Interferon-Gamma Release Assay Performance of Pleural Fluid and Peripheral Blood in Pleural Tuberculosis

Liu, Fei; Gao, Mengqiu; Zhang, Xia; Du, Fengjiao; Jia, Hongyan; Yang, Xinting; Wang, Zitong; Zhang, Liqun; Ma, Li; Wu, Xia; Xie, Li; Zhang, Zongde

doi:10.1371/journal.pone.0083857

Cited by 28 publications

(39 citation statements)

References 25 publications

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“…The full text of the remaining 10 articles was examined, and one study (Losi et al, 2010) was excluded because it did not use the t-spot assay format. The final meta-analysis therefore included nine publications (Losi et al, 2007;Lee et al, 2009;Dheda et al, 2009;Kang et al, 2012;Keng et al, 2013;Liao et al, 2014;Zhang et al, 2014;Liu et al, 2013Liu et al, , 2014 TN = truly negative result; TP = truly positive result; FN = false-negative result; FP = false-positive result. a Enzymelinked immunospot assay (T-SPOT-TB; Oxford Immunotec Ltd., Oxford, UK) measuring the immune response to an ESAT-6 or CFP-10 peptide.…”

Section: Resultsmentioning

confidence: 99%

Accuracy of enzyme-linked immunospot assay for diagnosis of pleural tuberculosis: a meta-analysis

Li¹,

Qin²,

Li³

et al. 2015

Genet. Mol. Res.

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ABSTRACT. Current methods for diagnosing tuberculous pleurisy are poor. Some studies have explored the diagnostic value of a pleural effusion enzyme-linked immunospot (ELISPOT) assay, but its accuracy remains controversial. Therefore, we performed a meta-analysis of the existing evidence on the ability of the ELISPOT assay to diagnose tuberculous pleurisy. We systematically searched PubMed, Google Scholar, and EMBASE databases for studies measuring the sensitivity, specificity, and other measures of accuracy of the pleural effusion ELISPOT assay for diagnosis of tuberculous pleurisy. A total of nine studies were identified and subjected to meta-analysis, giving the following pooled values for sufficiently accurate to diagnose tuberculous pleurisy as a stand-alone technique. In fact, it appears to be superior to assays based on adenosine deaminase and gamma interferon for screening patients and confirming the diagnosis of tuberculous pleurisy.

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Section: Resultsmentioning

confidence: 99%

Accuracy of enzyme-linked immunospot assay for diagnosis of pleural tuberculosis: a meta-analysis

Li¹,

Qin²,

Li³

et al. 2015

Genet. Mol. Res.

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“…Due to the shortage of available methods for diagnosis of TB, IGRAs have increasingly been used as an auxiliary diagnostic tool for active TB in clinical practice in China (18,(31)(32)(33). Indeed, it has been reported that detection of IFN-␥ in pleural fluid mononuclear cells is useful for diagnosis of tuberculous pleurisy (31,32).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, it has been reported that detection of IFN-␥ in pleural fluid mononuclear cells is useful for diagnosis of tuberculous pleurisy (31,32). Additionally, IGRAs have improved the sensitivity for diagnosis of pulmonary TB (18), pediatric TB (34), and osteoarticular TB (33).…”

Section: Discussionmentioning

confidence: 99%

IP-10 and MIG Are Compartmentalized at the Site of Disease during Pleural and Meningeal Tuberculosis and Are Decreased after Antituberculosis Treatment

Yang

Cai

Zhao

et al. 2014

Clin. Vaccine Immunol.

