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Zailani NNB, Ho PCL. Dried Blood Spots-A Platform for Therapeutic Drug Monitoring (TDM) and Drug/Disease Response Monitoring (DRM). Eur J Drug Metab Pharmacokinet 2023; 48:467-494. [PMID: 37495930 PMCID: PMC10480258 DOI: 10.1007/s13318-023-00846-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 07/28/2023]
Abstract
This review provides an overview on the current applications of dried blood spots (DBS) as matrices for therapeutic drug (TDM) and drug or disease response monitoring (DRM). Compared with conventional methods using plasma/serum, DBS offers several advantages, including minimally invasiveness, a small blood volume requirement, reduced biohazardous risk, and improved sample stability. Numerous assays utilising DBS for TDM have been reported in the literature over the past decade, covering a wide range of therapeutic drugs. Several factors can affect the accuracy and reliability of the DBS sampling method, including haematocrit (HCT), blood volume, sampling paper and chromatographic effects. It is crucial to evaluate the correlation between DBS concentrations and conventional plasma/serum concentrations, as the latter has traditionally been used for clinical decision. The feasibility of using DBS sampling method as an option for home-based TDM is also discussed. Furthermore, DBS has also been used as a matrix for monitoring the drug or disease responses (DRM) through various approaches such as genotyping, viral load measurement, assessment of inflammatory factors, and more recently, metabolic profiling. Although this research is still in the development stage, advancements in technology are expected to lead to the identification of surrogate biomarkers for drug treatment in DBS and a better understanding of the correlation between DBS drug levels and drug responses. This will make DBS a valuable matrix for TDM and DRM, facilitating the achievement of pharmacokinetic and pharmacodynamic correlations and enabling personalised therapy.
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Affiliation(s)
- Nur Nabihah Binte Zailani
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Paul Chi-Lui Ho
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore.
- School of Pharmacy, Monash University Malaysia, Level 5, Building 2, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia.
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2
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Auma E, Hall T, Chopra S, Bilton S, Ramkhelawon L, Amini F, Calvert A, Amirthalingam G, Jones CE, Andrews N, Heath PT, Le Doare K. Using Dried Blood Spots for a Sero-Surveillance Study of Maternally Derived Antibody against Group B Streptococcus. Vaccines (Basel) 2023; 11:vaccines11020357. [PMID: 36851236 PMCID: PMC9966576 DOI: 10.3390/vaccines11020357] [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: 12/13/2022] [Revised: 01/18/2023] [Accepted: 01/27/2023] [Indexed: 02/08/2023] Open
Abstract
Vaccination during pregnancy could protect women and their infants from invasive Group B Streptococcus (GBS) disease. To understand if neonatal dried blood spots (DBS) can be used to determine the amount of maternally derived antibody that protects infants against invasive GBS disease, a retrospective case-control study was conducted in England between 1 April 2014 and 30 April 2015. The DBS of cases with invasive GBS disease (n = 61) were matched with healthy controls (n = 125). The haematocrit, DBS storage temperature, freeze-thaw cycle, and paired serum/DBS studies were set up to optimise the antibody assessment. The samples were analysed using a multiplex immunoassay, and the results were assessed using parametric and nonparametric tests. Antibody concentrations were stable at haematocrits of up to 50% but declined at 75%. DBS storage at room temperature was stable for three months compared with storage from collection at -20 °C and rapidly degraded thereafter. Total IgG levels measured in DBS and paired serum showed a good correlation (r2 = 0.99). However, due to suboptimal storage conditions, no difference was found in the GBS IgG levels between DBS samples from cases and controls. We have demonstrated a proof of concept that assays utilising DBS for assessing GBS serotype-specific antibodies in infants is viable. This method could be used to facilitate future large sero-correlate studies, but DBS samples must be stored at -20 °C for long term preservation of antibody.
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Affiliation(s)
- Erick Auma
- Department of Biology, Université Claude Bernard Lyon, ENS de Lyon, CNRS, UMR, 69100 Villeurbanne, France
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George’s, University of London, London SW17 0RE, UK
| | - Tom Hall
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George’s, University of London, London SW17 0RE, UK
- Correspondence:
| | - Simran Chopra
- Immunity and Infection, Faculty of Medicine, Imperial College London, London SW7 2BX, UK
| | - Sam Bilton
- Neonatal Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
| | - Laxmee Ramkhelawon
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George’s, University of London, London SW17 0RE, UK
| | - Fahimah Amini
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George’s, University of London, London SW17 0RE, UK
| | - Anna Calvert
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George’s, University of London, London SW17 0RE, UK
| | - Gayatri Amirthalingam
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London NW9 5EQ, UK
| | - Christine E. Jones
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George’s, University of London, London SW17 0RE, UK
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, SO16 6YD, UK
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Nick Andrews
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London NW9 5EQ, UK
| | - Paul T. Heath
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George’s, University of London, London SW17 0RE, UK
| | - Kirsty Le Doare
- Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George’s, University of London, London SW17 0RE, UK
- Makerere University—Johns Hopkins University Research Collaboration, Kampala P.O. Box 23491, Uganda
- Pathogen Immunology Group, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
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3
