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Strzelak A, Komorowska-Piotrowska A, Borowa A, Krasińska M, Feleszko W, Kulus M. IP-10 for the Diagnosis and Treatment Monitoring of Tuberculosis in Children. Diagnostics (Basel) 2024; 14:177. [PMID: 38248054 PMCID: PMC10814829 DOI: 10.3390/diagnostics14020177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
PURPOSE To determine the utility of interferon-gamma-inducible protein 10 (IP-10) for identifying active tuberculosis (TB) and TB infection (TBI) in children in BCG-vaccinated populations, establish its diagnostic performance characteristics, and evaluate changes in IP-10 level during anti-TB chemotherapy. METHODS Concentrations of IP-10 and IFN-γ were measured in QuantiFERON-TB Gold (QFT) supernatants in children with suspected TB or due to recent TB contact. A total of 225 children were investigated: 33 with active TB, 48 with TBI, 83 TB contacts, 20 with suspected TB but other final diagnoses, and 41 controls. In 60 children, cytokine responses were evaluated at a follow-up visit after 2 months of anti-TB treatment. RESULTS IP-10 expression was significantly higher in infected children (active TB and TBI cases) than in uninfected individuals. IP-10 proved effective in identifying TB infection at its optimal cut-off (>1084.5 pg/mL) but was incapable of differentiating between children with active TB and TBI. Combining IP-10 and IFN-γ increased the QFT sensitivity. IP-10 but not IFN-γ decreased significantly during anti-TB treatment in children with active TB (p = 0.003). CONCLUSION IP-10 identifies TB infection and declines during anti-TB chemotherapy in children. Incorporating IP-10 into new immunodiagnostic assays could improve TB diagnosis and allow for treatment monitoring.
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Affiliation(s)
- Agnieszka Strzelak
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, 63A Zwirki i Wigury Street, 02-091 Warsaw, Poland
| | - Anna Komorowska-Piotrowska
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, 63A Zwirki i Wigury Street, 02-091 Warsaw, Poland
| | - Agnieszka Borowa
- Department of Lung Diseases and Tuberculosis for Children and Adolescents, Mazovian Center for Treatment of Lung Diseases and Tuberculosis, Reymonta 83/91 Street, 05-400 Otwock, Poland
| | - Maria Krasińska
- Department of Lung Diseases and Tuberculosis for Children and Adolescents, Mazovian Center for Treatment of Lung Diseases and Tuberculosis, Reymonta 83/91 Street, 05-400 Otwock, Poland
| | - Wojciech Feleszko
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, 63A Zwirki i Wigury Street, 02-091 Warsaw, Poland
| | - Marek Kulus
- Department of Pediatric Pulmonology and Allergy, Medical University of Warsaw, 63A Zwirki i Wigury Street, 02-091 Warsaw, Poland
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Zhang L, Manning S, Wu TT, Zeng Y, Lee A, Wu Y, Paster BJ, Chen G, Fiscella K, Xiao J. Impact of Nystatin Oral Rinse on Salivary and Supragingival Microbial Community among Adults with Oral Candidiasis. Microorganisms 2023; 11:1497. [PMID: 37374999 DOI: 10.3390/microorganisms11061497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/25/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
This study aimed to evaluate the impact of Nystatin oral rinse on salivary and supragingival microbiota in adults with oral candidiasis and identify predictive factors related to individuals' responses to Nystatin. The trial involved twenty participants who used 600,000 International Units/application of Nystatin oral rinse for seven days, four times a day, and were followed up at one week and three months after the rinse. The salivary and plaque microbiome of the participants were assessed via 16S rDNA amplicon sequencing. Overall, salivary and plaque microbiomes remained stable. However, among the participants (53 percent) who responded to Nystatin rinse (defined as free of oral Candida albicans post treatment), Veillonella emerged as a core genus alongside Streptococcus and Actinomyces in supragingival plaque at the 3-month follow-up. Furthermore, statistical models were fit to identify predictive factors of Nystatin rinse success (elimination of C. albicans) or failure (remaining C. albicans). The results revealed that an increased level of salivary Interferon (IFN)-γ-inducible protein (IP-10), also known as C-X-C motif chemokine ligand 10 (CXCL10), was an indicator of a failure of responding to Nystatin rinse. Future clinical trials are warranted to comprehensively assess the impact of antifungal treatment on the oral flora.
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Affiliation(s)
- Lanxin Zhang
- Department of Molecular and Cell Biology, University of California Berkeley, Berkeley, CA 94720, USA
| | - Samantha Manning
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14627, USA
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14627, USA
| | - Yan Zeng
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY 14627, USA
| | - Aaron Lee
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY 14627, USA
| | - Yan Wu
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY 14627, USA
| | - Bruce J Paster
- Department of Microbiology, Forsyth Institute, Cambridge, MA 02142, USA
| | - George Chen
- Department of Microbiology, Forsyth Institute, Cambridge, MA 02142, USA
| | - Kevin Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY 14627, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY 14627, USA
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3
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Zhou Y, Zhang F, Shi H, Wu P, Zhou Y. Host biomarkers other than interferon gamma in QFT-TB supernatants for identifying active tuberculosis. Tuberculosis (Edinb) 2022; 136:102256. [PMID: 36113397 DOI: 10.1016/j.tube.2022.102256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/12/2022] [Accepted: 08/29/2022] [Indexed: 11/18/2022]
Abstract
Interferon gamma release assays (IGRAs) for tuberculosis (TB) remain limited in their ability to discriminate between active TB (ATB) and latent TB infection (LTBI). The objective of our study was to evaluate the value of additional cytokines/chemokines other than interferon gamma (IFN-γ) as biomarkers to identify different TB infection status. A total of 128 subjects were enrolled to detect the quantification of IL-2, IP-10, MCP-1 and RANTES in the supernatants of QuantiFERON®-TB (QFT-TB). Area under the curve (AUC) was used to evaluate the diagnostic efficiency. Notably, Mycobacterium tuberculosis (Mtb) induced cytokines/chemokines of ATB patients were significantly higher than those of the LTBI, other lung related diseases (ORD) and healthy controls (HC). Moreover, ROC analysis indicated that all cytokine/chemokine parameters detected were more capable of distinguishing ATB from LTBI than IFN-γ, especially IL-2. The diagnostic model including TB specific IL-2 and RANTES improved the performance in distinguishing ATB from LTBI, which was superior to single cytokines/chemokines in QFT-TB supernatants. Our results suggest that the combination of Mtb specific cytokines/chemokines has great prospects in the diagnosis of ATB, and the diagnostic model based on IL-2 and RANTES can be used as an alternative to distinguish ATB from LTBI.
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Affiliation(s)
- Yu Zhou
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China.
| | - Fujie Zhang
- Department of Clinical Laboratory, Qian Xi Nan Hospital of Traditional Chinese Medicine, Guizhou, 562400, Qian Xi Nan Buyei and Miao Autonomous Prefecture, China.
| | - Hanlu Shi
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Zhejiang, 310053, Hangzhou, China.
| | - Peihao Wu
- Department of Clinical Laboratory, School of Medicine, Women's Hospital, Zhejiang University, Zhejiang, 310006, Hangzhou, China.
| | - Yonglie Zhou
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China.
