Preliminary results in the immunodiagnosis of tuberculosis in children based on T cell responses to ESAT-6 and PPD antigens

Van-Lume, Daniele S M; Souza, Joelma Rodrigues de; Melo, Wlademir; Melo, Victor Leonardo Mello Varela Ayres de; Cabral, Marta Maciel Lyra; Rego, J. C.; Schindler, Haiana Charifker; Abath, Frederico G. C.; Montenegro, Sílvia Maria Lucena

doi:10.1590/s0074-02762008000400015

Cited by 5 publications

(6 citation statements)

References 22 publications

(15 reference statements)

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“…Usually, TB diagnosis is based on a combination of clinical and radiological examination, epidemiological investigation, appropriate response to anti-tuberculosis therapy and microbiological tests (bacilloscopy and culture) for confirmation. However, diagnosis in children is very difficult, especially in the youngest, because they are paucibacillary, thereby lowering the sensitivity of microbiological tests, and do not exhibit specific symptoms of TB [6].…”

Section: Introductionmentioning

confidence: 99%

Immunological Diagnosis of Tuberculosis Based on Recombinant Antigens ESAT-6 and CFP-10 in Children from an Endemic Area in Northeast Brazil

Van-Lume¹,

Souza²,

Cabral

et al. 2010

Scandinavian Journal of Immunology

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Diagnostic tests for tuberculosis (TB) using interferon gamma (IFN‐γ) responses produced by T lymphocytes after stimulation by early secretory antigen target 6 (ESAT‐6), culture filtrate protein 10 (CFP‐10) or purified protein derivate (PPD) were carried out using ELISA (enzyme‐linked immunosorbent assay) in whole blood culture supernatants from children with suspected TB disease (n = 21), latent TB infection (LTBI; n = 17) and negative controls (NC; n = 21) from Recife, Pernambuco, Brazil. The results were analysed using the ROC (receiver operating characteristic) curves and the areas under the curve (AUC) generated varied from 0.5 to 1.0 with higher values indicating increased discriminatory ability. Comparisons of AUCs were made using non‐parametric assumptions, and the differences were considered significant if P < 0.05. The ROC curve showed a statistical difference (P = 0.015) between the LTBI and NC groups with an AUC of 0.731, TB disease and NC (AUC = 0.780; P = 0.002) and a group with TB (latent infection + disease, n = 38) and NC (AUC = 0.758; P = 0.001) when the antigen used was ESAT‐6. No statistical difference was found between the groups when CFP‐10 or PPD was used. In conclusion, the ESAT‐6 test may be the most appropriate for diagnosis of childhood TB, both LTBI and TB disease, when associated with epidemiological and clinical data, especially in endemic areas such as Brazil.

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Section: Introductionmentioning

confidence: 99%

Immunological Diagnosis of Tuberculosis Based on Recombinant Antigens ESAT-6 and CFP-10 in Children from an Endemic Area in Northeast Brazil

Van-Lume¹,

Souza²,

Cabral

et al. 2010

Scandinavian Journal of Immunology

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“…Six months later, her renal function remained normal and the urinalysis returned to TB is still a common disease worldwide. The World Health Organization estimates that one-third of the world's population is infected with Mycobacterium tuberculosis, which is responsible for 8.7 million new TB cases and approximately 3 million deaths annually (13). Most often, the lung is affected, but after tuberculous lymphadenopathy, the next most common form of nonpulmonary tuberculosis is genitourinary disease, accounting for 27% of nonpulmonary TB cases in several surveys in the United States, Canada, and United Kingdom (5).…”

Section: Case Reportmentioning

confidence: 99%

Lumbar Tuberculosis Associated with Membranous Nephropathy and Interstitial Nephritis