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Chang J, Zou D, Ren H, Liu X, Li M, Si Z, Han C, Liu Z, Lu S, Hu P. An ultrasensitive and long-lasting chemiluminescence immunoassay for IP-10 detection based on a 4-bromophenol-reinforced bienzymatic system. Microchem J 2022. [DOI: 10.1016/j.microc.2022.107719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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4
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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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Amini F, Auma E, Hsia Y, Bilton S, Hall T, Ramkhelawon L, Heath PT, Le Doare K. Reliability of dried blood spot (DBS) cards in antibody measurement: A systematic review. PLoS One 2021; 16:e0248218. [PMID: 33720928 PMCID: PMC7959368 DOI: 10.1371/journal.pone.0248218] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 02/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Increasingly, vaccine efficacy studies are being recommended in low-and-middle-income countries (LMIC), yet often facilities are unavailable to take and store infant blood samples correctly. Dried blood spots (DBS), are useful for collecting blood from infants for diagnostic purposes, especially in low-income settings, as the amount of blood required is miniscule and no refrigeration is required. Little is known about their utility for antibody studies in children. This systematic review aims to investigate the correlation of antibody concentrations against infectious diseases in DBS in comparison to serum or plasma samples that might inform their use in vaccine clinical trials. METHODS AND FINDINGS We searched MEDLINE, Embase and the Cochrane library for relevant studies between January 1990 to October 2020 with no language restriction, using PRISMA guidelines, investigating the correlation between antibody concentrations in DBS and serum or plasma samples, and the effect of storage temperature on DBS diagnostic performance. We included 40 studies in this systematic review. The antibody concentration in DBS and serum/plasma samples reported a good pooled correlation, (r2 = 0.86 (ranged 0.43 to 1.00)). Ten studies described a decline of antibody after 28 days at room temperature compared to optimal storage at -20°C, where antibodies were stable for up to 200 days. There were only five studies of anti-bacterial antibodies. CONCLUSIONS There is a good correlation between antibody concentrations in DBS and serum/plasma samples, supporting the wider use of DBS in vaccine and sero-epidemiological studies, but there is limited data on anti-bacterial antibodies. The correct storage of DBS is critical and may be a consideration for longer term storage.
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Affiliation(s)
- Fahimah Amini
- Paediatric Infectious Disease Research Group, Institute for Infection and Immunity, St. George’s University of London, London, United Kingdom
| | - Erick Auma
- Department of Biology, University of Lyon, Université Claude Bernard Lyon, ENS de Lyon, CNRS, UMR, Lyon, France
| | - Yingfen Hsia
- Paediatric Infectious Disease Research Group, Institute for Infection and Immunity, St. George’s University of London, London, United Kingdom
- School of Pharmacy, Queen’s University Belfast, Belfast, United Kingdom
| | - Sam Bilton
- St Georges University Hospitals NHS Foundation Trust, Tooting, London, United Kingdom
| | - Tom Hall
- Paediatric Infectious Disease Research Group, Institute for Infection and Immunity, St. George’s University of London, London, United Kingdom
| | - Laxmee Ramkhelawon
- Paediatric Infectious Disease Research Group, Institute for Infection and Immunity, St. George’s University of London, London, United Kingdom
| | - Paul T. Heath
- Paediatric Infectious Disease Research Group, Institute for Infection and Immunity, St. George’s University of London, London, United Kingdom
- St Georges University Hospitals NHS Foundation Trust, Tooting, London, United Kingdom
| | - Kirsty Le Doare
- Paediatric Infectious Disease Research Group, Institute for Infection and Immunity, St. George’s University of London, London, United Kingdom
- St Georges University Hospitals NHS Foundation Trust, Tooting, London, United Kingdom
- Pathogen Immunology Group, Public Health England, Porton Down, United Kingdom
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6
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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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7
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Diagnostic Accuracy of Interferon Gamma-Induced Protein 10 mRNA Release Assay for Tuberculosis. J Clin Microbiol 2020; 58:JCM.00848-20. [PMID: 32719030 DOI: 10.1128/jcm.00848-20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/16/2020] [Indexed: 01/31/2023] Open
Abstract
Interferon gamma (IFN-γ) release assays (IGRAs) are increasingly used to test for latent tuberculosis (TB) infection. Although highly specific, IGRAs have a relatively high false-negative rate in active TB patients. A more sensitive assay is needed. IFN-γ-induced protein 10 (IP-10) is an alternative biomarker with a 100-fold-higher expression level than IFN-γ, allowing for different analysis platforms, including molecular detection. The PCR technique is already an integrated tool in most TB laboratories and, thus, an obvious platform to turn to. In this case-control study, we investigated the diagnostic sensitivity and specificity of a molecular assay detecting IP-10 mRNA expression following antigen stimulation of a blood sample. We included 89 TB patients and 99 healthy controls. Blood was drawn in QuantiFeron-TB gold in-tube (QFT) assay tubes. Eight hours poststimulation, IP-10 mRNA expression was analyzed, and 20 h poststimulation, IP-10 and IFN-γ protein plasma levels were analyzed using an in-house IP-10 enzyme-linked immunosorbent assay (ELISA) and the official QFT ELISA, respectively. The IP-10 mRNA assay provided high specificity (98%), sensitivity (80%), and area under the concentration-time curve (AUC) (0.97); however, the QFT assay provided a higher overall diagnostic potential, with specificity of 100%, sensitivity of 90%, and AUC of 0.99. The IP-10 protein assay performed on par with the QFT assay, with specificity of 98%, sensitivity of 87%, and AUC of 0.98. We have provided proof of high technical performance of a molecular assay detecting IP-10 mRNA expression. As a diagnostic tool, this assay would gain from further optimization, especially on the kinetics of IP-10 mRNA expression.
