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Li P, Wang J, Tang M, Li M, Han R, Zhou S, Wu X, Wang R. A CT-based radiomics predictive nomogram to identify pulmonary tuberculosis from community-acquired pneumonia: a multicenter cohort study. Front Cell Infect Microbiol 2024; 14:1388991. [PMID: 39364148 PMCID: PMC11446906 DOI: 10.3389/fcimb.2024.1388991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 08/30/2024] [Indexed: 10/05/2024] Open
Abstract
Purpose To develop a predictive nomogram based on computed tomography (CT) radiomics to distinguish pulmonary tuberculosis (PTB) from community-acquired pneumonia (CAP). Methods A total of 195 PTB patients and 163 CAP patients were enrolled from three hospitals. It is divided into a training cohort, a testing cohort and validation cohort. Clinical models were established by using significantly correlated clinical features. Radiomics features were screened by the least absolute shrinkage and selection operator (LASSO) algorithm. Radiomics scores (Radscore) were calculated from the formula of radiomics features. Clinical radiomics conjoint nomogram was established according to Radscore and clinical features, and the diagnostic performance of the model was evaluated by receiver operating characteristic (ROC) curve analysis. Results Two clinical features and 12 radiomic features were selected as optimal predictors for the establishment of clinical radiomics conjoint nomogram. The results showed that the predictive nomogram had an outstanding ability to discriminate between the two diseases, and the AUC of the training cohort was 0.947 (95% CI, 0.916-0.979), testing cohort was 0.888 (95% CI, 0.814-0.961) and that of the validation cohort was 0.850 (95% CI, 0.778-0.922). Decision curve analysis (DCA) indicated that the nomogram has outstanding clinical value. Conclusions This study developed a clinical radiomics model that uses radiomics features to identify PTB from CAP. This model provides valuable guidance to clinicians in identifying PTB.
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Affiliation(s)
- Pulin Li
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jiling Wang
- Department of Infectious Disease, Hefei Second People’s Hospital, Hefei, China
| | - Min Tang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Min Li
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Rui Han
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Sijing Zhou
- Department of Occupational Disease, Hefei Third Clinical College of Anhui Medical University, Hefei, China
| | - Xingwang Wu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ran Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Lu R, Ang YS, Cheung KW, Quek KY, Sin WX, Lee E, Lim SL, Yung LYL, Birnbaum ME, Han J, Cheow LF, Zeming KK. iSECRETE: Integrating Microfluidics and DNA Proximity Amplification for Synchronous Single-Cell Activation and IFN-γ Secretion Profiling. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024:e2309920. [PMID: 39175207 DOI: 10.1002/advs.202309920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 06/27/2024] [Indexed: 08/24/2024]
Abstract
Cytokines, crucial in immune modulation, impact disease progression when their secretion is dysregulated. Existing methods for profiling cytokine secretion suffer from time-consuming and labor-intensive processes and often fail to capture the dynamic nature of immune responses. Here, iSECRETE, an integrated platform that enables synchronous cell activation, wash-free, and target-responsive protein detection for single-cell IFN-γ cytokine secretion analysis within 30 min at room temperature is presented. By incorporating a DNA proximity assay (DPA) into a multifunctional microfluidic system, one-pot homogenous cytokine signal amplification, with a limit of detection of ≈50 secreted molecules per cell is achieved. iSECRETE can robustly handle various sample types that are shown. Two distinct immune activation assay modalities are demonstrated on iSECRETE. Finally, the detection of single-cell IFN-γ secretion as an activation hallmark of chimeric antigen receptor T cells within 6 h of exposure to cancer targets is shown. iSECRETE represents the fastest single-cell sample-to-result cytokine secretion assay to date, providing a powerful tool for advancing the understanding of biological phenotypes, functions, and pathways under in vivo-like conditions.
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Affiliation(s)
- Ri Lu
- Critical Analytics for Manufacturing of Personalised Medicine IRG, Singapore-MIT Alliance for Research and Technology, Singapore, 138602, Singapore
- Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, 119077, Singapore
| | - Yan Shan Ang
- Department of Chemical and Biomolecular Engineering, National University of Singapore, Singapore, 117585, Singapore
| | - Ka-Wai Cheung
- Critical Analytics for Manufacturing of Personalised Medicine IRG, Singapore-MIT Alliance for Research and Technology, Singapore, 138602, Singapore
| | - Kai Yun Quek
- Critical Analytics for Manufacturing of Personalised Medicine IRG, Singapore-MIT Alliance for Research and Technology, Singapore, 138602, Singapore
| | - Wei-Xiang Sin
- Critical Analytics for Manufacturing of Personalised Medicine IRG, Singapore-MIT Alliance for Research and Technology, Singapore, 138602, Singapore
| | - Elizabeth Lee
- Critical Analytics for Manufacturing of Personalised Medicine IRG, Singapore-MIT Alliance for Research and Technology, Singapore, 138602, Singapore
| | - Shir Lynn Lim
- National University Health System, National University Hospital, Singapore, 119228, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
| | - Lin-Yue Lanry Yung
- Department of Chemical and Biomolecular Engineering, National University of Singapore, Singapore, 117585, Singapore
| | - Michael E Birnbaum
- Critical Analytics for Manufacturing of Personalised Medicine IRG, Singapore-MIT Alliance for Research and Technology, Singapore, 138602, Singapore
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Jongyoon Han
- Critical Analytics for Manufacturing of Personalised Medicine IRG, Singapore-MIT Alliance for Research and Technology, Singapore, 138602, Singapore
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Department of Electrical Engineering, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Lih Feng Cheow
