Interferon-γ and Immunoglobulins in Latent Tuberculosis Infection

Topić, Renata Zrinski; Dodig, Slavica; Zoričić-Letoja, Ivka

doi:10.1016/j.arcmed.2008.11.001

Cited by 12 publications

(13 citation statements)

References 22 publications

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“…Three studies evaluated a range of TST cut-offs in the analysis and all showed that agreement could be improved by employing a more stringent TST cut-off (ie, 15 mm vs 10 mm) 33 46 47. In all 19 studies that reported on discordance, TST+/IGRA– subjects was the predominant type of discordance 25 27 29 32–35 37 39 46–52 54–56…”

Section: Resultsmentioning

confidence: 99%

Interferon-gamma release assays for tuberculosis screening of healthcare workers: a systematic review

Zwerling

Hof²,

Scholten³

et al. 2011

Thorax

217

195

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Healthcare workers (HCWs) are at increased risk of exposure to tuberculosis (TB). Traditionally, screening for latent TB infection (LTBI) is done using the tuberculin skin test (TST). Interferon-gamma release assays (IGRAs) are now increasingly being used for diagnosis of LTBI, but their role in HCW screening is unclear. A systematic review was conducted of all IGRA studies in HCWs to summarise their performance in cross-sectional and serial testing settings. By searching four electronic databases and other sources, all available studies using any one of the commercial IGRA assays in HCWs were retrieved and screened. 50 unique studies were identified which met the inclusion criteria including five from high TB incidence settings. Among 24 cross-sectional studies in low TB incidence settings, the pooled prevalence of positive IGRA using either test was significantly lower than for a positive TST. However, in high-incidence settings (n¼2) there were no consistent differences in the prevalence of positive tests. IGRAs showed good correlation with occupational risk factors for TB exposure in low-incidence settings. Only 10 studies assessed use of IGRA for serial testing and all showed large variation in the rates of conversions and reversions, with no data suggesting that IGRAs are better at identifying the incidence of new TB infection than the TST. The use of IGRAs instead of TST for one-time screening may result in a lower prevalence of positive tests and fewer HCWs who require LTBI treatment, particularly in low TB incidence settings. However, the use of IGRAs for serial testing is complicated by lack of data on optimum cut-offs for serial testing and unclear interpretation and prognosis of conversions and reversions. Further longitudinal research will be required to inform guidelines on serial testing using IGRAs.

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Section: Resultsmentioning

confidence: 99%

Interferon-gamma release assays for tuberculosis screening of healthcare workers: a systematic review

Zwerling

Hof²,

Scholten³

et al. 2011

Thorax

217

195

View full text Add to dashboard Cite

show abstract

“…Therefore, a more stringent definition for TST will reduce the number of TST-positive results not confirmed by IGRA. However, this will increase the number of TST-negative/IGRA-positive discordant results [59,60,67]. In addition, even if the cutoff for the TST is increased to 15 mm, only every second positive TST is confirmed by IGRA [13,22].…”

Section: The Effect Of Introducing Igra In Tb Screening Of Hcwmentioning

confidence: 99%

“…The difference in Review the prevalence of positive TST and IGRA was not statistically significant in seven studies [25,48,[53][54][55][56][57]. In the other 24 studies, the difference was statistically significant [13,21,23,27,30,46,47,[49][50][51][58][59][60][61][62][63][64][65][66][67][68][69][70]. However, there was no clear trend that TST-positive/ IGRA-negative discordant results increased with an increasing proportion of BCG-vaccinated HCW in the study populations.…”

Section: The Effect Of Introducing Igra In Tb Screening Of Hcwmentioning

confidence: 99%

IFN-γ release assay versus tuberculin skin test for monitoring TB infection in healthcare workers

Nienhaus

Ringshausen

Costa³

et al. 2013

Expert Review of Anti-infective Therapy

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“…To our knowledge, only a few well-defined subsets of mycobacterial antigens can elicit an IgA response [39,40]. Second, it has been documented that IgA provides protection from early tuberculous pulmonary infection and that the protection is of short duration [41]. As TP onset is insidious, IgA-producing cells might already have been stimulated in vivo and unresponsive to further stimulation when patients sought medical care.…”

mentioning

confidence: 99%

B lymphocytes that migrate to tuberculous pleural fluid via the SDF‐1/CXCR4 axis actively respond to antigens specific for Mycobacterium tuberculosis

Feng

Liu

et al. 2011

Eur J Immunol

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B-cell biology has been largely uncharacterized in the field of tuberculosis (TB). In this study, we investigated the immunophenotypical and functional characteristics of B cells obtained from the pleural fluid (PF) and peripheral blood of patients with tuberculous pleuritis (TP). Our results indicated that the total numbers of B cells, CD271 memory B cells and plasmablasts were clearly lower in the PF than in peripheral blood. Furthermore, we found significantly higher expression of CXCR4 on B cells in the PF, and a chemotaxis assay showed that B cells in the PF were more responsive to stromal cell-derived factor-1 (SDF-1) than B cells from peripheral blood. In addition, SDF-1 levels in PF were remarkably high compared with SDF-1 levels in plasma, suggesting that the SDF-1/CXCR4 axis might facilitate the migration of circulating B cells into tuberculous pleural space. Importantly, we observed that significantly more antibodies were produced by B cells in the PF following stimulation with BCG, early secretory antigenic target (ESAT-6)/culture filtrate protein-10 (CFP-10) or ESAT-6 protein.Collectively, these data demonstrate that Mycobacterium tuberculosis-specific B cells exist at local sites of infection in TP patients and this localization might influence the immune response to M. tuberculosis. Key words: B cells . Chemokine receptors . Immune responses . Tuberculous pleuritis Supporting Information available onlineIntroduction Tuberculosis (TB), one of the oldest infectious diseases associated with humans, is a chronic disease caused by infection with Mycobacterium tuberculosis [1,2]. The incidence of TB has increased during the past 20 years for reasons such as insufficient prevention efforts, incorrectly prescribed medication, the emergence of drug-resistant strains of M. tuberculosis and the prevalence of human immunodeficiency virus (HIV) infection [3,4]. Traditionally, the immune response against M. tuberculosis infection is dominated by cell-mediated immunity (CMI), which relies primarily on CD4 1 and CD8 1 T cells. Therefore, many studies have been conducted in an attempt to augment cellular immunity, with an aim to develop new vaccine candidates against TB [5][6][7]. In contrast to these investigations, the contribution of B cells and humoral immunity in the TB field remains largely unexamined and elusive. Fewer efforts to promote an effective humoral response against M. tuberculosis have been made compared with those devised to elicit a cellular response [8]. However, it is worth noting that any successful, novel vaccine strategy against TB will have to properly invoke both humoral and cellular immunity, given that these responses are the two critical arms of adaptive immunity and always collaborate to repel infectious pathogens [9]. Numerous murine studies have shown that B cells and antibodies have pleiotropic activities and display previously underappreciated roles during M. tuberculosis infection [10][11][12]. In contrast to the murine studies, there are limited data regarding any phenotypic and...

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Interferon-γ and Immunoglobulins in Latent Tuberculosis Infection

Cited by 12 publications

References 22 publications

Interferon-gamma release assays for tuberculosis screening of healthcare workers: a systematic review

Interferon-gamma release assays for tuberculosis screening of healthcare workers: a systematic review

IFN-γ release assay versus tuberculin skin test for monitoring TB infection in healthcare workers

B lymphocytes that migrate to tuberculous pleural fluid via the SDF‐1/CXCR4 axis actively respond to antigens specific for Mycobacterium tuberculosis

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