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4
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Strzelak A, Komorowska-Piotrowska A, Krenke K, Zagórska W, Bartosiewicz W, Feleszko W, Kulus M. Diagnostic Value of IP-10 Level in Plasma and Bronchoalveolar Lavage Fluid in Children with Tuberculosis and Other Lung Diseases. Diagnostics (Basel) 2022; 12:diagnostics12040840. [PMID: 35453887 PMCID: PMC9032840 DOI: 10.3390/diagnostics12040840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: IP-10 has been proposed as a new diagnostic biomarker for Mycobacterium tuberculosis infection (MTBI). However, data on IP-10 concentration in bronchoalveolar lavage fluid (BALF) for pediatric tuberculosis are lacking. Aim: To determine IP-10 levels in unstimulated BALF and plasma in children with and without MTBI. Methods: IP-10 concentrations in BALF and plasma were measured in children hospitalized with suspected tuberculosis or other respiratory disease and scheduled for bronchoscopy. Thirty-five children were enrolled: 13 with suspected tuberculosis and 22 controls. The association between IP-10 and age was examined. Results: The IP-10 expression was increased in BALF compared to plasma (p = 0.008). We noticed higher BALF IP-10 levels in children with asthma, interstitial lung disease, and lung anomaly than in children with MTBI and other respiratory tract infections, but the differences were statistically insignificant. There was a moderate correlation between plasma and BALF IP-10 concentrations (rs = 0.46, p = 0.018). No correlation between IP-10 level and age was detected. Conclusions: IP-10 is detectable in unstimulated BALF in children with respiratory diseases, reaches higher concentrations in unstimulated BALF vs plasma, and does not correlate with age. However, it could not discriminate MTBI from other respiratory diseases.
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Household contact investigation for the detection of active tuberculosis and latent tuberculosis: a comprehensive evaluation in two high-burden provinces in Iran. New Microbes New Infect 2022; 45:100958. [PMID: 35242336 PMCID: PMC8861284 DOI: 10.1016/j.nmni.2022.100958] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 09/09/2021] [Accepted: 01/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background Systematic evaluation of household contacts of persons with pulmonary tuberculosis (TB) in low- and middle-income countries is recommended by the World Health Organization (WHO). This study recruited adult household contacts of diagnosed TB patients in two high burden provinces of Iran to estimate the prevalence and incidence of active disease and latent TB infection (LTBI) among individuals exposed to TB cases. Methods We conducted a cohort study among adults in household contact with a pulmonary TB index case. All subjects were assessed for active disease through evaluation of symptoms. Tuberculin skin test (TST) and QuantiFERON®-TB Gold Plus (QFT-Plus) were used to define LTBI. These tests were performed at the time of the index TB case diagnosis and repeated if the previous result was negative, at three-, 12-, and 18-months post recruitment. In addition, interferon-γ-induced protein-10 (IP-10) concentrations were measured in QFT-Plus supernatants for all participants three months after diagnosing the index case. Results A total of 451 individuals who had close contact with 95 active TB patients were enrolled in this study. Five (1.1%) contacts were diagnosed with active TB and 285 (63.2%) were identified with LTBI during our study. The incidence rate of LTBI among adult household contacts of TB index cases was 0.44 per person per year. Conclusion The overall rate of LTBI was high. Systematic screening of all household contacts of pulmonary TB should be expanded in Iran to make the timely achievement of the global end TB strategy feasible.
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Petruccioli E, Najafi Fard S, Navarra A, Petrone L, Vanini V, Cuzzi G, Gualano G, Pierelli L, Bertoletti A, Nicastri E, Palmieri F, Ippolito G, Goletti D. Exploratory analysis to identify the best antigen and the best immune biomarkers to study SARS-CoV-2 infection. J Transl Med 2021; 19:272. [PMID: 34174875 PMCID: PMC8235902 DOI: 10.1186/s12967-021-02938-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/13/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Recent studies proposed the whole-blood based IFN-γ-release assay to study the antigen-specific SARS-CoV-2 response. Since the early prediction of disease progression could help to assess the optimal treatment strategies, an integrated knowledge of T-cell and antibody response lays the foundation to develop biomarkers monitoring the COVID-19. Whole-blood-platform tests based on the immune response detection to SARS-CoV2 peptides is a new approach to discriminate COVID-19-patients from uninfected-individuals and to evaluate the immunogenicity of vaccine candidates, monitoring the immune response in vaccine trial and supporting the serological diagnostics results. Here, we aimed to identify in the whole-blood-platform the best immunogenic viral antigen and the best immune biomarker to identify COVID-19-patients. METHODS Whole-blood was overnight-stimulated with SARS-CoV-2 peptide pools of nucleoprotein-(NP) Membrane-, ORF3a- and Spike-protein. We evaluated: IL-1β, IL-1Ra, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12p70, IL-13, IL- 15, IL-17A, eotaxin, FGF, G-CSF, GM-CSF, IFN-γ, IP-10, MCP-1, MIP-1α, MIP-1β, PDGF, RANTES, TNF-α, VEGF. By a sparse partial least squares discriminant analysis we identified the most important soluble factors discriminating COVID-19- from NO-COVID-19-individuals. RESULTS We identified a COVID-19 signature based on six immune factors: IFN-γ, IP-10 and IL-2 induced by Spike; RANTES and IP-10 induced by NP and IL-2 induced by ORF3a. We demonstrated that the test based on IP-10 induced by Spike had the highest AUC (0.85, p < 0.0001) and that the clinical characteristics of the COVID-19-patients did not affect IP-10 production. Finally, we validated the use of IP-10 as biomarker for SARS-CoV2 infection in two additional COVID-19-patients cohorts. CONCLUSIONS We set-up a whole-blood assay identifying the best antigen to induce a T-cell response and the best biomarkers for SARS-CoV-2 infection evaluating patients with acute COVID-19 and recovered patients. We focused on IP-10, already described as a potential biomarker for other infectious disease such as tuberculosis and HCV. An additional application of this test is the evaluation of immune response in SARS-CoV-2 vaccine trials: the IP-10 detection may define the immunogenicity of a Spike-based vaccine, whereas the immune response to the virus may be evaluated detecting other soluble factors induced by other viral-antigens.
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Affiliation(s)
- Elisa Petruccioli
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Saeid Najafi Fard
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Assunta Navarra
- Clinical Epidemiology Unit, National Institute for Infectious Disease Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Linda Petrone
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Valentina Vanini
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.,UOS Professioni Sanitarie Tecniche National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Gilda Cuzzi
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Gina Gualano
- Clinical Division of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Luca Pierelli
- UOC Transfusion Medicine and Stem Cell Unit, San Camillo Forlanini Hospital, Rome, Italy
| | - Antonio Bertoletti
- Programme in Emerging Infectious Diseases, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Emanuele Nicastri
- Clinical Division of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Fabrizio Palmieri
- Clinical Division of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy
| | - Giuseppe Ippolito
- Scientific Direction, National Institute for Infectious Disease "Lazzaro Spallanzani"-IRCCS, Rome, Italy
| | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.
