Specific Detection of Tuberculosis Infection

Mori, Toru; Sakatani, Mitsunori; Yamagishi, Fumio; Takashima, Tetsuya; Kawabe, Yojiro; Nagao, Keiji; Shigeto, Eriko; Harada, Nobuyuki; Mitarai, Satoshi; Okada, Masaji; Suzuki, Katsuhiro; Inoue, Yoshikazu; Tsuyuguchi, Kazunari; Sasaki, Yuka; Mazurek, Gerald H.; Tsuyuguchi, Izuo

doi:10.1164/rccm.200402-179oc

Cited by 570 publications

(137 citation statements)

References 21 publications

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“…Foreign-born subjects in the present study were from countries with TB prevalence of 25 to 300 per 100,000 population compared to a TB prevalence of less than 10 per 100,000 population in the United States (4). This interpretation, however, would be in contrast to data showing that the sensitivity of IFN-␥ assay has been directly estimated in patients with known TB disease (27). A more likely explanation of the apparent underestimation of LTBI by the IFN-␥ assay among the foreign-born subjects in the present study is the distinct immunological mechanisms that are responsible for positive results in either the TST or the IFN-␥ assay.…”

Section: Discussioncontrasting

confidence: 98%

“…Consequently, IFN-␥ assays utilizing ESAT-6 and CFP-10 either as recombinant antigens (5,7,38) or mixtures of overlapping peptides (8,27,37) have been shown to be significantly more specific than TST. In addition, these assays offer several advantages over TST, including the need for only a single patient contact, simultaneous measurement of a subject's immune reactivity to mitogen (phytohemagglutinin) and nil control (normal saline) antigens, elimination of subjectivity in administering the test or reading the result, and the availability of test results within 24 h. IFN-␥ assays utilizing ESAT-6 and CFP-10 antigens have been studied in the general population in several countries including India, Korea, Italy, Denmark, The Netherlands, and Japan (5,7,8,15,23,27,29,30,38). To date, there are no published reports on comparison of TST to the newly approved IFN-␥ assay in studies within the United States.…”

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confidence: 99%

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Comparison of a New ESAT-6/CFP-10 Peptide-Based Gamma Interferon Assay and a Tuberculin Skin Test for Tuberculosis Screening in a Moderate-Risk Population

Porsa

Liu

Seale

et al. 2006

Clin Vaccine Immunol

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Section: Discussioncontrasting

confidence: 98%

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confidence: 99%

Comparison of a New ESAT-6/CFP-10 Peptide-Based Gamma Interferon Assay and a Tuberculin Skin Test for Tuberculosis Screening in a Moderate-Risk Population

Porsa

Liu

Seale

et al. 2006

Clin Vaccine Immunol

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“…Mycobacterium marinum, Mycobacterium kansasii, etc. ), and are not found in any of the BCG vaccine strains used worldwide [6][7][8][9]. However, these tests are expensive, require phlebotomy (technically difficult in children and some adults), transport of samples to a laboratory with availability of required equipment and infrastructure (e.g.…”

Section: Introductionmentioning

confidence: 99%

Sensitivity of C-Tb: a novel RD-1-specific skin test for the diagnosis of tuberculosis infection

et al. 2015

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C-Tb, a novel Mycobacterium tuberculosis and 6-kDa early secretory antigenic target/10-kDa culture filtrate protein (ESAT-6/CFP-10)-specific skin test, has high specificity in bacille Calmette-Guerinvaccinated healthy controls. However, the sensitivity of C-Tb has hitherto not been determined. The objective was to determine the sensitivity of C-Tb in patients with active tuberculosis (TB) in comparison with the tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube (QFT-GIT).C-Tb and TST were randomly administered in a double-blinded fashion to one or the other forearm in 253 patients with active TB with or without HIV co-infection. QFT-GIT testing was performed prior to skin testing.Using a receiver operating characteristic curve-derived cut-point of 5 mm, C-Tb sensitivity was similar to QFT-GIT (73.9 (95% CI 67.8-79.3) versus 75.1 (95% CI 69.3-80.2)), and similar in HIV-infected and HIV-uninfected patients (76.7 (95% CI 69.0-83.3) versus 69.5 (95% CI 59.2-78.5)). However, sensitivity was significantly diminished in HIV-infected patients with CD4 counts <100 cells·mm -3 . C-Tb and QFT-GIT combined had significantly higher sensitivity than C-Tb alone ( p<0.0001). C-Tb was safe with no significant adverse events. The 5 mm cut-point corresponded to that found in the previously published specificity study (TESEC-04).C-Tb has similar sensitivity compared with QFT-GIT for the diagnosis of M. tuberculosis infection. Sensitivity was reduced only in HIV-infected patients with severe immunosuppression. Further studies in different settings are required to validate the proposed 5 mm cut-point. @ERSpublications C-Tb has similar sensitivity compared with QFT-GIT for the diagnosis of M. tuberculosis infection