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8
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Villar-Hernández R, Latorre I, De Souza-Galvão ML, Jiménez MA, Ruiz-Manzano J, Pilarte J, García-García E, Muriel-Moreno B, Cantos A, Altet N, Millet JP, González-Díaz Y, Molina-Pinargote I, Prat C, Ruhwald M, Domínguez J. Use of IP-10 detection in dried plasma spots for latent tuberculosis infection diagnosis in contacts via mail. Sci Rep 2019; 9:3943. [PMID: 30850687 PMCID: PMC6408503 DOI: 10.1038/s41598-019-40778-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 02/22/2019] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was to test the use of IP-10 detection in dried plasma from contact studies individuals (contacts of smear positive patients), by comparing it with IP-10 and IFN-γ detection in direct plasma, to establish IP-10 detection in DPS as a useful assay for LTBI diagnosis. Whole blood samples were collected from 80 subjects: 12 with active tuberculosis (TB), and 68 from contact studies. The amount of IFN-γ produced by sensitized T cells was determined in direct plasma by QuantiFERON Gold In-Tube test. IP-10 levels were determined in direct and dried plasma by an in-house ELISA. For dried plasma IP-10 determination, two 25 µl plasma drops were dried in Whatman903 filter paper and sent by mail to the laboratory. Regarding TB patients, 100.0%, 91.7% and 75.0% were positive for IFN-γ detection and IP-10 detection in direct and dried plasma, respectively. In contacts, 69.1%, 60.3% and 48.5% had positive results after IFN-γ and IP-10 in direct and dried plasma, respectively. The agreement among in vitro tests was substantial and IP-10 levels in direct and dried plasma were strongly correlated (r = 0.897). In conclusion, IP-10 detection in dried plasma is a simple and safe method that would help improve LTBI management.
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Affiliation(s)
- R Villar-Hernández
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Carretera del Canyet, 08916 Badalona, Barcelona, Spain.,CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Carretera del Canyet, 08916 Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Carretera del Canyet, 08916 Badalona, Barcelona, Spain
| | - I Latorre
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Carretera del Canyet, 08916 Badalona, Barcelona, Spain.,CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Carretera del Canyet, 08916 Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Carretera del Canyet, 08916 Badalona, Barcelona, Spain
| | - M L De Souza-Galvão
- Unitat de Tuberculosi de Drassanes, Hospital Universitari Vall d'Hebron. Av. de les Drassanes, 17, 08001 Barcelona, Barcelona, Spain
| | - M A Jiménez
- Unitat de Tuberculosi de Drassanes, Hospital Universitari Vall d'Hebron. Av. de les Drassanes, 17, 08001 Barcelona, Barcelona, Spain
| | - J Ruiz-Manzano
- CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Carretera del Canyet, 08916 Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Carretera del Canyet, 08916 Badalona, Barcelona, Spain.,Servei de Pneumologia, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet, 08916 Badalona, Barcelona, Spain
| | - J Pilarte
- Unitat de Tuberculosi de Drassanes, Hospital Universitari Vall d'Hebron. Av. de les Drassanes, 17, 08001 Barcelona, Barcelona, Spain
| | - E García-García
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Carretera del Canyet, 08916 Badalona, Barcelona, Spain.,CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Carretera del Canyet, 08916 Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Carretera del Canyet, 08916 Badalona, Barcelona, Spain
| | - B Muriel-Moreno
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Carretera del Canyet, 08916 Badalona, Barcelona, Spain.,CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Carretera del Canyet, 08916 Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Carretera del Canyet, 08916 Badalona, Barcelona, Spain
| | - A Cantos
- Unitat de Tuberculosi de Drassanes, Hospital Universitari Vall d'Hebron. Av. de les Drassanes, 17, 08001 Barcelona, Barcelona, Spain
| | - N Altet
- Unitat de Tuberculosi de Drassanes, Hospital Universitari Vall d'Hebron. Av. de les Drassanes, 17, 08001 Barcelona, Barcelona, Spain.,Unidad Clínica de Tratamiento Directamente Observado "Serveis Clinics", Carrer de García Mariño, 4, 08022, Barcelona, Spain.,CIBER de Epidemiología y Salud Pública, CIBEREESP, Instituto de Salud Carlos III, Carretera del Canyet, 08916 Badalona, Barcelona, Spain
| | - J P Millet
- Unidad Clínica de Tratamiento Directamente Observado "Serveis Clinics", Carrer de García Mariño, 4, 08022, Barcelona, Spain.,CIBER de Epidemiología y Salud Pública, CIBEREESP, Instituto de Salud Carlos III, Carretera del Canyet, 08916 Badalona, Barcelona, Spain
| | - Y González-Díaz
- Unidad Clínica de Tratamiento Directamente Observado "Serveis Clinics", Carrer de García Mariño, 4, 08022, Barcelona, Spain
| | - I Molina-Pinargote
- Unidad Clínica de Tratamiento Directamente Observado "Serveis Clinics", Carrer de García Mariño, 4, 08022, Barcelona, Spain
| | - C Prat
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Carretera del Canyet, 08916 Badalona, Barcelona, Spain.,CIBER Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, Carretera del Canyet, 08916 Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Carretera del Canyet, 08916 Badalona, Barcelona, Spain
| | - M Ruhwald
- Department of Infectious Disease Immunology Statens Serum Institut, Copenhagen, Denmark - Artillerivej 5, 2300, Copenhagen, Denmark