- Critical Analytics for Manufacturing of Personalised Medicine IRG, Singapore-MIT Alliance for Research and Technology, Singapore, 138602, Singapore
- Department of Biomedical Engineering, National University of Singapore, Singapore, 117583, Singapore
| | - Kerwin Kwek Zeming
- Critical Analytics for Manufacturing of Personalised Medicine IRG, Singapore-MIT Alliance for Research and Technology, Singapore, 138602, Singapore
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Yu Z, Shang Z, Huang Q, Wen F, Patil S. Integrating systemic immune-inflammation index, fibrinogen, and T-SPOT.TB for precision distinction of active pulmonary tuberculosis in the era of mycobacterial disease research. Front Microbiol 2024; 15:1382665. [PMID: 38725688 PMCID: PMC11079184 DOI: 10.3389/fmicb.2024.1382665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
Background The clinical challenge of differentiating suspected tuberculosis with positive T-SPOT.TB results persist. This study aims to investigate the utility of the Systemic Immune-Inflammation Index (SII), Fibrinogen, and T-SPOT.TB in distinguishing between active pulmonary tuberculosis (PTB) and non-tuberculous lung diseases. Methods A retrospective analysis included 1,327 cases of active PTB with positive T-SPOT.TB results and 703 cases of non-tuberculous lung diseases from May 2016 to December 2020 at Meizhou People's Hospital. These were designated as the case group and the control group, respectively. The detection indicators of T-SPOT.TB: Early Secreted Antigenic Target 6 (ESAT-6), Culture Filtrate Protein 10 (CFP-10), as well as SII and Fibrinogen levels-were compared and analyzed for association and joint diagnostic value between the two groups. Results The case group showed higher values of ESAT-6, CFP-10, SII, and Fibrinogen compared to the control group (all p < 0.001). In the case group, SII and Fibrinogen did not correlate with ESAT-6 and CFP-10 (∣rs∣ all < 0.3) but were positively correlated with C-reactive protein (CRP; rs all > 0.3). SII and Fibrinogen values in smear-positive pulmonary tuberculosis were higher than in smear-negative cases (all p < 0.05). The optimal diagnostic thresholds for ESAT-6, CFP-10, SII, and Fibrinogen in differentiating between active PTB and non-tuberculous lung diseases were 21.50 SFCs/106 PBMC, 22.50 SFCs/106 PBMC, 2128.32, and 5.02 g/L, respectively. Regression logistic analysis showed that ESAT-6 < 21.5 (OR: 1.637, 95% CI: 1.311-2.043, p < 0.001), CFP-10 < 22.5 (OR: 3.918, 95% CI: 3.138-4.892, p = 0.025), SII < 2128.32 (OR: 0.763, 95% CI: 0.603-0.967, p < 0.001), and FIB < 5.02 (OR: 2.287, 95% CI: 1.865-2.806, p < 0.001) were independent risk factors for active PTB. The specificity for ESAT-6 + CFP-10, ESAT-6 + CFP-10 + SII, ESAT-6 + CFP-10 + FIB, and ESAT-6 + CFP-10 + SII + FIB was 82.5%, 83.2%, 95.8%, and 80.1%, respectively, while sensitivity was 52.6%, 53.0%, 55.8%, and 44.7%, and positive predictive values were 85.0%, 85.6%, 84.1%, and 89.6%, respectively. Conclusion SII and Fibrinogen are positively correlated with the degree of tuberculosis inflammation and the bacterial load of Mycobacterium tuberculosis. The combined detection of SII, Fibrinogen, and T-SPOT.TB is significant in distinguishing between active PTB with positive T-SPOT.TB results and non-tuberculous lung diseases.
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Affiliation(s)
- Zhikang Yu
- Research Experiment Center, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
- Guangdong Engineering Technological Research Center of Clinical Molecular Diagnosis and Antibody Drugs, Meizhou, China
| | - Zifang Shang
- Research Experiment Center, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
- Guangdong Engineering Technological Research Center of Clinical Molecular Diagnosis and Antibody Drugs, Meizhou, China
| | - Qingyan Huang
- Research Experiment Center, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, China
- Guangdong Engineering Technological Research Center of Clinical Molecular Diagnosis and Antibody Drugs, Meizhou, China
| | - Feiqiu Wen
- Department of Haematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Sandip Patil
- Department of Haematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
- Paediatric Research Institute, Shenzhen Children’s Hospital, Shenzhen, China
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Xia Z, Rong X, Chen Q, Fang M, Xiao J. A nomogram to predict lung cancer in pulmonary lesions for tuberculosis infection patients. Monaldi Arch Chest Dis 2024. [PMID: 38497197 DOI: 10.4081/monaldi.2024.2847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/01/2024] [Indexed: 03/19/2024] Open
Abstract
Similar clinical features make the differential diagnosis difficult, particularly between lung cancer and pulmonary tuberculosis (TB), without pathological evidence for patients with concomitant TB infection. Our study aimed to build a nomogram to predict malignant pulmonary lesions applicable to clinical practice. We retrospectively analyzed clinical characteristics, imaging features, and laboratory indicators of TB infection patients diagnosed with lung cancer or active pulmonary TB at Xiangya Hospital of Central South University. A total of 158 cases from January 1, 2018 to May 30, 2019 were included in the training cohort. Predictive factors for lung cancer were screened by a multiple-stepwise logistic regression analysis. A nomogram model was established, and the discrimination, stability, and prediction performance of the model were analyzed. A total of 79 cases from June 1, 2019, to December 30, 2019, were used as the validation cohort to verify the predictive value of the model. Eight predictor variables, including age, pleural effusion, mediastinal lymph node, the number of positive tumor markers, the T cell spot test for TB, pulmonary lesion morphology, location, and distribution, were selected to construct the model. The corrected C-statistics and the Brier scores were 0.854 and 0.130 in the training cohort, and 0.823 and 0.163 in the validation cohort. Calibration plots showed good performance, and decision curve analysis indicated a high net benefit. In conclusion, the nomogram model provides an effective method to calculate the probability of lung cancer in TB infection patients, and it has excellent discrimination, stability, and prediction performance in detecting a malignant diagnosis of undiagnosed pulmonary lesions.
