Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital Melbourne, Parkville, Australia; Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia.
Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital Melbourne, Parkville, Australia; Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia; Infectious Diseases Unit, The Royal Children's Hospital, Parkville, Australia.
J Infect. 2020 Dec;81(6):873-881. doi: 10.1016/j.jinf.2020.09.032. Epub 2020 Sep 29.
New tests are needed to overcome the limitations of existing immunodiagnostic tests for tuberculosis (TB) infection, including their inability to differentiate between active TB and latent TB infection (LTBI). This review aimed to identify the most promising cytokine biomarkers for use as stage-specific markers of TB infection.
A systematic review was done using electronic databases to identify studies that have investigated Mycobacterium tuberculosis (MTB)-specific cytokine responses as diagnostic tools to differentiate between LTBI and active TB.
The 56 studies included in this systematic review measured the MTB-specific responses of 100 cytokines, the most frequently studied of which were IFN-γ, IL-2, TNF-α, IP-10, IL-10 and IL-13. Ten studies assessed combinations of cytokines, most commonly IL-2 and IFN-γ. For most cytokines, findings were heterogenous between studies. The variation in results likely relates to differences in the study design and laboratory methods, as well as participant and environmental factors.
Although several cytokines show promise as stage-specific markers of TB infection, this review highlights the need for further well-designed studies, in both adult and paediatric populations, to establish which cytokine(s) will be of most use in a new generation of immunodiagnostic tests.
需要新的检测方法来克服现有结核病（TB）感染免疫诊断检测的局限性，包括无法区分活动性 TB 和潜伏性 TB 感染（LTBI）。本综述旨在确定最有前途的细胞因子生物标志物，作为 TB 感染的特定阶段标志物。
使用电子数据库进行系统综述，以确定研究调查结核分枝杆菌（MTB）特异性细胞因子反应作为区分 LTBI 和活动性 TB 的诊断工具的研究。
本系统综述纳入的 56 项研究测量了 100 种细胞因子的 MTB 特异性反应，其中研究最多的是 IFN-γ、IL-2、TNF-α、IP-10、IL-10 和 IL-13。有 10 项研究评估了细胞因子的组合，最常用的是 IL-2 和 IFN-γ。对于大多数细胞因子，研究结果在不同研究之间存在差异。结果的差异可能与研究设计和实验室方法以及参与者和环境因素的差异有关。
尽管有几种细胞因子作为 TB 感染的特定阶段标志物显示出前景，但本综述强调需要进一步设计良好的研究，包括成人和儿童人群，以确定哪种细胞因子（或多种细胞因子）将在新一代免疫诊断检测中最有用。