| | - J Domínguez
- Servei de Microbiología, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Carretera del Canyet, 08916 Badalona, Barcelona, Spain. .,CIBER Enfermedades Respiratorias, CIBERES, 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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9
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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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10
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Velghe S, Delahaye L, Stove CP. Is the hematocrit still an issue in quantitative dried blood spot analysis? J Pharm Biomed Anal 2019; 163:188-196. [DOI: 10.1016/j.jpba.2018.10.010] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 01/12/2023]
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Determination of anti-HCV and quantification of HCV-RNA and IP-10 from dried blood spots sent by regular mail. PLoS One 2018; 13:e0201629. [PMID: 30063765 PMCID: PMC6067740 DOI: 10.1371/journal.pone.0201629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/18/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND With the introduction of direct acting antivirals, treatment of hepatitis C virus (HCV) in hard-to-reach populations is now feasible. Therefore, new cost-effective and reliable test methods are needed. Determination of HCV antibodies and HCV-RNA from dried blood spots samples could represent one such method. Here we examined whether anti-HCV could be detected-and HCV-RNA quantified-from dried blood spots, sent by regular mail. We also investigated, if IP-10 determined from dried blood spots correlated with fibrosis progression appraised by transient elastography. METHOD Forty chronic HCV infected patients were consecutively enrolled. At baseline and after six months, dried blood spots were prepared from blood collected by venous puncture, dried for 4-6 hours, then stored in gas-impermeable plastic bags with a desiccator, before being sent by regular mail. At each visit, approximately six months apart, paired venous samples was obtained and analyzed for anti-HCV, HCV-RNA and IP-10. RESULTS Anti-HCV was found in 66/67 of the dried blood spots. Sixty-six paired samples were available for HCV-RNA analysis. A statistically significant correlation was found between log HCV-RNA concentrations in plasma, and log HCV-RNA obtained from (P < 0.0001, Pearson's R 0.6788, R2 0.4607). HCV-RNA, derived from DBS samples, was lower than the corresponding plasma concentration, reflected by a Bland-Altman bias of 3 with SD of bias ± 0.6472. We found no correlation between IP-10 and fibrosis progression. CONCLUSIONS We identified anti-HCV in 66/67samples, and quantified IP-10 and HCV-RNA from dried blood spots, dried at room temperature and sent by regular mail. HCV-RNA concentrations from the dried blood spots were lower than corresponding plasma values; a probable result of heparin coated test tubes. We found no correlation between IP-10 and fibrosis progression. Overall, dried blood spots could be a cost-effective and easy-to-use alternative to standard tests for the diagnosis of HCV infections.
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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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Ibarra-Meneses AV, Mondal D, Alvar J, Moreno J, Carrillo E. Cytokines and chemokines measured in dried SLA-stimulated whole blood spots for asymptomatic Leishmania infantum and Leishmania donovani infection. Sci Rep 2017; 7:17266. [PMID: 29222521 PMCID: PMC5722824 DOI: 10.1038/s41598-017-17315-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 11/24/2017] [Indexed: 11/09/2022] Open
Abstract
Whole blood stimulation with soluble Leishmania antigen (SLA), followed by plasma cytokine and chemokine determination, provides means of detecting subjects with asymptomatic Leishmania infection. This work examines the potential of Protein Saver 903 cards for the storage and transport of SLA-stimulated dried plasma spot samples. Blood was collected from asymptomatic and negative control subjects living in a Leishmania infantum- (Spain) and Leishmania donovani-endemic area (Bangladesh). After SLA-stimulation, three types of sample were prepared: frozen liquid plasma (-20 °C), and plasma dropped onto Protein Saver cards kept at -20 °C (DPS-FZ), and at ambient temperature (DPS-AT). The concentrations of IFN-γ, IL-2, CXCL10, CXCL9, CCL2 and CXCL8 in the thawed liquid plasma (TLP), DPS-FZ and DPS-AT samples were then determined. Strong correlations were seen between the TLP and DPS-FZ/AT samples for all the studied cytokines/chemokines in both the L. infantum and L. donovani areas. Protein Saver 903 cards would therefore appear to allow for the transport of SLA-stimulated plasma samples by courier at ambient temperature. The CXCL10 and CXCL9 detectable in these plasma spots provided robust markers for identifying asymptomatic subjects from both endemic areas. This easy procedure opens up new possibilities for field studies in resource-limited settings, which could help in Leishmania control.
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Affiliation(s)
- A V Ibarra-Meneses
- WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - D Mondal
- Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - J Alvar
- Drugs for Neglected Diseases Initiative (DNDi), Geneva, Switzerland
| | - J Moreno
- WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - E Carrillo
- WHO Collaborating Centre for Leishmaniasis, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain.