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Affiliation(s)
- Zhi Xia
- Department of Oncology, Hunan Provincial People's Hospital, Changsha; Key Laboratory of Small Molecule Targeted Drug Research and Creation in Hunan Province, Changsha; Hunan Provincial Clinical Medical Research Center for Hepatobiliary Pancreatic Tumors, Changsha.
| | - Xueyao Rong
- Department of Geriatric Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha.
| | - Qiong Chen
- Department of Geriatric Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha.
| | - Min Fang
- Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, the "Double-First Class" Application Characteristic Discipline of Hunan Province (Pharmaceutical Science), Changsha Medical University; School of Pharmacy, Changsha Medical University.
| | - Jian Xiao
- Department of Geriatric Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha.
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Lin J, Pulst-Korenberg J, Zamvil SS, Graves J, Newsome SD, Amezcua L. Tuberculous Meningitis or Neurosarcoidosis-a Diagnostic Quandary. From the National Multiple Sclerosis Society Case Conference Proceedings. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200184. [PMID: 38118077 PMCID: PMC10732344 DOI: 10.1212/nxi.0000000000200184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/05/2023] [Indexed: 12/22/2023]
Abstract
Distinguishing granulomatous diseases remains diagnostically challenging. Clinical phenotypes and neuroimaging findings resemble many infectious and noninfectious disorders. We describe a Hispanic/Latino man diagnosed with tuberculous meningitis who deteriorated neurologically after treatments. Additional workup revealed a pathology more consistent with neurosarcoidosis. Care access delays and social circumstances likely complicated his diagnosis.
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Affiliation(s)
- Jia Lin
- From the Department of Neurology (J.L., J.P.-K., L.A.), University of Southern California, Keck School of Medicine, Los Angeles; Department of Neurology (S.S.Z.), University of California San Francisco; Department of Neurosciences (J.G.), University of California San Diego; and Department of Neurology and Neurosurgery (S.D.N.), Johns Hopkins University, Baltimore, MD
| | - Johannes Pulst-Korenberg
- From the Department of Neurology (J.L., J.P.-K., L.A.), University of Southern California, Keck School of Medicine, Los Angeles; Department of Neurology (S.S.Z.), University of California San Francisco; Department of Neurosciences (J.G.), University of California San Diego; and Department of Neurology and Neurosurgery (S.D.N.), Johns Hopkins University, Baltimore, MD
| | - Scott S Zamvil
- From the Department of Neurology (J.L., J.P.-K., L.A.), University of Southern California, Keck School of Medicine, Los Angeles; Department of Neurology (S.S.Z.), University of California San Francisco; Department of Neurosciences (J.G.), University of California San Diego; and Department of Neurology and Neurosurgery (S.D.N.), Johns Hopkins University, Baltimore, MD
| | - Jennifer Graves
- From the Department of Neurology (J.L., J.P.-K., L.A.), University of Southern California, Keck School of Medicine, Los Angeles; Department of Neurology (S.S.Z.), University of California San Francisco; Department of Neurosciences (J.G.), University of California San Diego; and Department of Neurology and Neurosurgery (S.D.N.), Johns Hopkins University, Baltimore, MD
| | - Scott D Newsome
- From the Department of Neurology (J.L., J.P.-K., L.A.), University of Southern California, Keck School of Medicine, Los Angeles; Department of Neurology (S.S.Z.), University of California San Francisco; Department of Neurosciences (J.G.), University of California San Diego; and Department of Neurology and Neurosurgery (S.D.N.), Johns Hopkins University, Baltimore, MD
| | - Lilyana Amezcua
- From the Department of Neurology (J.L., J.P.-K., L.A.), University of Southern California, Keck School of Medicine, Los Angeles; Department of Neurology (S.S.Z.), University of California San Francisco; Department of Neurosciences (J.G.), University of California San Diego; and Department of Neurology and Neurosurgery (S.D.N.), Johns Hopkins University, Baltimore, MD
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Kobashi Y. Current status and future landscape of diagnosing tuberculosis infection. Respir Investig 2023; 61:563-578. [PMID: 37406419 DOI: 10.1016/j.resinv.2023.04.010] [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: 02/08/2023] [Revised: 03/29/2023] [Accepted: 04/10/2023] [Indexed: 07/07/2023]
Abstract
Interferon-γ release assays (IGRAs), such as QuantiFERON-TB Gold (QFT) or T-SPOT.TB, are frequently used as tools for the diagnosis of tuberculosis (TB) infection in the 21st century. QFT-Plus recently emerged as the fourth generation of QFT assays and has replaced QFT In-Tube. However, IGRAs have several problems regarding the identification of active, latent, and cured TB infection, and the time-consuming diagnosis of TB infection because of the overnight incubation of clinical specimens or complexity of measuring the level of interferon (IFN)-γ. To easily diagnose TB infection and quickly compare it with conventional IGRAs, many in vitro tests are developed based on assays other than enzyme-linked immunosorbent assay or enzyme-linked immunospot, such as the fluorescent lateral flow assay that requires less manual operation and a shorter time. Simplified versions of IGRAs are emerging, including QIAreach QuantiFERON-TB. On the other hand, to distinguish active TB from latent or cured TB infection, new immunodiagnostic biomarkers beyond IFN-γ are evaluated using QFT supernatants. While IFN-γ or IFN-γ-related chemokine such as IFN-γ induced protein 10 is a potential biomarker in patients with active TB, interleukin-2 or latency-associated antigen such as heparin-binding hemagglutinin may be useful to distinguish active TB from latent or cured TB infection. There are no potential biomarkers to fully distinguish the time-phase of TB infection at present. It is necessary to discover new immunodiagnostic biomarkers to facilitate decisions on treatment selection for active or latent TB infection.
