Clinical effect of T-SPOT.TB test for the diagnosis of tuberculosis

Ma, Yanfen; Li, Ruicheng; Shen, Jinghui; He, Longmei; Li, Ying; Zhang, Ning; Wu, Qian; Zhang, Jinling; Zheng, Jie; Wang, Xiaoqin

doi:10.1186/s12879-019-4597-8

Cited by 25 publications

(19 citation statements)

References 26 publications

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“…Notably, here the observed ESAT-6 and CFP-10 positivity rates (84.8% and 80.7%, respectively) were lower than respective rates reported previously (95.1% and 83.7%). [ 22 ] This discrepancy may reflect inconsistencies in sample sizes, inclusion criteria and study populations; our study population originated from 5 provinces and municipalities of China and included a relatively high proportion of patients with hypoproteinemia that may have had false negative IGRA results. [ 23 ] Even so, the previous study also demonstrated a higher ESAT-6 positivity rate than that obtained for CFP-10 for active tuberculosis cases, suggesting that ESAT-6 had greater antigenic dominance than CFP-10 and triggered greater IFN-γ release, in accordance with other reported studies.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with differential T cell responses to antigens ESAT-6 and CFP-10 in pulmonary tuberculosis patients

Liu

Wu²,

Ertai³

et al. 2021

Medicine

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The T-SPOT.TB assay detects cellular immune responses to 2 core Mycobacterium tuberculosis antigens, early secreted antigenic target of 6-kDa protein (ESAT-6) and culture filtrate protein-10 (CFP-10). T-SPOT.TB has been recently used for auxiliary diagnosis of active pulmonary tuberculosis (PTB). However, testing can produce inconsistent results due to differential PTB patient immune responses to these antigens, prompting us to identify factors underlying inconsistent results. Data were retrospectively analyzed from 1225 confirmed PTB patients who underwent T-SPOT.TB testing at 5 specialized tuberculosis hospitals in China between December 2012 and November 2015. Numbers of spot-forming cells (SFCs) reflecting T cell responses to ESAT-6 and CFP-10 antigens were recorded then analyzed via multivariable logistic regression to reveal factors underlying discordant T cell responses to these antigens. The agreement rate of 84.98% (82.85%–86.94%) between PTB patient ESAT-6 and CFP-10 responses demonstrated high concordance. Additionally, positivity rates were higher for ESAT-6 than for CFP-10 (84.8% vs 80.7%, P < .001), with ESAT-6 and CFP-10 microwell SFC numbers for each single positive group not differing significantly (P > .99), while spot numbers of the single positive group were lower than numbers for the double positive group (P < .001). Elderly patients (aged ≥66 years) and patients receiving retreatment were most likely to have discordance results. ESAT-6 promoted significantly more positive T-SPOT.TB results than did CFP-10 in PTB patients. Advanced age and retreatment status were correlated with discordant ESAT-6 and CFP-10 results. Assessment of factors underlying discordance may lead to improved PTB diagnosis using T-SPOT.TB.

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Section: Discussionmentioning

confidence: 99%

Factors associated with differential T cell responses to antigens ESAT-6 and CFP-10 in pulmonary tuberculosis patients

Liu

Wu²,

Ertai³

et al. 2021

Medicine

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“…Although WB assays are more robust than PBMCbased protocols [16], concerns about impaired test performance remain when stimulation conditions are suboptimal, e.g., in the presence of immunosuppressive therapy or after long pre-analytic delays [16,[20][21][22][23]. Furthermore, most functional T-cell assays currently applied in the clinical routine are designed to specifically detect interferon gamma (IFN-γ) [24][25][26][27] and thus require optimization for reliable analysis of the complex cytokine milieu elicited by mold antigens. Prior work suggested differential robustness of individual T-helper cell subsets, with particularly poor reliability of type 17 T-helper cell (Th17) stimulation [28] and, consequently, quantification of IL-17 [12], a cytokine regarded as a cornerstone in both protective anti-Aspergillus immunity and inflammatory immunopathology [1].…”