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Pastor L, Casellas A, Rupérez M, Carrillo J, Maculuve S, Jairoce C, Paredes R, Blanco J, Naniche D. Interferon-γ-Inducible Protein 10 (IP-10) as a Screening Tool to Optimize Human Immunodeficiency Virus RNA Monitoring in Resource-Limited Settings. Clin Infect Dis 2017; 65:1670-1675. [PMID: 29020145 PMCID: PMC5850521 DOI: 10.1093/cid/cix600] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 07/04/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Achieving effective antiretroviral treatment (ART) monitoring is a key determinant to ensure viral suppression and reach the UNAIDS 90-90-90 targets. The gold standard for detecting virological failure is plasma human immunodeficiency virus (HIV) RNA (viral load [VL]) testing; however, its availability is very limited in low-income countries due to cost and operational constraints. METHODS HIV-1-infected adults on first-line ART attending routine visits at the Manhiça District Hospital, Mozambique, were previously evaluated for virologic failure. Plasma levels of interferon-γ-inducible protein 10 (IP-10) were quantified by enzyme-linked immunosorbent assay. Logistic regression was used to build an IP-10-based model able to identify individuals with VL >150 copies/mL. From the 316 individuals analyzed, 253 (80%) were used for model training and 63 (20%) for validation. Receiver operating characteristic curves were employed to evaluate model prediction. RESULTS From the individuals included in the training set, 34% had detectable VL. Mean age was 41 years, 70% were females, and median time on ART was 3.4 years. IP-10 levels were significantly higher in subjects with detectable VL (108.2 pg/mL) as compared to those with undetectable VL (38.0 pg/mL) (P < .0001, U test). IP-10 univariate model demonstrated high classification performance (area under the curve = 0.85 [95% confidence interval {CI}, .80-.90]). Using a cutoff value of IP-10 ≥44.2 pg/mL, the model identified detectable VL with 91.9% sensitivity (95% CI, 83.9%-96.7%) and 59.9% specificity (95% CI, 52.0%-67.4%), values confirmed in the validation set. CONCLUSIONS IP-10 is an accurate biomarker to screen individuals on ART for detectable viremia. Further studies should evaluate the benefits of IP-10 as a triage approach to monitor ART in resource-limited settings.
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Affiliation(s)
- Lucía Pastor
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic–Universitat de Barcelona
- IrsiCaixa AIDS Research Institute, Hospital Germans Trias i Pujol
- Germans Trias i Pujol Research Institute, Hospital Germans Trias i Pujol, Universitat Autonoma de Barcelona, Badalona, Spain
- Centro de Investigação em Saúde da Manhiça, Maputo, Mozambique
| | - Aina Casellas
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic–Universitat de Barcelona
| | - María Rupérez
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic–Universitat de Barcelona
- Centro de Investigação em Saúde da Manhiça, Maputo, Mozambique
| | - Jorge Carrillo
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic–Universitat de Barcelona
- IrsiCaixa AIDS Research Institute, Hospital Germans Trias i Pujol
| | - Sonia Maculuve
- Centro de Investigação em Saúde da Manhiça, Maputo, Mozambique
| | | | - Roger Paredes
- IrsiCaixa AIDS Research Institute, Hospital Germans Trias i Pujol
- Universitat de Vic–Universitat Central de Catalunya, Barcelona
- Lluita Contra la Sida Foundation, HIV Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Julià Blanco
- IrsiCaixa AIDS Research Institute, Hospital Germans Trias i Pujol
- Germans Trias i Pujol Research Institute, Hospital Germans Trias i Pujol, Universitat Autonoma de Barcelona, Badalona, Spain
- Universitat de Vic–Universitat Central de Catalunya, Barcelona
| | - Denise Naniche
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic–Universitat de Barcelona
- Centro de Investigação em Saúde da Manhiça, Maputo, Mozambique
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15
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Inflammation and post-operative recovery in patients undergoing total knee arthroplasty-secondary analysis of a randomized controlled trial. Osteoarthritis Cartilage 2017; 25:1265-1273. [PMID: 28323139 DOI: 10.1016/j.joca.2017.03.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 03/01/2017] [Accepted: 03/08/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Reduced function persists for many patients after total knee arthroplasty (TKA). Inflammation is part of osteoarthritis' pathophysiology, and surgery induces a marked inflammatory response. We therefore wanted to explore the role of inflammation in long-term recovery after TKA, and thus conducted this secondary analysis of our randomized controlled trial (RCT) of physical rehabilitation ± progressive strength training (PST). We aimed to investigate whether (1) inflammation is associated with functional performance, knee-extension strength, and knee pain before TKA; (2) PST affects inflammation, and the inflammatory state over time; (3) baseline or surgery-induced inflammation modifies the effect of rehabilitation ± PST on change in 6-min walk test (Δ6MWT); and (4) baseline or surgery-induced inflammation is associated with Δ6MWT following TKA. DESIGN In the primary trial report's per-protocol analysis, 72/82 patients were included. Sixty had ≥1 blood sample before and after TKA, and were included in this secondary analysis. Inflammation was measured by interferon γ-inducible protein (IP)-10, soluble urokinase plasminogen activator receptor (suPAR), interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-α at baseline; day 1, week 4, 8, and 26 after TKA. RESULTS At baseline, suPAR (P = 006) was negatively associated with 6MWT. Neither baseline nor surgery-induced inflammation modified the response to rehabilitation ± PST. Only surgery-induced IL-10 was associated with Δ6MWT26 weeks-baseline (P = 0.001), also adjusted for 6MWTbaseline, age, sex and body mass index (BMI). CONCLUSION In this secondary analysis, only increased surgery-induced IL-10 response was associated with decreased long-term functional performance after TKA. The importance of controlling the surgery-induced immune response remains to be investigated further. TRIAL IDENTIFICATION NCT01351831.