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Affiliation(s)
- Yoshihiro Kobashi
- Department of Respiratory Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, Japan.
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Mukherjee S, Perveen S, Negi A, Sharma R. Evolution of tuberculosis diagnostics: From molecular strategies to nanodiagnostics. Tuberculosis (Edinb) 2023; 140:102340. [PMID: 37031646 PMCID: PMC10072981 DOI: 10.1016/j.tube.2023.102340] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/12/2023] [Accepted: 03/30/2023] [Indexed: 04/09/2023]
Abstract
Tuberculosis has remained a global concern for public health affecting the lives of people for ages. Approximately 10 million people are affected by the disease and 1.5 million succumb to the disease worldwide annually. The COVID-19 pandemic has highlighted the role of early diagnosis to win the battle against such infectious diseases. Thus, advancement in the diagnostic approaches to provide early detection forms the foundation to eradicate and manage contagious diseases like tuberculosis. The conventional diagnostic strategies include microscopic examination, chest X-ray and tuberculin skin test. The limitations associated with sensitivity and specificity of these tests demands for exploring new techniques like probe-based assays, CRISPR-Cas and microRNA detection. The aim of the current review is to envisage the correlation between both the conventional and the newer approaches to enhance the specificity and sensitivity. A significant emphasis has been placed upon nanodiagnostic approaches manipulating quantum dots, magnetic nanoparticles, and biosensors for accurate diagnosis of latent, active and drug-resistant TB. Additionally, we would like to ponder upon a reliable method that is cost-effective, reproducible, require minimal infrastructure and provide point-of-care to the patients.
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Affiliation(s)
| | - Summaya Perveen
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Anjali Negi
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
| | - Rashmi Sharma
- Infectious Diseases Division, CSIR- Indian Institute of Integrative Medicine, Jammu, 180001, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India.
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Yu X, Jiang S, Li Y, Zhou H, Wei Y, Li X, Zhang Y, Hu P, Wu H, Wang H, Wu S, Zhang S. Development of a new cellular immunological detection method for tuberculosis based on HupB protein induced IL-6 release test. Front Microbiol 2023; 14:1148503. [PMID: 37077246 PMCID: PMC10106748 DOI: 10.3389/fmicb.2023.1148503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/14/2023] [Indexed: 04/05/2023] Open
Abstract
ObjectiveAs a virulence factor, HupB plays important roles in the survival of MTB after infection and modulates the host immune response. In the current study, we aim to explore a new cellular immunological detection method for tuberculosis infection detection based on HupB protein.MethodsHupB was used to stimulate PBMCs extracted from pulmonary tuberculosis (PTB) patients, and secreted cytokines was examined. Then, we constructed a single center and a multi-center clinical trials to collect PBMCs from PTB patients, nPTB patients, or healthy volunteers to verify our findings.ResultsCytokine’s screening illustrated that IL-6 was the only cytokine released after HupB stimulation. Single-center and multi-center clinical trials showed that HupB stimulation significantly increased the level of IL-6 in the supernatant of PBMCs from PTB patients. Then we compared the specificity and sensitivity of HupB induced IL-6 release assay with ESAT-6 and CFP10 induced interferon γ release assay (IGRA), and found in smear positive PTB patients, the specificity and sensitivity of HupB induced IL-6 release assay was better than IGRA, and in smear negative PTB patients, the sensitivity was better. Combination of both assays provided an improved specificity and sensitivity for tuberculosis diagnosis.ConclusionThis study explored an immunological detection method for tuberculosis infection cells based on HupB protein-induced IL-6 release test, which can be used to enhance the diagnosis diagnostic accuracy of TB.