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“…The presence of IFN-␥ is a strong indicator of M. tuberculosis infection, but the value of IGRAs for the diagnosis of TP is still controversial. Some studies show that IGRAs are useful for TP diagnosis even in areas where TB is highly endemic (10,11). However, other studies show that assays for the detection of adenosine deaminase and IFN-␥ are superior to IGRAs and do not recommend the use of IGRAs for TP diagnosis (12)(13)(14)(15).…”

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confidence: 99%

Rapid Detection of Cell-Free Mycobacterium tuberculosis DNA in Tuberculous Pleural Effusion

et al. 2017

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Tuberculous pleurisy is one of the most common types of extrapulmonary tuberculosis, but its diagnosis remains difficult. In this study, we report for the first time on the detection of cell-free Mycobacterium tuberculosis DNA in pleural effusion and an evaluation of a newly developed molecular assay for the detection of cell-free Mycobacterium tuberculosis DNA. A total of 78 patients with pleural effusion, 60 patients with tuberculous pleurisy, and 18 patients with alternative diseases were included in this study. Mycobacterial culture, the Xpert MTB/RIF assay, the adenosine deaminase assay, the T-SPOT.TB assay, and the cell-free Mycobacterium tuberculosis DNA assay were performed on all the pleural effusion samples. The cell-free Mycobacterium tuberculosis DNA assay and adenosine deaminase assay showed significantly higher sensitivities of 75.0% and 68.3%, respectively, than mycobacterial culture and the Xpert MTB/RIF assay, which had sensitivities of 26.7% and 20.0%, respectively (P Ͻ 0.01). All four of these tests showed good specificities: 88.9% for the adenosine deaminase assay and 100% for the remaining three assays. The T-SPOT.TB assay with pleural effusion showed the highest sensitivity of 95.0% but the lowest specificity of 38.9%. The cell-free Mycobacterium tuberculosis DNA assay detected as few as 1.25 copies of IS6110 per ml of pleural effusion and showed good accordance of the results between repeated tests (r ϭ 0.978, P ϭ 2.84 ϫ 10 Ϫ10 ). These data suggest that the cell-free Mycobacterium tuberculosis DNA assay is a rapid and accurate molecular test which provides direct evidence of Mycobacterium tuberculosis etiology.KEYWORDS Mycobacterium tuberculosis, cell-free DNA, pleural effusion T uberculous pleurisy (TP) is one of the most common extrapulmonary manifestations of tuberculosis, but its diagnosis is quite challenging (1). The definite diagnosis of TP is made by detecting Mycobacterium tuberculosis from the pleural effusion (PE), sputum, or pleural tissue (1, 2). However, due to the paucity of M. tuberculosis organisms in PE, culture and molecular tests like the Xpert MTB/RIF assay show poor sensitivities (3-5).Other assays for the immunochemical biomarkers mostly reported in PE are the adenosine deaminase assay (ADA), the interferon gamma (IFN-␥) assay, and IFN-␥ release assays (IGRAs). Adenosine deaminase and IFN-␥ are believed to be released during the immune response triggered by the presence of mycobacterial antigens in the pleural cavity. Recent meta-analyses show that adenosine deaminase and IFN-␥ appear to be relatively accurate biomarkers for TP diagnosis. However, a wide range of diagnostic cutoff values may cause heterogeneity (6-9). IGRAs are T-cell-based assays that measure IFN-␥ release by sensitized T cells in response to M. tuberculosis-specific antigens. The presence of IFN-␥ is a strong indicator of M. tuberculosis infection, but the value of IGRAs for the diagnosis of TP is still controversial. Some studies show that

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Interferon-Gamma Release Assay Performance of Pleural Fluid and Peripheral Blood in Pleural Tuberculosis

Cited by 28 publications

References 25 publications

Accuracy of enzyme-linked immunospot assay for diagnosis of pleural tuberculosis: a meta-analysis

Accuracy of enzyme-linked immunospot assay for diagnosis of pleural tuberculosis: a meta-analysis

IP-10 and MIG Are Compartmentalized at the Site of Disease during Pleural and Meningeal Tuberculosis and Are Decreased after Antituberculosis Treatment

Rapid Detection of Cell-Free Mycobacterium tuberculosis DNA in Tuberculous Pleural Effusion

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