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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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Introducing the ESAT-6 free IGRA, a companion diagnostic for TB vaccines based on ESAT-6. Sci Rep 2017; 7:45969. [PMID: 28387329 PMCID: PMC5384086 DOI: 10.1038/srep45969] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/07/2017] [Indexed: 12/11/2022] Open
Abstract
There is a need for an improved vaccine for tuberculosis. ESAT-6 is a cardinal vaccine antigen with unique properties and is included in several vaccine candidates in development. ESAT-6 is also the core antigen in the IFN-γ release assays (IGRA) used to diagnose latent infection, rendering IGRA tests unspecific after vaccination. This challenge has prompted the development of a companion diagnostic for ESAT-6 based vaccines, an ESAT-6 free IGRA. We screened a panel of seven potential new diagnostic antigens not recognized in BCG vaccinated individuals. Three highly recognized antigens EspC, EspF and Rv2348c were identified and combined with CFP10 in an ESAT-6 free antigen cocktail. The cocktail was prepared in a field-friendly format, lyophilized with heparin in ready-to-use vacutainer tubes. The diagnostic performance of the ESAT-6 free IGRA was determined in a cross-validation study. Compared IGRA, the ESAT-6 free IGRA induced a comparable magnitude of IFN-γ release, and the diagnostic performance was on par with Quantiferon (sensitivity 84% vs 79%; specificity 99% vs 97%). The comparable performance of the ESAT-6 free IGRA to IGRA suggests potential as companion diagnostic for ESAT-6 containing vaccines and as adjunct test for latent infection.
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18
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Goosen WJ, van Helden PD, Warren RM, Miller MA, Parsons SDC. The stability of plasma IP-10 enhances its utility for the diagnosis of Mycobacterium bovis infection in African buffaloes (Syncerus caffer). Vet Immunol Immunopathol 2016; 173:17-20. [PMID: 27090621 DOI: 10.1016/j.vetimm.2016.03.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 03/22/2016] [Accepted: 03/24/2016] [Indexed: 02/02/2023]
Abstract
The measurement of interferon gamma-induced protein 10 (IP-10) in antigen-stimulated whole blood is a sensitive biomarker of Mycobacterium bovis infection in African buffaloes (Syncerus caffer). However, this species often occurs in remote locations and diagnostic samples must be transported to centralised laboratories for processing. In humans, plasma IP-10 is highly stable and this feature contributes to its diagnostic utility; for this reason we aimed to characterize the stability of this molecule in buffaloes. Blood from M. bovis-infected and -uninfected animals was incubated with pathogen-specific peptides, saline and phytohaemagglutinin, respectively. Plasma fractions were harvested and aliquots of selected samples were: (i) stored at different temperatures for various times; (ii) heat treated before storage at RT, and (iii) stored on Protein Saver Cards (PSCs) at RT for either 2 or 8 weeks before measurement of IP-10. Incubation of plasma at 65°C for 20 min caused no loss of IP-10 and this protein could be quantified in plasma stored on PSCs for 2 and 8 weeks. Moreover, for all storage conditions, IP-10 retained its excellent diagnostic characteristics. These features of IP-10 might allow for the heat inactivation of potentially infectious plasma which would facilitate the safe and simple transport of samples.
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Affiliation(s)
- Wynand J Goosen
- DST/NRF Centre of Excellence for Biomedical Tuberculosis Research/SAMRC Centre for Tuberculosis Research/Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Paul D van Helden
- DST/NRF Centre of Excellence for Biomedical Tuberculosis Research/SAMRC Centre for Tuberculosis Research/Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Robin M Warren
- DST/NRF Centre of Excellence for Biomedical Tuberculosis Research/SAMRC Centre for Tuberculosis Research/Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Michele A Miller
- DST/NRF Centre of Excellence for Biomedical Tuberculosis Research/SAMRC Centre for Tuberculosis Research/Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Sven D C Parsons
- DST/NRF Centre of Excellence for Biomedical Tuberculosis Research/SAMRC Centre for Tuberculosis Research/Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
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Drabe CH, Vestergaard LS, Helleberg M, Nyagonde N, Rose MV, Francis F, Theilgaard OP, Asbjørn J, Amos B, Bygbjerg IC, Ruhwald M, Ravn P. Performance of Interferon-Gamma and IP-10 Release Assays for Diagnosing Latent Tuberculosis Infections in Patients with Concurrent Malaria in Tanzania. Am J Trop Med Hyg 2016; 94:728-35. [PMID: 26834199 DOI: 10.4269/ajtmh.15-0633] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 12/14/2015] [Indexed: 01/14/2023] Open
Abstract
Interferon-gamma (IFN-γ) release assays (IGRAs) are used to detect cellular immune recognition of Mycobacterium tuberculosis The chemokine IFN-γ-inducible protein 10 (IP-10) is an alternative diagnostic biomarker to IFN-γ. Several conditions interfere with IGRA test performance. We aimed to assess the possible influence of Plasmodium falciparum infection on the IGRA test QuantiFERON-TB GOLD® In-Tube (QFT) test and an in-house IP-10 release assay. In total, 241 Tanzanian adults were included; 184 patients with uncomplicated malaria (88 human immunodeficiency virus [HIV] coinfected) and 57 HIV-infected patients without malaria infection. Malaria was treated with artemether-lumefantrine (Coartem®). QFT testing was performed before initiation of malaria treatment and at days 7 and 42. In total, 172 patients completed follow-up. IFN-γ and IP-10 was measured in QFT supernatants. We found that during malaria infection IFN-γ and IP-10 levels in the unstimulated samples were elevated, mitogen responsiveness was impaired, and CD4 cell counts were decreased. These alterations reverted after malaria treatment. Concurrent malaria infection did not affect QFT test results, whereas there were more indeterminate IP-10 results during acute malaria infection. We suggest that IGRA and IP-10 release assay results of malaria patients should be interpreted with caution and that testing preferably should be postponed until after malaria treatment.