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Affiliation(s)
- Xiaoli Yu
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan, China
| | - Shengsheng Jiang
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan, China
| | - Yang Li
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan, China
| | - Huaiheng Zhou
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan, China
| | - Yutong Wei
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan, China
| | - Xuefang Li
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan, China
| | - Ye Zhang
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan, China
| | - Peng Hu
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan, China
| | - Haoming Wu
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan, China
| | - Hualin Wang
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan, China
- *Correspondence: Hualin Wang,
| | - Shimin Wu
- Center for Clinical Laboratory, General Hospital of the Yangtze River Shipping, Wuhan Brain Hospital, Wuhan, China
- Shimin Wu,
| | - Shulin Zhang
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan, China
- Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shulin Zhang,
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9
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Sun Y, Yao X, Ni Y, Peng Y, Shi G. Diagnostic Efficacy of T-SPOT.TB for Active Tuberculosis in Adult: A Retrospective Study. Infect Drug Resist 2022; 15:7077-7093. [DOI: 10.2147/idr.s388568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
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10
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Qian M, Zhu B, Zhan Y, Wang L, Shen Q, Zhang M, Yue L, Wu D, Chen H, Wang X, Cheng Y. Analysis of Negative Results of Metagenomics Next-Generation Sequencing in Clinical Practice. Front Cell Infect Microbiol 2022; 12:892076. [PMID: 35651750 PMCID: PMC9149223 DOI: 10.3389/fcimb.2022.892076] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/19/2022] [Indexed: 12/16/2022] Open
Abstract
BackgroundMetagenomics next-generation sequencing (mNGS) has been increasingly used in the clinic, which provides a powerful tool for the etiological diagnosis of infectious diseases. Precise treatment can be carried out according to the positive mNGS results. However, the role of negative results of mNGS remains poorly defined in clinical practice.MethodsThe results of 1,021 samples from patients who received the mNGS test at Zhongshan Hospital, Fudan University, between January 2019 and December 2019 were analyzed.ResultsThere were 308 samples (30.17%) of negative results included in the current study. The top 2 types of negative samples were blood (130/308) and tissue (63/308), which also accounted for the highest negative proportion in diseases. Sputum and bronchoalveolar lavage fluid (BALF) were more likely to have positive results. In false-negative results (defined as negative in mNGS test but reported positive in other sample types or assays), 118 samples were found when compared to regular microbiological assays. The negative predictive value (NPV) of mNGS was 95.79% [95%CI, 93.8%–97.8%] as compared to culture and smear. Mycobacterium, Aspergillus, and Mycoplasma ranked as the top 3 microorganisms on the undetected pathogen list.ConclusionsThe present data indicate that when the mNGS test is negative, the negative prediction accuracy rate of the original specimen is significant. However, other laboratory assays results and clinical presentations should always be carefully considered prior to drawing a diagnosis.
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Affiliation(s)
- Mengjia Qian
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Bijun Zhu
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yanxia Zhan
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lingyan Wang
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qi Shen
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Miaomiao Zhang
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lei Yue
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Duojiao Wu
- Center for Tumor Diagnosis & Therapy, Jinshan Hospital, Fudan University, Shanghai, China
| | - Hao Chen
- Department of Thoracic Surgery, Zhongshan Hospital Xuhui Branch, Fudan University, Shanghai, China
| | - Xiangdong Wang
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China
- Center for Tumor Diagnosis & Therapy, Jinshan Hospital, Fudan University, Shanghai, China
- *Correspondence: Yunfeng Cheng, ; Xiangdong Wang,
| | - Yunfeng Cheng
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
- Center for Tumor Diagnosis & Therapy, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Hematology, Zhongshan Hospital Qingpu Branch, Fudan University, Shanghai, China
- *Correspondence: Yunfeng Cheng, ; Xiangdong Wang,
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Zhang J, He F. Mycobacterium tuberculosis piezoelectric sensor based on AuNPs-mediated enzyme assisted signal amplification. Talanta 2022; 236:122902. [PMID: 34635273 DOI: 10.1016/j.talanta.2021.122902] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/13/2021] [Accepted: 09/19/2021] [Indexed: 10/20/2022]
Abstract
Rapid diagnosis of tuberculosis disease (TB) still remained a pressing need for TB control efforts all over the world. However, the existing detection approaches cannot satisfy demand of rapid detection of clinical Mycobacterium tuberculosis (M. tuberculosis) because of the long detection time and high cost. Herein, we proposed a new M. tuberculosis piezoelectric sensor based on AuNPs-mediated enzyme assisted signal amplification. A hairpin-shaped DNA duplex with a protrusion of the 3' end was designed. In the presence of specific 16 S rDNA fragment of M. tuberculosis, the hairpin probe was opened, which triggered the selective cleavage of hairpin probe by Exonuclease III (Exo III), resulting in the release of uncut DNA probe and target DNA. The released target DNA hybridized with another hairpin-shaped DNA duplex, and a new digestion cycle was started, thus generating large amounts of uncut DNA probes. The uncut DNA was pulled to the electrode surface by the hybridization with capture probe modified on the electrode. Subsequently detection probe labeled AuNPs was hybridized with uncut DNA and entered between the two electrodes. The AuNPs linked to hybridized detection probe were grown in the HAuCl4 and Nicotinamide adenine dinucleotide (NADH) solution and offered the conductive connection between the gaps of electrode. The changes were monitored by the piezoelectric sensor. The piezoelectric biosensor could achieve a detection of M. tuberculosis (102-108 CFU mL-1) within 3 h, the detection limit (LOD) was 30 CFU mL-1. The methodology could be transformed into different microbial targets, which is suitable for further development of small portable equipment and multifunctional detection.
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Affiliation(s)
- Jialin Zhang
- Institute of Molecular Materials Chemistry and Technology, School of Chemistry and Chemical Engineering, Jiangxi University of Science and Technology, Ganzhou, 341000, PR China; State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, 410082, PR China
| | - Fengjiao He
- State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha, 410082, PR China.