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7
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Ghanaie RM, Karimi A, Azimi L, James S, Nasehi M, Mishkar AP, Sheikhi M, Fallah F, Tabatabaei SR, Hoseini-Alfatemi SM. Diagnosis of latent tuberculosis infection among pediatric household contacts of Iranian tuberculosis cases using tuberculin skin test, IFN- γ release assay and IFN-γ-induced protein-10. BMC Pediatr 2021; 21:76. [PMID: 33573613 PMCID: PMC7877026 DOI: 10.1186/s12887-021-02524-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 01/26/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although the World Health Organization has recommended the diagnosis and prophylactic treatment of latent tuberculous infection (LTBI) in child household contacts of tuberculosis (TB) cases, the national programs in high-burden TB regions rarely implement adequate screening of this high-risk group, mainly because of resource limitations. We aimed to evaluate the prevalence of LTBI among pediatric household contacts of TB cases in two high-burden provinces in Iran. METHODS We conducted a cohort study in children who had been in household contact with a TB index. All subjects were assessed for active TB disease. For LTBI diagnosis, tuberculin skin test (TST) and QuantiFERON®-TB Gold Plus (QFT-Plus) were performed at the time of the index TB case diagnosis, as well as, 3, 12, and 18 months, if the first results were negative. In addition, interferon-γ-induced protein-10(IP-10) concentrations were measured for all participants. RESULTS A total of 230 children were enrolled, who had contact with an index TB case. Three contacts were diagnosed with active TB. According to the TST/QFT-Plus results, 104 (45.2%) children were identified with LTBI during our study. Significantly increased IP-10 levels were found in LTBI patients compared to healthy contacts. Accordingly, more than 50% of LTBI contacts and about 10% of healthy contacts were considered as IP-10-positive. CONCLUSION This study alarmingly illustrates a high prevalence of LTBI among Iranian children exposed to TB cases. We, therefore, emphasize that the children living in close contact with an infectious TB case should be screened effectively and receive prophylactic therapy.
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Affiliation(s)
- Roxana Mansour Ghanaie
- Pediatric Infections Research Center (PIRC), Research Institute for Children's Health (RICH), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdollah Karimi
- Pediatric Infections Research Center (PIRC), Research Institute for Children's Health (RICH), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Azimi
- Pediatric Infections Research Center (PIRC), Research Institute for Children's Health (RICH), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seddon James
- Centre for International Child Health, Department of Paediatrics, Imperial College London, London, UK
| | - Mahshid Nasehi
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mahnaz Sheikhi
- TB Coordinator of Deputy Health, Golestan University of Medical Sciences, Gorgan, Golestan, Iran
| | - Fatemeh Fallah
- Pediatric Infections Research Center (PIRC), Research Institute for Children's Health (RICH), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedigheh Rafiei Tabatabaei
- Pediatric Infections Research Center (PIRC), Research Institute for Children's Health (RICH), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh Mahsan Hoseini-Alfatemi
- Pediatric Infections Research Center (PIRC), Research Institute for Children's Health (RICH), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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IP-10 dried blood spots assay monitoring treatment efficacy in extrapulmonary tuberculosis in a low-resource setting. Sci Rep 2019; 9:3871. [PMID: 30846768 PMCID: PMC6405853 DOI: 10.1038/s41598-019-40458-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 02/12/2019] [Indexed: 12/17/2022] Open
Abstract
Treatment efficacy is difficult to evaluate in extrapulmonary tuberculosis (EPTB) patients. Interferon-γ inducible protein (IP-)10 has been suggested as a biomarker for response to treatment. We have investigated if IP-10 from dried plasma spots (DPS) or dried blood spots (DBS) can be used in treatment monitoring of EPTB patients in a low-resource setting of Zanzibar. IP-10 levels in plasma, DPS and DBS samples collected before, during (2 months) and after TB treatment of 36 EPTB patients (6 culture and/or Xpert MTB/RIF positive and 30 clinically diagnosed) and 8 pulmonary tuberculosis (PTB) patients, were quantified by an enzyme-linked immunosorbent assay. There was a high positive correlation between IP-10 measured in plasma and DPS and DBS, respectively. We found a significant decline in IP-10 levels from baseline to end of treatment in plasma, DPS and DBS, both in EPTB and PTB patients. The declines were observed already after 2 months in HIV negative patients. In conclusion, the DPS/DBS IP-10 assay allows for easy and manageable monitoring in low-resource settings and our findings suggest that IP-10 may serve as a biomarker for treatment efficacy in EPTB patients, albeit further studies in cohorts of patients with treatment failure and relapse are needed.
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Lu T, Han Y, Zhang R, Zhang K, Lin G, Li J. Quantitative detection of hepatitis C virus RNA in urine of patients with chronic hepatitis C using a novel real-time PCR assay. J Med Virol 2018; 91:115-123. [PMID: 30091789 DOI: 10.1002/jmv.25280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 08/06/2018] [Indexed: 11/09/2022]
Abstract
Hepatitis C virus (HCV) RNA can be detected in body fluids such as urine. However, because of deficiencies in established isolation and detection methods, the actual prevalence and form of HCV RNA in the urine of patients with hepatitis C remain unclear. To more sensitively and accurately measure urine HCV RNA levels, a novel real-time PCR assay with a modified isolation method and short amplicon designed for short HCV RNA fragments was developed in this study. The limit of detection, precision, linearity, and specificity of the assay was evaluated and demonstrated high-quality performance. The prevalence of HCV RNA in the urine of viremic patients infected with HCV was 60% (36/60), as determined by a 62-bp assay. The HCV RNA detection rate and concentration were much lower with a 157-bp assay, and were undetectable with 222- and 304-bp assays. With the 62-bp assay, patients with detectable urine HCV RNA had significantly higher plasma HCV RNA levels ( P < 0.001), and plasma and urine concentrations were significantly positively correlated ( R 2 = 0.708, P < 0.001). The method not only increased the detection rate of urine HCV RNA but also revealed the presence of short HCV RNA fragments in urine, indicating that urine from CHC patients with normal kidney function should not be infectious. In addition, it raised the possibility of urinary HCV RNA as a potential noninvasive marker for therapeutic monitoring of patients with hepatitis C.
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Affiliation(s)
- Tian Lu
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
| | - Yanxi Han
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
| | - Rui Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
| | - Kuo Zhang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
| | - Guigao Lin
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
| | - Jinming Li
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Beijing, China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
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10
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Petrone L, Bondet V, Vanini V, Cuzzi G, Palmieri F, Palucci I, Delogu G, Ciccosanti F, Fimia GM, Blauenfeldt T, Ruhwald M, Duffy D, Goletti D. First description of agonist and antagonist IP-10 in urine of patients with active TB. Int J Infect Dis 2018; 78:15-21. [PMID: 30201505 DOI: 10.1016/j.ijid.2018.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/31/2018] [Accepted: 09/03/2018] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES Biomarkers for tuberculosis (TB) diagnosis and clinical management are needed to defeat TB. In chronic hepatitis, patients not responding to interferon/ribavirin treatment had high levels of an antagonist form of IP-10. Recently, antagonist IP-10 has been shown to be involved also in TB pathogenesis. Here, we investigated IP-10 agonist/antagonist forms as potential inflammatory biomarkers to support TB diagnosis and monitoring. METHODS Total IP-10 and its agonist/antagonist forms were measured by SIMOA digital ELISA in urine obtained from patients with active TB at baseline and after treatment. Healthy donors (HD) and patients with pneumonia were enrolled as controls. RESULTS Patients with active TB had significantly higher levels of total and agonist IP-10 at baseline compared to HD; conversely, no differences were observed between IP-10 levels in active TB vs pneumonia. Moreover, in active TB a decline of total urine IP-10 was observed at therapy completion; agonist/antagonist forms reflected this decline although their differences were not statistically significant. CONCLUSIONS We showed for the first time that agonist/antagonist IP-10 forms are measurable in urine. IP-10 levels associate with TB and pneumonia disease, suggesting their association with acute inflammation. Further studies are needed to assess their role to monitor TB treatment efficacy.
