通过 ELISA 检测 QFN-G-IT 上清液中的 IP-10。
当将 QFN-G-IT 和 IP-10 检测联合使用时，阳性结果从 QFN-G-IT 的 38.3%和 IP-10 的 33.9%显著提高到 41.3%。年龄和接触类型是与 QFN-G-IT 和 IP-10 阳性结果相关的显著危险因素。与 IFN-γ 水平相比，抗原特异性刺激后 IP-10 水平显著升高。三种检测方法之间的相关性良好（κ=0.717-0.783）。
IP-10 细胞因子是在 QFN-G-IT 中使用的 TB 特异性抗原刺激下表达的。总之，使用 IFN-γ T 细胞检测联合 IP-10 检测可能有助于诊断儿童活动性 TB 和 LTBI。