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A Case of Nasopharyngeal Mycobacteriosis with Bony Erosion of the External Skull Base. Case Rep Otolaryngol 2021; 2021:7500273. [PMID: 34691798 PMCID: PMC8536460 DOI: 10.1155/2021/7500273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/20/2021] [Accepted: 10/05/2021] [Indexed: 12/03/2022] Open
Abstract
Primary nasopharyngeal mycobacteriosis is a rare disease. We present a case in which skull base bone erosion appeared and was alleviated during the course of the treatment. Bone complications occur in osteoarticular mycobacteriosis, but their occurrence in primary nasopharyngeal mycobacteriosis has not been reported. A 77-year-old immunocompromised Asian woman presented with a right occipitotemporal headache. An ulcerative mass covered with a thick yellowish discharge was found in the roof and posterior walls of the right nasopharynx. Because histopathological examination indicated the presence of mycobacterial infection, we began using antituberculosis medication for the treatment because of the possibility of primary nasopharyngeal tuberculosis. However, this was followed by glossopharyngeal and vagus nerve paralysis. Computed tomography (CT) showed a diffuse enhancing mucosal irregularity in the nasopharynx with bony erosion of the external skull base. Deep tissue biopsy was repeated to differentiate it from malignant lesions, and drainage of pus from the right nasopharynx was confirmed. Subsequently, the headache, neurological findings, and the yellowish discharge disappeared, and the bony erosion of the external skull base was alleviated. Surgical intervention should also be considered for drug-resistant mycobacteriosis. We concluded that mycobacteriosis should also be considered apart from carcinoma even if CT shows a diffuse enhancing mucosal irregularity with bone destruction in the nasopharynx.
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Use of Rv0222-Rv2657c-Rv1509 Fusion Protein to Improve the Accuracy of an Antibody ELISA for Extra-Pulmonary Tuberculosis in Humans. Pathogens 2021; 10:pathogens10070828. [PMID: 34209358 PMCID: PMC8308687 DOI: 10.3390/pathogens10070828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/12/2021] [Accepted: 04/17/2021] [Indexed: 12/01/2022] Open
Abstract
(1) Background: Tuberculosis (TB) in humans is a serious chronic epidemic disease caused by Mycobacterium tuberculosis (M. tb). The diagnosis of TB, especially extra-pulmonary TB (EPTB), is difficult. Isolation of M. tb from culture has a low sensitivity in patients with TB and an even lower sensitivity in cases of EPTB. Although Xpert MTB/RIF assays and serological tests are more sensitive than the above tests, they still lack sensitivity for EPTB diagnosis. (2) Methods: To improve the accuracy of TB diagnosis, a Rv0222-Rv2657c-Rv1509 fusion protein based iELISA was constructed, the diagnosis of TB, pulmonary TB (PTB) and EPTB was then evaluated. Sera of 40 TB patients including 14 with PTB, 14 with EPTB and 12 with no information about the form of TB, and five pneumonia patients were investigated. (3) Results: The sensitivity of the ELISA in TB, PTB and EPTB patients was 80% (95% CI: 64.4, 90.9%), 85.7% (95% CI: 57.2, 98.2%) and 92.8% (95% CI: 66.1, 99.8%), respectively, with a specificity of 70% (95% CI: 53.5, 83.4%). Both the sensitivity and specificity with this fusion protein were higher than for CFP10/ESAT6 (used as reference antigen) fusion protein (71.4%; 95% CI: 41.9, 91.6%, and 67.5%; 95% CI: 50.9, 81.4%), respectively, in cases of EPTB. All pneumonia patients’ sera tested negative in both ELISAs. (4) Conclusion: use of these new fusion proteins as antigens in serological assays has the potential to improve the diagnosis of all forms of TB in humans, especially EPTB.
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Liang T, Chen J, Xu G, Zhang Z, Xue J, Zeng H, Jiang J, Chen T, Qin Z, Li H, Ye Z, Nie Y, Liu C, Zhan X. Immune status changing helps diagnose osteoarticular tuberculosis. PLoS One 2021; 16:e0252875. [PMID: 34129634 PMCID: PMC8205131 DOI: 10.1371/journal.pone.0252875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 05/24/2021] [Indexed: 01/06/2023] Open
Abstract
Objective This study is aimed to develop a new nomogram for the clinical diagnosis of osteoarticular tuberculosis (TB). Methods xCell score estimation to obtained the immune cell type abundance scores. We downloaded the expression profile of GSE83456 from GEO and proceed xCell score estimation. The routine blood examinations of 326 patients were collected for further validation. We analyzed univariate and multivariate logistic regression to identified independent predicted factor for developing the nomogram. The performance of the nomogram was assessed using the receiver operating characteristic (ROC) curves. The correlation of ESR with lymphocytes, monocytes, and ML ratio was performed and visualized in osteoarticular TB patients. Results Compared with the healthy control group in the dataset GSE83456, the xCell score of basophils, monocytes, neutrophils, and platelets was higher, while lymphoid was lower in the EPTB group. The clinical data showed that the cell count of monocytes were much higher, while the cell counts of lymphocytes were lower in the osteoarticular TB group. AUCs of the nomogram was 0.798 for the dataset GSE83456, and 0.737 for the clinical data. We identified the ML ratio, BMI, and ESR as the independent predictive factors for osteoarticular TB diagnosis and constructed a nomogram for the clinical diagnosis of osteoarticular TB. AUCs of this nomogram was 0.843. Conclusions We demonstrated a significant change between the ML ratio of the EPTB and non-TB patients. Moreover, we constructed a nomogram for the clinical diagnosis of the osteoarticular TB diagnosis, which works satisfactorily.