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Affiliation(s)
- Linda Petrone
- Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI)-IRCCS, Rome, Italy
| | - Vincent Bondet
- Institut Pasteur, Laboratoire Immunobiologie des Cellules Dendritiques, Département d'Immunologie, Paris, France; INSERM U1223, Institut Pasteur, Paris, France
| | - Valentina Vanini
- Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI)-IRCCS, Rome, Italy
| | - Gilda Cuzzi
- Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI)-IRCCS, Rome, Italy
| | - Fabrizio Palmieri
- Respiratory Infectious Diseases Unit, "L. Spallanzani" National Institute for Infectious Diseases (INMI)-IRCCS, Rome, Italy
| | - Ivana Palucci
- Institute of Microbiology, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Roma - Università Cattolica del Sacro Cuore, Italy
| | - Giovanni Delogu
- Institute of Microbiology, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Roma - Università Cattolica del Sacro Cuore, Italy
| | - Fabiola Ciccosanti
- Department of Epidemiology and Preclinical Research, National Institutes for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, 00149, Italy
| | - Gian Maria Fimia
- Department of Epidemiology and Preclinical Research, National Institutes for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, 00149, Italy; Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali, University of Salento, Lecce, 73100, Italy
| | - Thomas Blauenfeldt
- Center for Vaccine Research, Statens Serum Institut, Artillerivej 5, 2300 S, Denmark
| | - Morten Ruhwald
- Center for Vaccine Research, Statens Serum Institut, Artillerivej 5, 2300 S, Denmark
| | - Darragh Duffy
- Institut Pasteur, Laboratoire Immunobiologie des Cellules Dendritiques, Département d'Immunologie, Paris, France; INSERM U1223, Institut Pasteur, Paris, France
| | - Delia Goletti
- Translational Research Unit, Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI)-IRCCS, Rome, Italy.
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11
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Petrone L, Vanini V, Chiacchio T, Petruccioli E, Cuzzi G, Schininà V, Palmieri F, Ippolito G, Goletti D. Evaluation of IP-10 in Quantiferon-Plus as biomarker for the diagnosis of latent tuberculosis infection. Tuberculosis (Edinb) 2018; 111:147-153. [PMID: 30029901 DOI: 10.1016/j.tube.2018.06.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/29/2018] [Accepted: 06/05/2018] [Indexed: 11/30/2022]
Abstract
The QuantiFERON-TB Gold Plus (QFT-Plus) is a new test for latent tuberculosis infection (LTBI) diagnosis, in which has been added a new tube containing shorter peptides stimulating CD8 T-cells and CD4-stimulating-peptides. Measurement of alternative biomarkers to Interferon-γ (IFN-γ) in QFT-Plus may improve its sensitivity. Interferon-γ inducible protein 10 (IP-10), has been proposed as a tuberculosis (TB) biomarker. We aimed to evaluate the IP-10 accuracy in QFT-Plus for LTBI diagnosis. QFT-Plus was performed in 36 active TB, 31 LTBI and 16 healthy donors (HD). IP-10 was detected by ELISA. IP-10 is increased in TB1 and TB2 tubes in subjects with active TB and LTBI compared to HD. A ROC analysis comparing active TB and HD was performed and a cut-off of 1174 pg/mL for TB1 and 928.8 pg/mL for TB2 identified active TB with 86% sensitivity (Se) and 94% specificity (Sp). Moreover, increased IP-10 in response to TB1 was found in subjects with LTBI compared to those with active TB. A cut-off point of ≥16,108 pg/mL was chosen to maximize the test performance. However, the test predicted LTBI only with 58% Se and 61% Sp. These results suggest that IP-10 is an alternative biomarker to IFN-γ in the QFT-Plus format.
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Affiliation(s)
- Linda Petrone
- Translational Research Unit, National Institute for Infectious Diseases "L.Spallanzani" (INMI), Via Portuense 292, 00149, Rome, Italy.
| | - Valentina Vanini
- Translational Research Unit, National Institute for Infectious Diseases "L.Spallanzani" (INMI), Via Portuense 292, 00149, Rome, Italy.
| | - Teresa Chiacchio
- Translational Research Unit, National Institute for Infectious Diseases "L.Spallanzani" (INMI), Via Portuense 292, 00149, Rome, Italy.
| | - Elisa Petruccioli
- Translational Research Unit, National Institute for Infectious Diseases "L.Spallanzani" (INMI), Via Portuense 292, 00149, Rome, Italy.
| | - Gilda Cuzzi
- Translational Research Unit, National Institute for Infectious Diseases "L.Spallanzani" (INMI), Via Portuense 292, 00149, Rome, Italy.
| | | | | | | | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases "L.Spallanzani" (INMI), Via Portuense 292, 00149, Rome, Italy.
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12
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Zhao Y, Yang X, Zhang X, Yu Q, Zhao P, Wang J, Duan C, Li J, Johnson H, Feng X, Zhang H. IP-10 and RANTES as biomarkers for pulmonary tuberculosis diagnosis and monitoring. Tuberculosis (Edinb) 2018; 111:45-53. [PMID: 30029914 DOI: 10.1016/j.tube.2018.05.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/20/2018] [Accepted: 05/12/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE We aimed to determine whether IP-10 and RANTES plasma levels can be used in diagnosis and monitoring of pulmonary tuberculosis (PTB). METHODS Plasma levels of cytokines/chemokines were measured using a Bio-Plex® multiplex cytokine assay system in a cohort containing 457 clinically suspected PTB patients including a training set (n = 41)and two independent test sets A (n = 242) and B (n = 174). RESULTS Plasma levels of IP-10 and RANTES were significantly higher in PTB patients than healthy controls' in both training and independent test sets (P < 0.05). Compared with other combinations, the combination of IP-10 and RANTES had the best performance with an AUC of 1.0 in training set. The performance characteristic of this model was successfully validated in independent test set A although this combination only resulted in a slightly improvement of AUC value in independent test set B. Plasma IP-10 and RANTES levels were weakly and positively correlated with blood glucose concentrations. Moreover, IP-10 levels were positively correlated with CRP and ESR in PTB patients. Furthermore, in response to therapy, both IP-10 and RANTES levels significantly decreased over the period of 6 months (P < 0.001). CONCLUSIONS Taken together, combination of IP-10 and RANTES could be potentially used as diagnostic and monitoring biomarker in PTB management.
