Interferon-Gamma Releasing Assay is Predictive in Active Tuberculosis Infection in Kidney Recipients and Guides Precise Prophylaxis

2021 ◽  
Author(s):  
Jun Zeng ◽  
Daiwen Zhu ◽  
Haohan Zhang ◽  
Qiang Zhong ◽  
Yu Fan ◽  
...  
Keyword(s):  
Interferon Gamma ◽  
Active Tuberculosis ◽  
Tuberculosis Infection ◽  
Kidney Recipients

scholarly journals Tuberculosis Screening for People With Chronic Conditions

2021 ◽  
Vol 1 (5) ◽  
Author(s):  
Kendra Brett ◽  
Melissa Severn
Keyword(s):  
Immune System ◽  
Interferon Gamma ◽  
Chronic Conditions ◽  
Active Tuberculosis ◽  
Tuberculosis Infection ◽  
Interferon Gamma Release Assay ◽  
People Living With Hiv ◽  
Solid Organ ◽  
Cell Transplant ◽  
Release Assay

Five guidelines were identified that provide recommendations about screening for tuberculosis in people with chronic conditions. These guidelines cover populations with HIV, psoriasis vulgaris, solid organ and stem transplants, chronic inflammation, and compromised immune systems. Three guidelines recommend regularly screening for latent and active tuberculosis in people diagnosed with HIV or those taking medication that suppresses their immune system. One guideline for patients with psoriasis recommends using interferon-gamma release assay and a chest X-ray to rule out tuberculosis infection before immunosuppressant treatment is initiated and during treatment. Two guidelines recommend using both the interferon-gamma release assay and the tuberculin skin test at the same time to screen for latent tuberculosis infection in people with HIV, people with or who need an organ or stem cell transplant, and in people taking medication that suppresses their immune system. One guideline for people living with HIV recommends using a rapid nucleic acid amplification test to confirm clinical suspicions of active tuberculosis in these patients.

scholarly journals Antigen-Specific Cytokine and Chemokine Gene Expression for Diagnosing Latent and Active Tuberculosis

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 716
Author(s):  
Workneh Korma ◽  
Adane Mihret ◽  
Yunhee Chang ◽  
Azeb Tarekegn ◽  
Metasebiya Tegegn ◽  
...  
Keyword(s):  
Gene Expression ◽  
Pulmonary Tuberculosis ◽  
Sensitivity And Specificity ◽  
Interferon Gamma ◽  
Active Tuberculosis ◽  
Tuberculosis Infection ◽  
Tuberculosis Patients ◽  
Cytokines And Chemokines ◽  
Ifn Γ ◽  
Sensitivity Specificity

Tuberculosis infection exhibits different forms, namely, pulmonary, extrapulmonary, and latent. Here, diagnostic markers based on the gene expression of cytokines and chemokines for differentiating between tuberculosis infection state(s) were identified. Gene expression of seven cytokines (Interferon gamma (IFN-γ), Interferon gamma-induced protein 10 (IP-10), Interleukin-2 receptor (IL-2R), C-X-C Motif Chemokine Ligand 9 (CXCL-9), Interleukin 10 (IL-10), Interleukin 4 (IL-4), and Tumor Necrosis Factor alpha (TNF-α)) in response to tuberculosis antigen was analyzed using real-time polymerase reaction. The sensitivity and specificity of relative quantification (2^-ΔΔCt) of mRNA expression were analyzed by constructing receiver operating characteristic curves and measuring the area under the curve (AUC) values. Combinations of cytokines were analyzed using the R statistical software package. IFN-γ, IP-10, IL2R, and CXCL-9 showed high expression in latent and active tuberculosis patients (p = 0.001), with a decrease in IL10 expression, and no statistical difference in IL-4 levels among all the groups (p = 0.999). IL-10 differentiated pulmonary tuberculosis patients from latent cases with an AUC of 0.731. IL10 combined with CXCL-9 distinguished pulmonary tuberculosis patients from extrapulmonary cases with a sensitivity, specificity, and accuracy of 85.7%, 73.9%, and 81.0%, respectively. IL-10 together with IP-10 and IL-4 differentiated pulmonary tuberculosis from latent cases with a sensitivity and specificity of 77.1% and 88.1%, respectively. Decision tree analysis demonstrated that IFN-γ IL-2R, and IL-4 can diagnose tuberculosis infection with a sensitivity, specificity, and accuracy of 89.7%, 96.1%, and 92.7%, respectively. A combination of gene expression of cytokines and chemokines might serve as an effective marker to differentiate tuberculosis infection state(s).

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