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Affiliation(s)
- Tuo Liang
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Jiarui Chen
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - GuoYong Xu
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Zide Zhang
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Jiang Xue
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Haopeng Zeng
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Jie Jiang
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Tianyou Chen
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Zhaojie Qin
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Hao Li
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Zhen Ye
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Yunfeng Nie
- Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Chong Liu
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Xinli Zhan
- Spine and Osteopathy Ward, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
- * E-mail:
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Development of a Simple and Robust Whole Blood Assay with Dual Co-Stimulation to Quantify the Release of T-Cellular Signature Cytokines in Response to Aspergillus fumigatus Antigens. J Fungi (Basel) 2021; 7:jof7060462. [PMID: 34201183 PMCID: PMC8230040 DOI: 10.3390/jof7060462] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 12/23/2022] Open
Abstract
Deeper understanding of mold-induced cytokine signatures could promote advances in the diagnosis and treatment of invasive mycoses and mold-associated hypersensitivity syndromes. Currently, most T-cellular immunoassays in medical mycology require the isolation of mononuclear cells and have limited robustness and practicability, hampering their broader applicability in clinical practice. Therefore, we developed a simple, cost-efficient whole blood (WB) assay with dual α-CD28 and α-CD49d co-stimulation to quantify cytokine secretion in response to Aspergillus fumigatus antigens. Dual co-stimulation strongly enhanced A. fumigatus-induced release of T-cellular signature cytokines detectable by enzyme-linked immunosorbent assay (ELISA) or a multiplex cytokine assay. Furthermore, T-cell-dependent activation and cytokine response of innate immune cells was captured by the assay. The protocol consistently showed little technical variation and high robustness to pre-analytic delays of up to 8 h. Stimulation with an A. fumigatus lysate elicited at least 7-fold greater median concentrations of key T-helper cell signature cytokines, including IL-17 and the type 2 T-helper cell cytokines IL-4 and IL-5 in WB samples from patients with Aspergillus-associated lung pathologies versus patients with non-mold-related lung diseases, suggesting high discriminatory power of the assay. These results position WB-ELISA with dual co-stimulation as a simple, accurate, and robust immunoassay for translational applications, encouraging further evaluation as a platform to monitor host immunity to opportunistic pathogens.
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Bucheli OTM, Sigvaldadóttir I, Eyer K. Measuring single-cell protein secretion in immunology: Technologies, advances, and applications. Eur J Immunol 2021; 51:1334-1347. [PMID: 33734428 PMCID: PMC8252417 DOI: 10.1002/eji.202048976] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/12/2021] [Accepted: 03/15/2021] [Indexed: 12/19/2022]
Abstract
The dynamics, nature, strength, and ultimately protective capabilities of an active immune response are determined by the extracellular constitution and concentration of various soluble factors. Generated effector cells secrete such mediators, including antibodies, chemo‐ and cytokines to achieve functionality. These secreted factors organize the individual immune cells into functional tissues, initiate, orchestrate, and regulate the immune response. Therefore, a single‐cell resolved analysis of protein secretion is a valuable tool for studying the heterogeneity and functionality of immune cells. This review aims to provide a comparative overview of various methods to characterize immune reactions by measuring single‐cell protein secretion. Spot‐based and cytometry‐based assays, such as ELISpot and flow cytometry, respectively, are well‐established methods applied in basic research and clinical settings. Emerging novel technologies, such as microfluidic platforms, offer new ways to measure and exploit protein secretion in immune reactions. Further technological advances will allow the deciphering of protein secretion in immunological responses with unprecedented detail, linking secretion to functionality. Here, we summarize the development and recent advances of tools that allow the analysis of protein secretion at the single‐cell level, and discuss and contrast their applications within immunology.
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Affiliation(s)
- Olivia T M Bucheli
- ETH Laboratory for Functional Immune Repertoire Analysis, Institute of Pharmaceutical Sciences, D-CHAB, ETH Zürich, Zürich, Switzerland
| | - Ingibjörg Sigvaldadóttir
- ETH Laboratory for Functional Immune Repertoire Analysis, Institute of Pharmaceutical Sciences, D-CHAB, ETH Zürich, Zürich, Switzerland
| | - Klaus Eyer
- ETH Laboratory for Functional Immune Repertoire Analysis, Institute of Pharmaceutical Sciences, D-CHAB, ETH Zürich, Zürich, Switzerland
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Liu S, Wu M, A E, Wu S, Geng S, Li Z, Li M, Li L, Pang Y, Kang W, Tang S. Factors associated with differential T cell responses to antigens ESAT-6 and CFP-10 in pulmonary tuberculosis patients. Medicine (Baltimore) 2021; 100:e24615. [PMID: 33663071 PMCID: PMC7909155 DOI: 10.1097/md.0000000000024615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/07/2021] [Indexed: 01/05/2023] Open
Abstract
The T-SPOT.TB assay detects cellular immune responses to 2 core Mycobacterium tuberculosis antigens, early secreted antigenic target of 6-kDa protein (ESAT-6) and culture filtrate protein-10 (CFP-10). T-SPOT.TB has been recently used for auxiliary diagnosis of active pulmonary tuberculosis (PTB). However, testing can produce inconsistent results due to differential PTB patient immune responses to these antigens, prompting us to identify factors underlying inconsistent results.Data were retrospectively analyzed from 1225 confirmed PTB patients who underwent T-SPOT.TB testing at 5 specialized tuberculosis hospitals in China between December 2012 and November 2015. Numbers of spot-forming cells (SFCs) reflecting T cell responses to ESAT-6 and CFP-10 antigens were recorded then analyzed via multivariable logistic regression to reveal factors underlying discordant T cell responses to these antigens.The agreement rate of 84.98% (82.85%-86.94%) between PTB patient ESAT-6 and CFP-10 responses demonstrated high concordance. Additionally, positivity rates were higher for ESAT-6 than for CFP-10 (84.8% vs 80.7%, P < .001), with ESAT-6 and CFP-10 microwell SFC numbers for each single positive group not differing significantly (P > .99), while spot numbers of the single positive group were lower than numbers for the double positive group (P < .001). Elderly patients (aged ≥66 years) and patients receiving retreatment were most likely to have discordance results.ESAT-6 promoted significantly more positive T-SPOT.TB results than did CFP-10 in PTB patients. Advanced age and retreatment status were correlated with discordant ESAT-6 and CFP-10 results. Assessment of factors underlying discordance may lead to improved PTB diagnosis using T-SPOT.TB.