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Affiliation(s)
- Yanfeng Zhao
- Department of Bio-diagnosis, Institute of Basic Medical Sciences, 27, Taiping Road, Beijing, 100850, China; Beijing Research Institute for Tuberculosis Control, No 5, Dongguang Hutong, Xinjiekou, Beijing, 100035, China
| | - Xiqin Yang
- Department of Bio-diagnosis, Institute of Basic Medical Sciences, 27, Taiping Road, Beijing, 100850, China
| | - Xuhui Zhang
- Department of Bio-diagnosis, Institute of Basic Medical Sciences, 27, Taiping Road, Beijing, 100850, China
| | - Qin Yu
- Chaoyang District Center for Disease Control and Prevention, 25 Panjiayuan, Huaweili, Beijing, 100029, China
| | - Ping Zhao
- Chaoyang District Center for Disease Control and Prevention, 25 Panjiayuan, Huaweili, Beijing, 100029, China
| | - Jianxia Wang
- Department of Bio-diagnosis, Institute of Basic Medical Sciences, 27, Taiping Road, Beijing, 100850, China
| | - Cuimi Duan
- Department of Bio-diagnosis, Institute of Basic Medical Sciences, 27, Taiping Road, Beijing, 100850, China
| | - Jiangxue Li
- Department of Bio-diagnosis, Institute of Basic Medical Sciences, 27, Taiping Road, Beijing, 100850, China
| | | | - Xiaoyan Feng
- Department of Bio-diagnosis, Institute of Basic Medical Sciences, 27, Taiping Road, Beijing, 100850, China.
| | - Heqiu Zhang
- Department of Bio-diagnosis, Institute of Basic Medical Sciences, 27, Taiping Road, Beijing, 100850, China.
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13
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Goletti D, Lee MR, Wang JY, Walter N, Ottenhoff THM. Update on tuberculosis biomarkers: From correlates of risk, to correlates of active disease and of cure from disease. Respirology 2018; 23:455-466. [PMID: 29457312 DOI: 10.1111/resp.13272] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 12/18/2017] [Accepted: 01/22/2018] [Indexed: 12/23/2022]
Abstract
Tuberculosis (TB) remains a devastating disease, yet despite its enormous toll on global health, tools to control TB are insufficient and often outdated. TB Biomarkers (TB-BM) would constitute extremely useful tools to measure infection status and predict outcome of infection, vaccination or therapy. There are several types of TB-BM: Correlate of Infection; Correlate of TB Disease; Correlate of Increased Risk of Developing Active TB Disease; Correlate of the Curative Response to Therapy; and Correlate of Protection (CoP). Most TB-BM currently studied are host-derived BM, and consist of transcriptomic, proteomic, metabolomic, cellular markers or marker combinations ('signatures'). In particular, vaccine-inducible CoP are expected to be transformative in developing new TB vaccines as they will de-risk vaccine research and development (R&D) as well as human testing at an early stage. In addition, CoP could also help minimizing the need for preclinical studies in experimental animals. Of key importance is that TB-BM are tested and validated in different well-characterized human TB cohorts, preferably with complementary profiles and geographically diverse populations: genetic and environmental factors such as (viral) coinfections, exposure to non-tuberculous mycobacteria, nutritional status, metabolic status, age (infants vs children vs adolescents vs adults) and other factors impact host immune set points and host responses across different populations. In this study, we review the most recent advances in research into TB-BM for the diagnosis of active TB, risk of TB development and treatment-induced TB cure.
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Affiliation(s)
- Delia Goletti
- Translational Research Unit, Department of Epidemiology and Preclinical Research, National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy
| | - Meng-Rui Lee
- Department of Internal Medicine, National Taiwan University Hospital, Hsinchu, Taiwan
| | - Jann-Yuan Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Nicholas Walter
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Tom H M Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
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14
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Villar-Hernández R, Latorre I, Mínguez S, Díaz J, García-García E, Muriel-Moreno B, Lacoma A, Prat C, Olivé A, Ruhwald M, Mateo L, Domínguez J. Use of IFN-γ and IP-10 detection in the diagnosis of latent tuberculosis infection in patients with inflammatory rheumatic diseases. J Infect 2017; 75:315-325. [PMID: 28751171 DOI: 10.1016/j.jinf.2017.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Biologic agents are used against rheumatic diseases, however, they increase the risk of developing severe infections and diseases such as tuberculosis. We aimed to determine the benefits of IP-10 detection to diagnose latent tuberculosis infection (LTBI) in patients with inflammatory rheumatic diseases on different immunosuppressive drug regimens, and compare these results with IFN-γ detection. MATERIALS AND METHODS We included 64 patients with inflammatory rheumatic diseases. We used QuantiFERON Gold In-Tube (QFN-G-IT) and T-SPOT.TB to detect IFN-γ production, and an in-house ELISA for IP-10 detection from the previous QFN-G-IT stimulated samples. We assessed the combined use of IFN-γ release assays (IGRAs) and IP-10 test, and analyzed the influence of immunotherapy on the tests performance. RESULTS We obtained 34.9% positive results by T-SPOT.TB, 25.0% by QFN-G-IT and 31.3% by IP-10 test. The combined use of IGRAs and IP-10 detection increased significantly the amount of positive results (p < 0.0001). Treatment intake had no significant effect on in vitro tests (p > 0.05). CONCLUSIONS IP-10 and IFN-γ detection is comparable and their combined use could increase the number of positive results in the diagnosis of LTBI in rheumatic patients. The tested assays were not influenced by rheumatoid immunosuppressive therapy. Thus, IP-10 could be of use in the development of new and improved LTBI diagnostic tools.
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Affiliation(s)
- Raquel Villar-Hernández
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol. CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Carretera del Canyet, 08916, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Carretera del Canyet, 08916, Badalona, Barcelona, Spain
| | - Irene Latorre
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol. CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Carretera del Canyet, 08916, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Carretera del Canyet, 08916, Badalona, Barcelona, Spain
| | - Sonia Mínguez
- Servei de Reumatología, Hospital Germans Trias i Pujol, Carretera del Canyet, 08916, Badalona, Barcelona, Spain
| | - Jéssica Díaz
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol. CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Carretera del Canyet, 08916, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Carretera del Canyet, 08916, Badalona, Barcelona, Spain
| | - Esther García-García
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol. CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Carretera del Canyet, 08916, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Carretera del Canyet, 08916, Badalona, Barcelona, Spain
| | - Beatriz Muriel-Moreno
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol. CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Carretera del Canyet, 08916, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Carretera del Canyet, 08916, Badalona, Barcelona, Spain
| | - Alicia Lacoma
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol. CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Carretera del Canyet, 08916, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Carretera del Canyet, 08916, Badalona, Barcelona, Spain
| | - Cristina Prat
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol. CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Carretera del Canyet, 08916, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Carretera del Canyet, 08916, Badalona, Barcelona, Spain
| | - Alex Olivé
- Universitat Autònoma de Barcelona, Carretera del Canyet, 08916, Badalona, Barcelona, Spain; Servei de Reumatología, Hospital Germans Trias i Pujol, Carretera del Canyet, 08916, Badalona, Barcelona, Spain
| | - Morten Ruhwald
- Department of Infectious Disease Immunology Statens Serum Institut, Artillerivej 5, 2300, København S, Copenhagen, Denmark
| | - Lourdes Mateo
- Universitat Autònoma de Barcelona, Carretera del Canyet, 08916, Badalona, Barcelona, Spain; Servei de Reumatología, Hospital Germans Trias i Pujol, Carretera del Canyet, 08916, Badalona, Barcelona, Spain
| | - José Domínguez
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol. CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Carretera del Canyet, 08916, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Carretera del Canyet, 08916, Badalona, Barcelona, Spain.