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Affiliation(s)
- Camilla H Drabe
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Lasse S Vestergaard
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Marie Helleberg
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Nyagonde Nyagonde
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Michala V Rose
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Filbert Francis
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Ola P Theilgaard
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Jens Asbjørn
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Ben Amos
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Ib Christian Bygbjerg
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Morten Ruhwald
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Pernille Ravn
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark; Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark; InterACT Project, Muheza District Hospital, Muheza, Tanzania; Centre for Medical Parasitology, Department of Immunology and Microbiology and Department of Public Health, University of Copenhagen; Department of Infectious Diseases and Department of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; National Institute for Medical Research, Tanga, Tanzania; Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark; Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
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Sun H, Qi C, Niu Y, Kang T, Wei Y, Jin G, Dong X, Wang C, Zhu W. Detection of Cytomegalovirus Antibodies Using a Biosensor Based on Imaging Ellipsometry. PLoS One 2015; 10:e0136253. [PMID: 26295458 PMCID: PMC4546680 DOI: 10.1371/journal.pone.0136253] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 08/03/2015] [Indexed: 11/19/2022] Open
Abstract
Background Cytomegalovirus (CMV) is the most common infectious cause of mental disability in newborns in developed countries. There is an urgent need to establish an early detection and high-throughput screening method for CMV infection using portable detection devices. Methods An antibody analysis method is reported for the detection and identification of CMV antibodies in serum using a biosensor based on high spatial resolution imaging ellipsometry (BIE). CMV antigen (CMV-3A) was immobilized on silicon wafers and used to capture CMV antibodies in serum. An antibody against human immunoglobulin G (anti-IgG) was used to confirm the IgG antibody against CMV captured by the CMV-3A. Results Our results show that this assay is rapid and specific for the identification of IgG antibody against CMV. Further, patient serum was quantitatively assessed using the standard curve method, and the quantitative results were in agreement with the enzyme-linked immunosorbent assay. The CMV antibody detection sensitivity of BIE reached 0.01 IU/mL. Conclusions This novel biosensor may be a valuable diagnostic tool for analysis of IgG antibody against CMV during CMV infection screening.
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Affiliation(s)
- Hongliu Sun
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, China
| | - Cai Qi
- Institute of Equipment Technology, Chinese Academy of Inspection and Quarantine, #3, Beijing,China
| | - Yu Niu
- Institute of Mechanics, Chinese Academy of Sciences, #15, Beijing, China
| | - Tengfei Kang
- Institute of Mechanics, Chinese Academy of Sciences, #15, Beijing, China
| | - Yongxin Wei
- Food Laboratory, Beijing Inspection and Quarantine Testing Center, #6, Beijing, China
| | - Gang Jin
- Institute of Mechanics, Chinese Academy of Sciences, #15, Beijing, China
| | - Xianzhi Dong
- Institute of Biophysics, Chinese Academy of Sciences, #15, Beijing, China
| | - Chunhua Wang
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, China
| | - Wei Zhu
- Institute of Radiation Medicine, Shandong Academy of Medical Sciences, #18877, Jinan, China
- * E-mail:
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21
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Blauenfeldt T, Wagner D, Aabye M, Heyckendorf J, Lange B, Lange C, Ernst M, Ravn P, Duarte R, Morais C, Hoffmann M, Schoch OD, Dominguez J, Latorre I, Ruhwald M. Thermostability of IFN-γ and IP-10 release assays for latent infection with Mycobacterium tuberculosis: A TBnet study. Tuberculosis (Edinb) 2015; 98:7-12. [PMID: 27156612 DOI: 10.1016/j.tube.2015.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 04/29/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Interferon-γ (IFN-γ) inducible protein 10kD (IP-10) and IFN-γ release assays (IGRAs) are immunodiagnostic tests aiming to identify the presence of specific cellular immune responses, interpreted as markers for latent infection with Mycobacterium tuberculosis. Incubation at higher temperatures could affect IFN-γ and IP-10 responsiveness in order to improve the performance of IP-10 release assays and IGRAs. AIM The aim of this study was to assess the robustness of whole blood based IP-10 release assay and IGRAs and the effect of hyper-thermic incubation (39 °C) on the diagnostic accuracy of IP-10 release assay and IGRAs. RESULTS We included 65 patients with confirmed pulmonary tuberculosis and 160 healthy controls from 6 European centres collaborating in the TBnet. In patients, IP-10 responses increased 1.07 (IQR 0.90-1.36) fold and IFN-γ responses decreased 0.88 (IQR 0.57-1.02) fold, with 39 °C compared to 37 °C incubation temperature. At 37 °C IGRA sensitivity was 85% and IP-10 sensitivity was 82%, whereas specificity was 97% for both tests (p > 0.8). These minor changes observed as a result of hyper-thermic incubation were not sufficient to impact IGRA and IP-10 release assay test performance. CONCLUSION The performance of IGRA and IP-10 release assays is robust despite variations in the incubation temperature between 37 °C and 39 °C.