Section: Introductionmentioning

confidence: 99%

Development of a Simple and Robust Whole Blood Assay with Dual Co-Stimulation to Quantify the Release of T-Cellular Signature Cytokines in Response to Aspergillus fumigatus Antigens

Lauruschkat

Page

White

et al. 2021

JoF

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Deeper understanding of mold-induced cytokine signatures could promote advances in the diagnosis and treatment of invasive mycoses and mold-associated hypersensitivity syndromes. Currently, most T-cellular immunoassays in medical mycology require the isolation of mononuclear cells and have limited robustness and practicability, hampering their broader applicability in clinical practice. Therefore, we developed a simple, cost-efficient whole blood (WB) assay with dual α-CD28 and α-CD49d co-stimulation to quantify cytokine secretion in response to Aspergillus fumigatus antigens. Dual co-stimulation strongly enhanced A. fumigatus-induced release of T-cellular signature cytokines detectable by enzyme-linked immunosorbent assay (ELISA) or a multiplex cytokine assay. Furthermore, T-cell-dependent activation and cytokine response of innate immune cells was captured by the assay. The protocol consistently showed little technical variation and high robustness to pre-analytic delays of up to 8 h. Stimulation with an A. fumigatus lysate elicited at least 7-fold greater median concentrations of key T-helper cell signature cytokines, including IL-17 and the type 2 T-helper cell cytokines IL-4 and IL-5 in WB samples from patients with Aspergillus-associated lung pathologies versus patients with non-mold-related lung diseases, suggesting high discriminatory power of the assay. These results position WB-ELISA with dual co-stimulation as a simple, accurate, and robust immunoassay for translational applications, encouraging further evaluation as a platform to monitor host immunity to opportunistic pathogens.

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“…Based on the just mentioned facts, we try to benefit from ML ratio, which can help us with osteoarticular TB diagnosis since it is difficult to obtain pus or tissue for M . tb culture [ 27 ]. Besides, a bacterial culture is frequently culture-negative.…”

Section: Discussionmentioning

confidence: 99%

Immune status changing helps diagnose osteoarticular tuberculosis

Liang

Chen

et al. 2021

PLoS ONE

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Objective This study is aimed to develop a new nomogram for the clinical diagnosis of osteoarticular tuberculosis (TB). Methods xCell score estimation to obtained the immune cell type abundance scores. We downloaded the expression profile of GSE83456 from GEO and proceed xCell score estimation. The routine blood examinations of 326 patients were collected for further validation. We analyzed univariate and multivariate logistic regression to identified independent predicted factor for developing the nomogram. The performance of the nomogram was assessed using the receiver operating characteristic (ROC) curves. The correlation of ESR with lymphocytes, monocytes, and ML ratio was performed and visualized in osteoarticular TB patients. Results Compared with the healthy control group in the dataset GSE83456, the xCell score of basophils, monocytes, neutrophils, and platelets was higher, while lymphoid was lower in the EPTB group. The clinical data showed that the cell count of monocytes were much higher, while the cell counts of lymphocytes were lower in the osteoarticular TB group. AUCs of the nomogram was 0.798 for the dataset GSE83456, and 0.737 for the clinical data. We identified the ML ratio, BMI, and ESR as the independent predictive factors for osteoarticular TB diagnosis and constructed a nomogram for the clinical diagnosis of osteoarticular TB. AUCs of this nomogram was 0.843. Conclusions We demonstrated a significant change between the ML ratio of the EPTB and non-TB patients. Moreover, we constructed a nomogram for the clinical diagnosis of the osteoarticular TB diagnosis, which works satisfactorily.

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Clinical effect of T-SPOT.TB test for the diagnosis of tuberculosis

Cited by 25 publications

References 26 publications

Factors associated with differential T cell responses to antigens ESAT-6 and CFP-10 in pulmonary tuberculosis patients

Factors associated with differential T cell responses to antigens ESAT-6 and CFP-10 in pulmonary tuberculosis patients

Development of a Simple and Robust Whole Blood Assay with Dual Co-Stimulation to Quantify the Release of T-Cellular Signature Cytokines in Response to Aspergillus fumigatus Antigens

Immune status changing helps diagnose osteoarticular tuberculosis

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