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15
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Shiratori B, Zhao J, Okumura M, Chagan-Yasutan H, Yanai H, Mizuno K, Yoshiyama T, Idei T, Ashino Y, Nakajima C, Suzuki Y, Hattori T. Immunological Roles of Elevated Plasma Levels of Matricellular Proteins in Japanese Patients with Pulmonary Tuberculosis. Int J Mol Sci 2016; 18:ijms18010019. [PMID: 28025511 PMCID: PMC5297654 DOI: 10.3390/ijms18010019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 12/16/2016] [Accepted: 12/16/2016] [Indexed: 01/17/2023] Open
Abstract
Elevated matricellular proteins (MCPs), including osteopontin (OPN) and galectin-9 (Gal-9), were observed in the plasma of patients with Manila-type tuberculosis (TB) previously. Here, we quantified plasma OPN, Gal-9, and soluble CD44 (sCD44) by enzyme-linked immunosorbent assay (ELISA), and another 29 cytokines by Luminex assay in 36 patients with pulmonary TB, six subjects with latent tuberculosis (LTBI), and 19 healthy controls (HCs) from Japan for a better understanding of the roles of MCPs in TB. All TB subjects showed positive results of enzyme-linked immunospot assays (ELISPOTs). Spoligotyping showed that 20 out of 36 Mycobacterium tuberculosis (MTB) strains belong to the Beijing type. The levels of OPN, Gal-9, and sCD44 were higher in TB (positivity of 61.1%, 66.7%, and 63.9%, respectively) than in the HCs. Positive correlations between OPN and Gal-9, between OPN and sCD44, and negative correlation between OPN and ESAT-6-ELISPOT response, between chest X-ray severity score of cavitary TB and ESAT-6-ELISPOT response were observed. Instead of OPN, Gal-9, and sCD44, cytokines G-CSF, GM-CSF, IFN-α, IFN-γ, IL-12p70, and IL-1RA levels were higher in Beijing MTB-infected patients. These findings suggest immunoregulatory, rather than inflammatory, effect of MCPs and can advance the understanding of the roles of MCPs in the context of TB pathology.
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Affiliation(s)
- Beata Shiratori
- Division of Disaster-Related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
| | - Jingge Zhao
- Division of Disaster-Related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
| | - Masao Okumura
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo 204-8533, Japan.
| | - Haorile Chagan-Yasutan
- Division of Disaster-Related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
| | - Hideki Yanai
- Department of Clinical Laboratory, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-2 4 Matsuyama, Kiyose, Tokyo 204-8533, Japan.
| | - Kazue Mizuno
- Department of Clinical Laboratory, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-2 4 Matsuyama, Kiyose, Tokyo 204-8533, Japan.
| | - Takashi Yoshiyama
- Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo 204-8533, Japan.
| | - Tadashi Idei
- Department of Clinical Laboratory, Fukujuji Hospital, Japan Anti-Tuberculosis Association, 3-1-2 4 Matsuyama, Kiyose, Tokyo 204-8533, Japan.
| | - Yugo Ashino
- Division of Disaster-Related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
| | - Chie Nakajima
- Division of Global Epidemiology, Research Center for Zoonosis Control, Hokkaido University, North 20, West 10, Kita-ku, Sapporo, Hokkaido 001-0020, Japan.
| | - Yasuhiko Suzuki
- Division of Global Epidemiology, Research Center for Zoonosis Control, Hokkaido University, North 20, West 10, Kita-ku, Sapporo, Hokkaido 001-0020, Japan.
| | - Toshio Hattori
- Department of Health Science and Social Welfare, Kibi International University, 8 Igamachi, Takahashi 716-8508, Japan.
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16
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El-Gohary A, Hegazy A, Abbas M, Kamel N, Nasef SI. Serum and Urinary Interferon-Gamma-Inducible Protein 10 in Lupus Nephritis. J Clin Lab Anal 2016; 30:1135-1138. [PMID: 27184880 DOI: 10.1002/jcla.21993] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 04/13/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Lupus nephritis is a serious manifestation of systemic lupus erythematosus (SLE). The objective of this study was to identify the sensitivity, specificity, and cut-off values of IP-10 in the serum and urine of patients with lupus nephritis compared to renal biopsy, albumin/creatinine ratio, and serum anti-dsDNA. METHODS Thirty female SLE patients were included. SLEDAI was calculated and blood and urine samples were collected. Patients were divided into 10 SLE patients with renal involvement (six active and four inactive), 10 active SLE, and 10 inactive SLE patients. Ten age-matched healthy (control) were included. Serum and urinary levels of IP-10 were measured by ELISA. Anti-dsDNA, urine albumin/creatinine ratio were performed. RESULTS Serum and urinary IP-10 in active SLE patients had significantly increased levels as compared to inactive SLE patients (P = 0.015, P = 0.033, respectively). However, there was no difference in serum and urinary levels between active renal and active non-renal patients. Albumin/creatinine ratio is a better marker in differentiating between lupus nephritis and SLE with no renal involvement. Any of serum and urinary IP-10, albumin/creatinine ratio, and anti-dsDNA did not correlate with the class of lupus nephritis in renal biopsy. CONCLUSION Urinary and serum IP-10 are useful markers of lupus activity, but not indicative of renal activity. Albumin/creatinine ratio is superior in identifying lupus nephritis and renal activity.
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Affiliation(s)
- Ahmed El-Gohary
- Clinical Pathology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Ann Hegazy
- Clinical Pathology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Mostafa Abbas
- Community medicine and Public Health Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Noha Kamel
- Clinical Pathology Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Samah Ismail Nasef
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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17
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Exploratory urinary metabolomics of type 1 leprosy reactions. Int J Infect Dis 2016; 45:46-52. [PMID: 26923082 DOI: 10.1016/j.ijid.2016.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 02/12/2016] [Accepted: 02/16/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Leprosy is an infectious disease caused by Mycobacterium leprae that affects the skin and nerves. Although curable with multidrug therapy, leprosy is complicated by acute inflammatory episodes called reactions, which are the major causes of irreversible neuropathy in leprosy that occur before, during, and even after treatment. Early diagnosis and prompt treatment of reactions reduces the risk of permanent disability. METHODS This exploratory study investigated whether urinary metabolic profiles could be identified that correlate with early signs of reversal reactions (RR). A prospective cohort of leprosy patients with and without reactions and endemic controls was recruited in Nepal. Urine-derived metabolic profiles were measured longitudinally. Thus, a conventional area of biomarker identification for leprosy was extended to non-invasive urine testing. RESULTS It was found that the urinary metabolome could be used to discriminate endemic controls from untreated patients with mycobacterial disease. Moreover, metabolic signatures in the urine of patients developing RR were clearly different before RR onset compared to those at RR diagnosis. CONCLUSIONS This study indicates that urinary metabolic profiles are promising host biomarkers for the detection of intra-individual changes during acute inflammation in leprosy and could contribute to early treatment and prevention of tissue damage.