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Affiliation(s)
- Shengsheng Liu
- Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing
| | | | - Ertai A
- Chest Hospital of Xinjiang Uygur Autonomous Region, Urumqi
| | | | | | | | - Mingwu Li
- Kunming 3rd People's Hospital, Kunming, China
| | - Liang Li
- Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing
| | - Yu Pang
- Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing
| | - Wanli Kang
- Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing
| | - Shenjie Tang
- Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing
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Yu J, Lu Y, Han B. Primary adrenal insufficiency due to adrenal tuberculosis: a case report. J Int Med Res 2020; 48:300060520980590. [PMID: 33356711 PMCID: PMC7768570 DOI: 10.1177/0300060520980590] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/20/2020] [Indexed: 12/24/2022] Open
Abstract
We report a case of primary adrenal insufficiency (PAI) due to adrenal tuberculosis with no findings of active tuberculosis in the lung of a 51-year-old female patient. The patient was admitted with a 10-year history of skin hyperpigmentation and was diagnosed with PAI. The primary cause was adrenal tuberculosis. An adrenocorticotropic hormone stimulation test, T-Spot test and adrenal computed tomography scan were used to confirm the diagnosis. The patient's status improved, and the hyperpigmentation subsided after 15 months of treatment with anti-tuberculosis drugs and cortisol replacement therapy.
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Affiliation(s)
- Jie Yu
- Department of Endocrinology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingli Lu
- Department of Endocrinology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bing Han
- Department of Endocrinology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Xuan WX, Li JJ, Zhang QC, Sun GN, Xu ZW, Sun ZF, Zhang XJ. Protein expression shift and potential diagnostic markers through proteomics profiling of tuberculous pleurisy biopsy tissues. Int J Infect Dis 2020; 99:245-252. [PMID: 32758691 DOI: 10.1016/j.ijid.2020.07.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/07/2020] [Accepted: 07/19/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Tuberculous pleurisy is a common type of tuberculosis (TB), but its diagnosis is challenging. This study aimed to profile the protein expression of this disease and identify new diagnostic makers. METHODS Biopsy tissues from patients with tuberculous pleurisy and controls were taken through thoracoscopy, and proteins were extracted for Tandem Mass Tag Mass Spectrometry. Differential protein expression was performed between patients and controls, and the identified proteins were analyzed for pathway enrichment. Selected proteins were further validated in another set of samples using a more quantitative method. RESULTS A total of 5101 proteins were detected and quantified in a discovery set of patients and controls. Overall protein expression was quite different between patients and controls. Most proteins were down-expressed, while a minority were overly expressed in the patient samples. At p value < 0.05 and absolute fold change >2, 295 proteins were found to be up-expressed and 608 down-expressed. The top enriched pathways included ECM-receptor interaction, complement and coagulation cascades and focal adhesion. All 19 selected candidates were validated in an independent set of patient and control samples. CONCLUSION This unbiased proteomics approach not only provided unique insights into protein expression and pathways, but also discovered potential diagnostic markers for tuberculous pleurisy.
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Affiliation(s)
- Wei-Xia Xuan
- Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| | - Jin-Jin Li
- Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Qun-Cheng Zhang
- Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Guan-Nan Sun
- Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhi-Wei Xu
- Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhi-Fu Sun
- Department of Health Sciences Research, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA
| | - Xiao-Ju Zhang
- Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.
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Higher T-SPOT.TB threshold may aid in diagnosing active tuberculosis?: A real-world clinical practice in a general hospital. Clin Chim Acta 2020; 509:60-66. [PMID: 32505775 DOI: 10.1016/j.cca.2020.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND This study aimed to determine whether increased cut-off of the T-SPOT.TB could aid in diagnosing active tuberculosis (ATB). METHODS Patients suspected of having TB were enrolled to derive a T-SPOT.TB threshold value to help diagnose ATB, which was subsequently validated in real-world clinical practice. RESULTS In total, 701 adult patients suspected of having tuberculosis who had undergone the T-SPOT.TB assay were included in the derivation cohort. The numbers of ESAT-6 (U = 43583, P = 0.0002) and CFP-10 (U = 41753, P < 0.0001) spot-forming cells (SFCs) significantly increased in the ATB group compared with the Latent tuberculosis infection (LTBI) group. According to receiver operating characteristic analysis, when a cut-off of 37.5 SFCs/2.5 × 105 cells was used to discriminate between ATB and LTBI, the sensitivity was 57.5% (95% confidence interval [CI] 50.7%-64.2%) and the specificity was 59.8% (95% CI 55.2%-64.2%). A threshold value of 173.5 SFCs/2.5 × 105 could be used to obtain a specificity of <90% to discriminate between ATB and LTBI. The diagnostic accuracy of higher T-SPOT.TB threshold values in the validation cohort was similar to that in the derivation cohort. CONCLUSIONS In high-burden countries, a higher threshold value of 173.5 SFCs/2.5 × 105 may aid in ATB diagnosis in suspected tuberculosis patients.
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