IP-10 is an accurate biomarker for the diagnosis of tuberculosis in children - 18/11/14

Doi : 10.1016/j.jinf.2014.06.013

I. Latorre ^a,^f,^g,^{^{i
Present affiliation: ICREA Infection Biology Laboratory, Department of Experimental and Health Sciences, Universitat Pompeu Fabra, 08003 Barcelona, Spain.}}, J. Díaz ^a,^f,^g, I. Mialdea ^b, M. Serra-Vidal ^a,^f,^g, N. Altet ^c,^f, C. Prat ^a,^f,^g, N. Díez ^b, A. Escribano ^b, I. Casas ^d,^f, C. Rodrigo ^f,^h, V. Ausina ^a,^f,^g, M. Ruhwald ^e, J. Domínguez ^a,^f,^g,^⁎
^a Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
^b Unidad de Neumología Infantil, Hospital Clínico Universitario Valencia, Universidad de Valencia, Spain
^c Unidad de Prevención y Control de la Tuberculosis de Barcelona, Spain
^d Servei de Medicina Preventiva, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
^e Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
^f Universitat Autònoma de Barcelona, Bellaterra, Spain
^g CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Spain
^h Servei de Pediatria, Hospital Universitari Germans Trias I Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain

^∗Corresponding author. Servei de Microbiologia, Institut d’Investigació “Germans Trias i Pujol”, Carretera del Canyet s/n, 08916 Badalona, Barcelona, Spain. Tel.: +34 93 497 88 94; fax: +34 93 497 88 95.

Summary

Objective

Performance of IFN-γ assays in children is compromised. Therefore, we investigated the utility of IP-10 for the detection of active tuberculosis (TB) and latent tuberculosis infection (LTBI) diagnosis in children; comparing its positivity with QuantiFERON-TB Gold In-Tube (QFN-G-IT) and T-SPOT.TB.

Methods

We studied 230 children from three groups: active TB, screening (healthy children without known exposure to active TB patient screened at school or by their paediatrician) and contact-tracing studies. IFN-γ release was determined by QFN-G-IT and T-SPOT.TB. IP-10 was detected in QFN-G-IT supernatants by ELISA.

Results

When combining QFN-G-IT and IP-10 assays, positive results improved significantly from 38.3% in QFN-G-IT and 33.9% in IP-10 to 41.3%. Age and type of contact were significant risk factors associated with positive QFN-G-IT and IP-10 results. IP-10 levels after antigen-specific stimulation were significantly higher in comparison to IFN-γ levels. Correlation between the three assays was good (κ = 0.717–0.783).

Conclusions

IP-10 cytokine is expressed in response to TB specific-antigens used in QFN-G-IT. In conclusion, the use of IFN-γ T-cell based assays in combination with an additional IP-10 assay detection could be useful for diagnosing active TB and LTBI in children.

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Highlights

•	Performance of IFN-γ assays in children younger than five years old is compromised.
•	IP-10 cytokine is expressed in response to TB specific-antigens used in QFN-G-IT.
•	Combining IGRAs with IP-10 could be useful for diagnosing tuberculosis in children.

Le texte complet de cet article est disponible en PDF.

Keywords : IP-10, IFN-γ, Tuberculosis, Children

Plan

Background

Materials and methods

Patients and inclusion criteria

Quanti-FERON TB Gold In Tube

QFN-G-IT and IP-10 ELISA in-house tests performance

QFN-G-IT, IP-10 and T-SPOT.TB results

Concordance and agreement between QFN-G-IT, IP-10 and T-SPOT.TB

Discussion

Conflict of interest

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Vol 69 - N° 6

P. 590-599 - décembre 2014 Retour au numéro

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IP-10 is an accurate biomarker for the diagnosis of tuberculosis in children - 18/11/14

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