评估结核分枝杆菌特异性抗原刺激的 CD27CD38IFN-γCD4 T 细胞在鉴别活动性肺结核中的作用。
Evaluation of Mycobacterium tuberculosis specific antigen-stimulated CD27CD38IFN-γCD4 T cells for discrimination of active tuberculosis.
机构信息
Clinic and Research Center for Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China.
Central Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China.
出版信息
BMC Infect Dis. 2022 Dec 1;22(1):899. doi: 10.1186/s12879-022-07895-1.
BACKGROUND
Active tuberculosis (ATB) originates from primary Mycobacterium tuberculosis (MTB) infection or reactivation of latent tuberculosis. Besides bacteriological examination, MTB-reactive immunocytes detection can be an alternative testing for discrimination of active tuberculosis. The purpose of this study is to investigate the accuracy of peripheral blood CD27CD38IFN-γCD4T cells in ATB diagnosis.
METHODS
This prospective diagnostic accuracy study was conducted at Shanghai Pulmonary Hospital between January 2019 and December 2021. Patients with ATB, non-tuberculosis mycobacterium infection (NTM), latent tuberculosis infection (LTBI), other respiratory diseases (OD), and healthy individuals (HC) were enrolled. The accuracy of CD27CD38IFN-γCD4/CD4 and other phenotypic markers for ATB diagnosis was assessed.
RESULTS
A total of 376 patients (237 ATB, 38 LTBI, 8 NTM, 50 OD, and 43 HC) were enrolled. The ratios of CD4IFN-γCD27 and CD4IFN-γCD27CD38 profiles in CD4IFNγ cells and the ratios of CD4IFN-γCD38, CD4IFN-γCD27, and CD4IFN-γCD38CD27 profiles in CD4 cells in the ATB group were significantly higher than in the other groups. The area under the curve (AUC) of CD27CD38IFN-γCD4/CD4 for the diagnosis of ATB was the highest, with a value of 0.890. With the optimal cutoff value of 1.34 × 10, the sensitivity and specificity of CD27CD38IFN-γCD4/CD4 for ATB diagnosis was 0.869 and 0.849, respectively.
CONCLUSION
CD27CD38IFN-γCD4/CD4 might be a potential biomarker for active tuberculosis diagnosis.
背景
活动性肺结核（ATB）源自原发性结核分枝杆菌（MTB）感染或潜伏性肺结核的再激活。除了细菌学检查外，MTB 反应性免疫细胞检测也可作为鉴别活动性肺结核的替代检测方法。本研究旨在探讨外周血 CD27CD38IFN-γCD4T 细胞在 ATB 诊断中的准确性。
方法
本前瞻性诊断准确性研究于 2019 年 1 月至 2021 年 12 月在上海肺科医院进行。纳入了 ATB、非结核分枝杆菌感染（NTM）、潜伏性结核感染（LTBI）、其他呼吸系统疾病（OD）和健康对照者（HC）。评估了 CD27CD38IFN-γCD4/CD4 和其他表型标志物对 ATB 诊断的准确性。
结果
共纳入 376 例患者（237 例 ATB、38 例 LTBI、8 例 NTM、50 例 OD 和 43 例 HC）。ATB 组 CD4IFN-γCD27 和 CD4IFN-γCD27CD38 表型在 CD4IFNγ细胞中的比例以及 CD4IFN-γCD38、CD4IFN-γCD27 和 CD4IFN-γCD38CD27 表型在 CD4 细胞中的比例均明显高于其他组。CD27CD38IFN-γCD4/CD4 对 ATB 诊断的曲线下面积（AUC）最高，为 0.890。以最佳截断值 1.34×10-3 计算，CD27CD38IFN-γCD4/CD4 对 ATB 诊断的灵敏度和特异性分别为 0.869 和 0.849。
结论
CD27CD38IFN-γCD4/CD4 可能是活动性肺结核诊断的潜在生物标志物。
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