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18
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De P, Amin AG, Valli E, Perkins MD, McNeil M, Chatterjee D. Estimation of D-Arabinose by Gas Chromatography/Mass Spectrometry as Surrogate for Mycobacterial Lipoarabinomannan in Human Urine. PLoS One 2015; 10:e0144088. [PMID: 26633829 PMCID: PMC4669150 DOI: 10.1371/journal.pone.0144088] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 11/12/2015] [Indexed: 11/22/2022] Open
Abstract
Globally, tuberculosis is slowly declining each year and it is estimated that 37 million lives were saved between 2000 and 2013 through effective diagnosis and treatment. Currently, diagnosis relies on demonstration of the bacteria, Mycobacterium tuberculosis (Mtb), in clinical specimens by serial sputum microscopy, culture and molecular testing. Commercial immunoassay lateral flow kits developed to detect Mtb lipoglycan lipoarabinomannan (LAM) in urine as a marker of active TB exhibit poor sensitivity, especially in immunocompetent individuals, perhaps due to low abundance of the analyte. Our present study was designed to develop methods to validate the presence of LAM in a quantitative fashion in human urine samples obtained from culture-confirmed TB patients. Herein we describe, a consolidated approach for isolating LAM from the urine and quantifying D-arabinose as a proxy for LAM, using Gas Chromatography/Mass Spectrometry. 298 urine samples obtained from a repository were rigorously analyzed and shown to contain varying amounts of LAM-equivalent ranging between ~10-40 ng/mL. To further substantiate that D-arabinose detected in the samples originated from LAM, tuberculostearic acid, the unique 10-methyloctadecanoic acid present at the phosphatidylinositol end of LAM was also analyzed in a set of samples and found to be present confirming that the D-arabinose was indeed derived from LAM. Among the 144 samples from culture-negative TB suspects, 30 showed presence of D-arabinose suggesting another source of the analyte, such as disseminated TB or from non-tuberculosis mycobacterium. Our work validates that LAM is present in the urine samples of culture-positive patients in small but readily detectable amounts. The study further substantiates LAM in urine as a powerful biomarker for active tuberculosis.
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Affiliation(s)
- Prithwiraj De
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, 1682 Campus Delivery, Fort Collins, Colorado, 80523, United States of America
| | - Anita G. Amin
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, 1682 Campus Delivery, Fort Collins, Colorado, 80523, United States of America
| | - Eloise Valli
- Foundation for Innovative New Diagnostics (FIND), Chemin des Mines 9, 1202, Genève, Switzerland
| | - Mark D. Perkins
- Foundation for Innovative New Diagnostics (FIND), Chemin des Mines 9, 1202, Genève, Switzerland
| | - Michael McNeil
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, 1682 Campus Delivery, Fort Collins, Colorado, 80523, United States of America
| | - Delphi Chatterjee
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology and Pathology, Colorado State University, 1682 Campus Delivery, Fort Collins, Colorado, 80523, United States of America
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19
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Petrone L, Vanini V, Petruccioli E, Ettorre GM, Schininà V, Busi Rizzi E, Ludovisi A, Corpolongo A, Ippolito G, Pozio E, Teggi A, Goletti D. Polyfunctional Specific Response to Echinococcus Granulosus Associates to the Biological Activity of the Cysts. PLoS Negl Trop Dis 2015; 9:e0004209. [PMID: 26575186 PMCID: PMC4648505 DOI: 10.1371/journal.pntd.0004209] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/13/2015] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) is a complex disease caused by Echinococcus granulosus (E.granulosus), and its immunophatogenesis is still not clearly defined. A peculiar feature of chronic CE is the coexistence of Th1 and Th2 responses. It has been suggested that Th1 cytokines are related to disease resistance, whereas Th2 cytokines are related to disease susceptibility and chronicity. The aim of this study was to evaluate, by multi-parametric flow cytometry (FACS), the presence of CE specific immune signatures. METHODOLOGY/PRINCIPAL FINDINGS We enrolled 54 subjects with suspected CE; 42 of them had a confirmed diagnosis, whereas 12 were classified as NO-CE. Based on the ultrasonography images, CE patients were further categorized as being in "active stages" (25) and "inactive stages" (17). The ability of CD4+ T-cells to produce IFN-γ, IL-2, TNF-α, Th2 cytokines or IL-10 was assessed by FACS on antigen-specific T-cells after overnight stimulation with Antigen B (AgB) of E.granulosus. Cytokine profiles were evaluated in all the enrolled subjects. The results show that none of the NO-CE subjects had a detectable AgB-specific response. Among the CE patients, the frequency and proportions of AgB-specific CD4+ T-cells producing IL-2+TNF-α+Th2+ or TNF-α+Th2+ were significantly increased in the "active stages" group compared to the "inactive stages" group. Moreover, an increased proportion of the total polyfunctional subsets, as triple-and double-functional CD4 T-cells, was found in CE patients with active disease. The response to the mitogen, used as a control stimulus to evaluate the immune competence status, was characterized by the same cytokine subsets in all the subjects enrolled, independent of CE. CONCLUSIONS We demonstrate, for the first time to our knowledge, that polyfunctional T-cell subsets as IL-2+TNF-α+Th2+ triple-positive and TNF-α+Th2+ double-positive specific T-cells associate with cyst biological activity. These results contribute to increase knowledge of CE immunophatogenesis and the disease outcome in terms of control and persistence.
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Affiliation(s)
- Linda Petrone
- Translational Research Unit Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), Rome, Italy
| | - Valentina Vanini
- Translational Research Unit Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), Rome, Italy
| | - Elisa Petruccioli
- Translational Research Unit Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), Rome, Italy
| | - Giuseppe Maria Ettorre
- Unit of Surgery and Transplantation "Interaziendale" Department, P.O.I.T., Polo Ospedaliero Interaziendale San Camillo-INMI Lazzaro Spallanzani, Rome, Italy
| | - Vincenzo Schininà
- Department of Radiology, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Elisa Busi Rizzi
- Department of Radiology, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Alessandra Ludovisi
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità (ISS), IRCCS, Rome, Italy
| | - Angela Corpolongo
- Clinical Department, National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Giuseppe Ippolito
- Scientific Direction, National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Edoardo Pozio
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità (ISS), IRCCS, Rome, Italy
| | - Antonella Teggi
- Department of Infectious and Tropical Diseases, Sant'Andrea Hospital, "Sapienza" University, Rome, Italy
| | - Delia Goletti
- Translational Research Unit Department of Epidemiology and Preclinical Research, "L. Spallanzani" National Institute for Infectious Diseases (INMI), Rome, Italy
- * E-mail:
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Blood or Urine IP-10 Cannot Discriminate between Active Tuberculosis and Respiratory Diseases Different from Tuberculosis in Children. BIOMED RESEARCH INTERNATIONAL 2015; 2015:589471. [PMID: 26346028 PMCID: PMC4540955 DOI: 10.1155/2015/589471] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/08/2015] [Accepted: 07/14/2015] [Indexed: 01/01/2023]
Abstract
Objectives. Interferon-γ inducible protein 10 (IP-10), either in blood or in urine, has been proposed as a tuberculosis (TB) biomarker for adults. This study aims to evaluate the potential of IP-10 diagnostics in children from Uganda, a high TB-endemic country. Methods. IP-10 was measured in the blood and urine concomitantly taken from children who were prospectively enrolled with suspected active TB, with or without HIV infection. Clinical/microbiological parameters and commercially available TB-immune assays (tuberculin skin test (TST) and QuantiFERON TB-Gold In-Tube (QFT-IT)) were concomitantly evaluated. Results. One hundred twenty-eight children were prospectively enrolled. The analysis was performed on 111 children: 80 (72%) of them were HIV-uninfected and 31 (27.9%) were HIV-infected. Thirty-three healthy adult donors (HAD) were included as controls. The data showed that IP-10 is detectable in the urine and blood of children with active TB, independent of HIV status and age. However, although IP-10 levels were higher in active TB children compared to HAD, the accuracy of identifying “active TB” was low and similar to the TST and QFT-IT. Conclusion. IP-10 levels are higher in children with respiratory illness compared to controls, independent of “TB status” suggesting that the evaluation of this parameter can be used as an inflammatory marker more than a TB test.