et al. 2010

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Tuberculosis is a common disease worldwide. However, it now is clear that tuberculosis can affect the kidney more insidiously. We describe a case of lumbar tuberculosis associated with simultaneous membranous nephropathy and interstitial nephritis, in which recovery of renal function occurred after treatment with steroids in addition to antituberculosis agents. CASE REPORTA 50-year-old woman was admitted to the hospital with a 2-week history of hematuria, proteinuria, and renal failure. She had been diagnosed with lumbar tuberculosis (TB) 6 weeks earlier because of mild fever, fatigue, night sweating, weight loss, and low-back pain. Her tuberculin skin test was strongly positive. A colloidal-gold-based serological assay with a Mycobacterium tuberculosis antibody assay kit (Assure TB Rapid Test; MP Biomedicals Asia Pacific Pte. Ltd., Singapore) was used to detect M. tuberculosis antibody. The result was positive. Lumbar X-ray examination showed that the L3-L4 disc space was narrow and destroyed ( Fig. 1). She had been treated with rifampin, isoniazid, ethambutol, and pyrazinamide for 4 weeks before admission. Her temperature normalized, and the lowback pain disappeared. However, 2 weeks before the admission, she developed hematuria and proteinuria. Her serum creatinine, which had been 63 mol/liter 1 month prior to presentation, rose to 183 mol/liter. She reported no abnormal urinary frequency, dysuria, or flank pain. Her remaining medical history, travel history, and family history were unremarkable. Physical examination showed a body temperature of 36.8°C, a regular pulse rate of 85/min, respiratory rate of 18/ min, and blood pressure of 140/85 mm Hg. Laboratory findings included a hemoglobin level of 9.3 g/dl, a platelet count of 320 ϫ 10 9 /liter, and a white cell count of 11.7 ϫ 10 9 /liter. The erythrocyte sedimentation rate was 24 mm/h, and C-reactive protein was 5.45 mg/dl. The blood urea nitrogen was 7.34 mmol/liter, and serum creatinine was 183 mol/liter. Serum complement levels were normal. Urinalysis revealed 2ϩ protein, with 12 to 15 red blood cells and 16 to 20 white blood cells per high-power field (HPF) in the urinary sediment. Daily urinary protein excretion was 2.6 g. Complement 3 (C3) and C4 concentrations were normal. Serology for antinuclear antibody, human immunodeficiency virus, and syphilis was negative, and the patient was not otherwise immunocompromised. Sputum smears for acid-fast stain were negative. Chest X-ray examination was normal. Renal ultrasonography showed normal-size kidneys without any abnormality. PCR analysis using specific primers for M. tuberculosis was performed on earlymorning urine samples for three consecutive days. DNA was extracted from the urine samples with the QIAamp DNA minikit (Qiagen, Hilden, Germany) according to the manufacturer's instructions. The primers targeted to the specific insertion element insertion sequence (IS) IS6110 of M. tuberculosis were synthesized by Takara Bio Inc. (Dalian, China). The amplicon size was 156 bp. The results were positive (Fig...

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“…En la era de los nuevos desarrollos tecnológicos, recientemente se han introducido en el mercado dos pruebas inmunológicas que inicialmente se destinaban al diagnóstico de la TB latente, pero que ahora se promueven para el estudio de casos activos: QuantiFERON 28,37 y el ELISpot 38,39 . Ambas se basan en la producción de interferón (IFN)-g antígeno específico por células T en respuesta a los antígenos ESAT-6 y CFP-10 de Mtb [40][41][42][43] . Esto sólo ocurre cuando los linfocitos T tienen memoria inmunológica generada por la infección previa con Mtb.…”

Section: Serología Y Otros Estudios Inmunológicosunclassified

Panorama actual en el diagnóstico de la tuberculosis cutánea

Almaguer-Chávez¹,

Ocampo‐Candiani²,

Rendón

2009

Actas Dermo-Sifiliográficas

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Pulmonary and cutaneous tuberculosis are caused by Mycobacterium tuberculosis. According to data from the World Health Organization, there are around 8 million new cases per year.The incidence of cutaneous tuberculosis has risen in parallel with that of pulmonary tuberculosis, and coinfection by M tuberculosis and human immunodeficiency virus is considered to be one of the main causes. Current diagnostic methods for pulmonary and extrapulmonary tuberculosis are far from perfect, leading to a delay in starting appropriate therapy.We present a review of these diagnostic methods and of their use in the cutaneous forms. In conclusion,histopathologic findings and isolation of M tuberculosis in cultures of biopsy material or by polymerase chain reaction are the most useful diagnostic tools in cutaneous tuberculosis.

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Preliminary results in the immunodiagnosis of tuberculosis in children based on T cell responses to ESAT-6 and PPD antigens

Abstract: The aim of this work was to study the difference in interferon gamma (IFN-γ)

Cited by 5 publications

References 22 publications

Immunological Diagnosis of Tuberculosis Based on Recombinant Antigens ESAT-6 and CFP-10 in Children from an Endemic Area in Northeast Brazil

Immunological Diagnosis of Tuberculosis Based on Recombinant Antigens ESAT-6 and CFP-10 in Children from an Endemic Area in Northeast Brazil

Lumbar Tuberculosis Associated with Membranous Nephropathy and Interstitial Nephritis

Panorama actual en el diagnóstico de la tuberculosis cutánea

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