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“…Discovery of the RD1 locus in the Mtb genome, encoding mainly the proteins actively secreted by mycobacteria into the culture medium, such as CFP-10 and ESAT-6, has further encouraged immunological tests as an adjunct to conventional diagnosis (12)(13)(14)(15). Proteins that are released from Mtb during late logarithmic growth phase, such as superoxide dismutase and isocitrate dehydrogenase (ICD), are used as autolysis markers (16).…”

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confidence: 99%

Mycobacterium tuberculosis ( Mtb ) isocitrate dehydrogenases show strong B cell response and distinguish vaccinated controls from TB patients

Banerjee

Nandyala

Raviprasad

et al. 2004

Proc. Natl. Acad. Sci. U.S.A.

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Proteins released from Mycobacterium tuberculosis (Mtb) during late logarithmic growth phase are often considered candidate components of immunogenic or autolysis markers. One such protein is isocitrate dehydrogenase (ICD), a key regulatory enzyme in the citric acid cycle. We have evaluated the immunogenic properties of two isoforms of Mtb ICD and compared them with the control antigens heat-shock protein 60 and purified protein derivative (PPD). PPD lacks the sensitivity to distinguish between bacillus Calmette-Gué rin (BCG)-vaccinated and tuberculosis (TB)-infected populations, and, therefore, epidemiological relevance of PPD in BCG-vaccinated regions is debatable. We show that Mtb ICDs elicit a strong B cell response in TB-infected populations and can differentiate between healthy BCG-vaccinated populations and those with TB. The study population (n ‫؍‬ 215) was categorized into different groups, namely, patients with fresh infection (n ‫؍‬ 42), relapsed TB cases (n ‫؍‬ 32), patients with extrapulmonary TB (n ‫؍‬ 35), clinically healthy donors (n ‫؍‬ 44), nontuberculous mycobacteria patients (n ‫؍‬ 30), and non-TB patients (culture negative for acid-fast bacteria but carrying other infections, n ‫؍‬ 32). The Mtb ICDs showed statistically significant antigenic distinction between healthy BCG-vaccinated controls and TB patients (P < 0.0001) and those with other infections. Although extrapulmonary infections could not be discriminated from healthy controls by heat-shock protein 60 (P ‫؍‬ 0.2177), interestingly, the Mtb ICDs could significantly (P < 0.0001) do so. Our results highlight the immunodominant, immunosensitive, and immunospecific nature of Mtb ICDs and point to an unusual property of this tricarboxylic acid energy cycle enzyme. T uberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a major threat to the human population, being responsible for Ϸ2-3 millions deaths every year worldwide (1-3). The secret of the pathogen's success is its ability to escape the host immune system and remain undetected in lungs for decades. In only 10% of infected people, the number being higher in immunocompromised patients, does TB erupt as a full-blown disease (4). Delay in diagnosis and treatment impedes the downstream management and control of the disease. With the increasing emergence of multidrug resistant strains and coinfection with HIV, the problem is further compounded (5-7). Early diagnosis, therefore, is a matter of utmost concern not just for TB disease management but also for epidemiological investigations (8). Current diagnostic tools for TB often lack sensitivity and can be time consuming. TB diagnosis in developing countries largely banks on tuberculin skin tests and staining and culture methods. The epidemiological relevance of the tuberculin test with purified protein derivative (PPD) is questionable in areas where bacillus Calmette-Guérin vaccination is compulsory because PPD is not sensitive enough to distinguish between vaccinated and infected individuals (9). Microscopic determination ...

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Specific Detection of Tuberculosis Infection

Cited by 570 publications

References 21 publications

Comparison of a New ESAT-6/CFP-10 Peptide-Based Gamma Interferon Assay and a Tuberculin Skin Test for Tuberculosis Screening in a Moderate-Risk Population

Comparison of a New ESAT-6/CFP-10 Peptide-Based Gamma Interferon Assay and a Tuberculin Skin Test for Tuberculosis Screening in a Moderate-Risk Population

Sensitivity of C-Tb: a novel RD-1-specific skin test for the diagnosis of tuberculosis infection

Mycobacterium tuberculosis ( Mtb ) isocitrate dehydrogenases show strong B cell response and distinguish vaccinated controls from TB patients

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