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Wergeland I, Pullar N, Assmus J, Ueland T, Tonby K, Feruglio S, Kvale D, Damås JK, Aukrust P, Mollnes TE, Dyrhol-Riise AM. IP-10 differentiates between active and latent tuberculosis irrespective of HIV status and declines during therapy. J Infect 2015; 70:381-91. [PMID: 25597826 DOI: 10.1016/j.jinf.2014.12.019] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 12/15/2014] [Accepted: 12/17/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Biomarkers for diagnosis and therapy efficacy in tuberculosis (TB) are requested. We have studied biomarkers that may differentiate between active and latent TB infection (LTBI), the influence of HIV infection and changes during anti-TB chemotherapy. METHODS Thirty-eight plasma cytokines, assessed by multiplex and enzyme immunoassays, were analyzed in patients with active TB before and during 24 weeks of anti-TB chemotherapy (n = 65), from individuals with LTBI (n = 34) and from QuantiFERON-TB (QFT) negative controls (n = 65). The study participants were grouped according to HIV status. RESULTS Plasma levels of the CXC chemokine IP-10 and soluble TNF receptor type 2 (sTNFr2) significantly differentiated active TB from the LTBI group, irrespective of HIV status. In the HIV-infected group the sensitivity and specificity was 100% for IP-10 with a cut-off of 2547 pg/mL. Plasma IP-10 declined gradually during anti-TB chemotherapy (12-24 weeks, p = 0.002) to a level comparable to LTBI and QFT negative control groups. sTNFr2 fluctuated throughout therapy, but was decreased after 12-24 weeks (p = 0.006). CONCLUSIONS IP-10 distinguished with high accuracy active TB from LTBI irrespective of HIV infection and declined during anti-TB chemotherapy. Plasma IP-10 may serve as a diagnostic biomarker to differentiate between the stages of TB infection and for monitoring therapy efficacy.
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Affiliation(s)
- I Wergeland
- Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
| | - N Pullar
- Department of Internal Medicine, Section for Infectious Diseases, University Hospital of Northern Norway, N-9038 Tromsø, Norway; Department of Clinical Medicine, University of Tromsø, N-9037 Tromsø, Norway
| | - J Assmus
- Center for Clinical Research, Haukeland University Hospital, N-5020 Bergen, Norway
| | - T Ueland
- Institute of Clinical Medicine and K.G. Jebsen IRC, University of Oslo, N-0424 Oslo, Norway; Research Institute of Internal Medicine, Oslo University Hospital, N-0424 Oslo, Norway
| | - K Tonby
- Institute of Clinical Medicine and K.G. Jebsen IRC, University of Oslo, N-0424 Oslo, Norway
| | - S Feruglio
- Institute of Clinical Medicine and K.G. Jebsen IRC, University of Oslo, N-0424 Oslo, Norway
| | - D Kvale
- Institute of Clinical Medicine and K.G. Jebsen IRC, University of Oslo, N-0424 Oslo, Norway; Department of Infectious Diseases, Oslo University Hospital, N-0424 Oslo, Norway
| | - J K Damås
- Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway; Department of Infectious Diseases, St Olav's Hospital, Trondheim, Norway
| | - P Aukrust
- Institute of Clinical Medicine and K.G. Jebsen IRC, University of Oslo, N-0424 Oslo, Norway; Research Institute of Internal Medicine, Oslo University Hospital, N-0424 Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, N-0424 Oslo, Norway
| | - T E Mollnes
- Institute of Clinical Medicine and K.G. Jebsen IRC, University of Oslo, N-0424 Oslo, Norway; Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway; Research Laboratory, Nordland Hospital, Bodø, and Faculty of Health Sciences, K.G. Jebsen TREC, University of Tromsø, Tromsø, Norway
| | - A M Dyrhol-Riise
- Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway; Institute of Clinical Medicine and K.G. Jebsen IRC, University of Oslo, N-0424 Oslo, Norway; Department of Infectious Diseases, Oslo University Hospital, N-0424 Oslo, Norway.
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IL-4 specific-response in whole blood associates with human Cystic Echinococcosis and cyst activity. J Infect 2014; 70:299-306. [PMID: 25444973 DOI: 10.1016/j.jinf.2014.10.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 09/15/2014] [Accepted: 10/17/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Human Cystic Echinococcosis (CE) is estimated in 2-3 million global cases. CE diagnosis and clinical management are based on imaging and serology, which lacks sensitivity and does not provide cyst stage information. This study aimed to evaluate tools for improving diagnosis by analysing the Interleukin (IL)-4-response to Antigen B (AgB) of Echinococcus granulosus. METHODS Whole blood (WB) and peripheral blood mononuclear cells were stimulated with AgB. IL-4 levels were measured by enzyme-linked immunosorbent assay. RESULTS WB 1-day stimulation resulted the best experimental condition for evaluating AgB IL-4-response. IL-4 levels were significantly higher in CE patients than healthy donors (p ≤ 0.0001). A ROC analysis showed significant area under the curve (AUC) results (AUC, 0.85; p = 0.0001) identifying an IL-4 level cut-off point ≥0.39 pg/mL which predicted CE with 71.4% sensitivity and 93.3% specificity. Moreover, we found that IL-4 levels were significantly increased in patients with active cysts compared to those with inactive cysts (p ≤ 0.0001). ROC analysis showed significant AUC results (0.94; p = 0.0001) with a cut-off point of 4.6 pg/mL which predicted active cysts with 84.6% sensitivity and 92% specificity. CONCLUSIONS We found immunological correlates associated with CE and biological cyst activity.
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Latorre I, Díaz J, Mialdea I, Serra-Vidal M, Altet N, Prat C, Díez N, Escribano A, Casas I, Rodrigo C, Ausina V, Ruhwald M, Domínguez J. IP-10 is an accurate biomarker for the diagnosis of tuberculosis in children. J Infect 2014; 69:590-9. [PMID: 24975172 DOI: 10.1016/j.jinf.2014.06.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/14/2014] [Accepted: 06/03/2014] [Indexed: 01/29/2023]
Abstract
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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Affiliation(s)
- I Latorre
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Spain
| | - J Díaz
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Spain
| | - I Mialdea
- Unidad de Neumología Infantil, Hospital Clínico Universitario Valencia, Universidad de Valencia, Spain
| | - M Serra-Vidal
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Spain
| | - N Altet
- Unidad de Prevención y Control de la Tuberculosis de Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - C Prat
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Spain
| | - N Díez
- Unidad de Neumología Infantil, Hospital Clínico Universitario Valencia, Universidad de Valencia, Spain
| | - A Escribano
- Unidad de Neumología Infantil, Hospital Clínico Universitario Valencia, Universidad de Valencia, Spain
| | - I Casas
- Servei de Medicina Preventiva, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - C Rodrigo
- Universitat Autònoma de Barcelona, Bellaterra, Spain; Servei de Pediatria, Hospital Universitari Germans Trias I Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain
| | - V Ausina
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Spain
| | - M Ruhwald
- Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - J Domínguez
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Spain.
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