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γ-干扰素释放试验在免疫功能低下人群中对结核病的诊断价值

Diagnostic Value of Interferon-Gamma Release Assays for Tuberculosis in the Immunocompromised Population.

作者信息

Yang Ying, Wang Hong-Jiao, Hu Wei-Lin, Bai Guan-Nan, Hua Chun-Zhen

机构信息

Department of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.

Department of Medical Microbiology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.

出版信息

Diagnostics (Basel). 2022 Feb 10;12(2):453. doi: 10.3390/diagnostics12020453.

Abstract

Interferon-gamma release assays (IGRAs) are widely used in the diagnosis of () infection by detecting interferon-γ released by previously sensitized T-cells in-vitro. Currently, there are two assays based on either enzyme-linked immunosorbent assay (ELISA) or enzyme-linked immunospot (ELISPOT) technology, with several generations of products available. The diagnostic value of IGRAs in the immunocompromised population is significantly different from that in the immunocompetent population because their results are strongly affected by the host immune function. Both physiological and pathological factors can lead to an immunocompromised situation. We summarized the diagnostic value and clinical recommendations of IGRAs for different immunocompromised populations, including peoplewith physiological factors (pregnant and puerperal women, children, and older people), as well as people with pathological factors (solid organ transplantation recipients, combination with human immunodeficiency virus infection, diabetes mellitus, end-stage renal disease, end-stage liver disease, and chronic immune-mediated inflammatory diseases). Though the performance of IGRAs is not perfect and often requires a combination with other diagnostic strategies, it still has some value in the immunocompromised population. Hopefully, the newly developed IGRAs could better target this population.

摘要

干扰素-γ释放试验(IGRAs)通过检测先前致敏的T细胞在体外释放的干扰素-γ,广泛应用于()感染的诊断。目前,有两种基于酶联免疫吸附测定(ELISA)或酶联免疫斑点(ELISPOT)技术的检测方法,并有几代产品可供使用。IGRAs在免疫功能低下人群中的诊断价值与免疫功能正常人群有显著差异,因为其结果受宿主免疫功能的强烈影响。生理和病理因素均可导致免疫功能低下的情况。我们总结了IGRAs对不同免疫功能低下人群的诊断价值和临床建议,包括有生理因素的人群(孕妇和产妇、儿童及老年人)以及有病理因素的人群(实体器官移植受者、合并人类免疫缺陷病毒感染、糖尿病、终末期肾病、终末期肝病及慢性免疫介导的炎症性疾病)。尽管IGRAs的性能并不完美,且往往需要与其他诊断策略相结合,但它在免疫功能低下人群中仍具有一定价值。希望新开发的IGRAs能更好地针对这一人群。

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