Centers for Disease Control and Prevention, Atlanta, GA, USA.
Kenya Medical Research Institute, Kisumu, Kenya.
Sci Rep. 2018 Jan 12;8(1):645. doi: 10.1038/s41598-017-17683-6.
New diagnostics are needed to improve clinicians' ability to detect tuberculosis (TB) disease in key populations such as children and persons living with HIV and to rapidly detect drug resistance. Circulating cell-free DNA (ccfDNA) in plasma is a diagnostic target in new obstetric and oncologic applications, but its utility for diagnosing TB is not known. Here we show that Mycobacterium tuberculosis complex DNA can be detected in plasma of persons with sputum smear-positive TB, even in the absence of mycobacteremia. Among 40 participants with bacteriologically-confirmed smear-positive TB disease who had plasma tested by quantitative PCR (qPCR), 18/40 (45%) had a positive result on at least one triplicate reaction. Our results suggest that plasma DNA may be a useful target for improving clinicians' ability to diagnose TB. We anticipate these findings to be the starting point for optimized methods of TB ccfDNA testing and sequence-based diagnostic applications such as molecular detection of drug resistance.
需要新的诊断方法来提高临床医生在关键人群（如儿童和艾滋病毒感染者）中检测结核病（TB）疾病的能力，并快速检测耐药性。血浆中的循环无细胞游离 DNA（ccfDNA）是新的产科和肿瘤学应用中的一个诊断靶点，但尚不清楚其在诊断 TB 中的用途。在这里，我们表明，结核分枝杆菌复合 DNA 可以在痰涂片阳性 TB 患者的血浆中检测到，即使没有菌血症。在通过定量 PCR（qPCR）检测血浆的 40 名经细菌学证实的涂片阳性 TB 疾病参与者中，至少有 18/40（45%）在至少一个三重反应中呈阳性结果。我们的研究结果表明，血浆 DNA 可能是提高临床医生诊断 TB 能力的有用靶点。我们预计这些发现将成为优化 TB ccfDNA 检测方法和基于序列的诊断应用（如耐药性的分子检测）的起点。