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Affiliation(s)
- Thomas Blauenfeldt
- Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark
| | - Dirk Wagner
- Department of Infectious Diseases and Center for Chronic Immunodeficiency, Medical Center, University of Freiburg, Freiburg, Germany
| | - Martine Aabye
- Department of Double Diagnosis, Mental Health Centre Sct. Hans, Roskilde, Denmark
| | - Jan Heyckendorf
- Division of Clinical Infectious Diseases, Research Center Borstel, Germany
| | - Berit Lange
- Department of Infectious Diseases and Center for Chronic Immunodeficiency, Medical Center, University of Freiburg, Freiburg, Germany
| | - Christoph Lange
- Division of Clinical Infectious Diseases, Research Center Borstel, Germany; German Center for Infection Research Tuberculosis Unit International Health/Infectious Diseases, University of Lübeck, Germany; Department of Internal Medicine, University of Namibia School of Medicine, Windhoek, Namibia; Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Martin Ernst
- Division of Clinical Infectious Diseases, Research Center Borstel, Germany
| | - Pernille Ravn
- Department of Pulmonary and Infectious Diseases, Nordsjaelland Hospital, Hillerød, Denmark
| | - Raquel Duarte
- Tuberculosis Outpatient Centre Vila Nova de Gaia, Portugal; Hospital Centre of Vila Nova de Gaia/Espinho, Portugal; Medical School, Porto University, Portugal; Institute of Public Health, Porto University, Portugal
| | - Clara Morais
- Pulmonology Diagnostic Center Porto and Vila Nova de Gaia, Portugal
| | - Matthias Hoffmann
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St.Gallen, Switzerland
| | - Otto D Schoch
- Division of Pneumology, Department of Internal Medicine, Cantonal Hospital St.Gallen, Switzerland
| | - Jose Dominguez
- Servei de Microbiologia, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Ciber Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Spain
| | - Irene Latorre
- Servei de Microbiologia, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Ciber Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Spain
| | - Morten Ruhwald
- Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen, Denmark.
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22
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IP-10 measured by Dry Plasma Spots as biomarker for therapy responses in Mycobacterium Tuberculosis infection. Sci Rep 2015; 5:9223. [PMID: 25783975 PMCID: PMC4363864 DOI: 10.1038/srep09223] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 02/23/2015] [Indexed: 12/13/2022] Open
Abstract
Tuberculosis (TB) has huge impact on human morbidity and mortality and biomarkers to support rapid TB diagnosis and ensure treatment initiation and cure are needed, especially in regions with high prevalence of multi-drug resistant TB. Soluble interferon gamma inducible protein 10 (IP-10) analyzed from dry plasma spots (DPS) has potential as an immunodiagnostic marker in TB infection. We analyzed IP-10 levels in plasma directly and extracted from DPS in parallel by ELISA from 34 clinically well characterized patients with TB disease before and throughout 24 weeks of effective anti-TB chemotherapy. We detected a significant decline of IP-10 levels in both plasma and DPS already after two weeks of therapy with good correlation between the tests. This was observed both in pulmonary and extrapulmonary TB. In conclusion, plasma IP-10 may serve as an early biomarker for anti-TB chemotherapy responses and the IP-10 DPS method has potential to be developed into a point-of care test for use in resource-limited settings. Further studies must be performed to validate the use of IP-10 DPS in TB high endemic countries.
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23
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Drabe CH, Blauenfeldt T, Ruhwald M. ELISA-based assay for IP-10 detection from filter paper samples. Methods Mol Biol 2015; 1172:27-37. [PMID: 24908292 DOI: 10.1007/978-1-4939-0928-5_3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
IP-10 is a small pro-inflammatory chemokine secreted primarily from monocytes and fibroblasts. Alterations in IP-10 levels have been associated with inflammatory conditions including viral and bacterial infections, immune dysfunction, and tumor development. IP-10 is increasingly recognized as a biomarker that predicts severity of various diseases and can be used in the immunodiagnostics of Mycobacterium tuberculosis and cytomegalovirus infection. Here, we describe an ELISA-based method to detect IP-10 from dried blood and plasma spot samples.
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Affiliation(s)
- Camilla Heldbjerg Drabe
- Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital of North Zealand, Hillerød, Denmark,
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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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Development of a one-step probe based molecular assay for rapid immunodiagnosis of infection with M. tuberculosis using dried blood spots. PLoS One 2014; 9:e105628. [PMID: 25184553 PMCID: PMC4153573 DOI: 10.1371/journal.pone.0105628] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 07/22/2014] [Indexed: 12/31/2022] Open
Abstract
Background Antigen specific release of IP-10 is the most promising alternative marker to IFN-γ for infection with M. tuberculosis. Compared to Interferon-γ release assays (IGRA), IP-10 is released in high levels enabling novel approaches such as field friendly dried blood spots (DBS) and molecular detection. Aim To develop a robust IP-10 based molecular assay for the diagnosis of infection with M. tubercuolsis from whole blood and DBS. Method We developed a one-step probe based multiplex RT-qPCR assay for detecting IP-10 and IFN-γ mRNA expression from whole blood and DBS samples. The assay was validated and applied for the diagnosis of M. tuberculosis infection in DBS samples from 43 patients with confirmed TB, 13 patients with latent TB and 96 presumed uninfected controls. In parallel, IP-10 and INF-γ levels were measured in Quantiferon (QFT-TB) plasma supernatants. Results IP-10 mRNA upregulation was detectable at 4 hours after stimulation (6 fold upregulation) peaking at 8 hours (108 fold upregulation). IFN-γ expression occurred in concert but levels were lower (peak 6.7 fold upregulation). IP-10 gene expression level was significantly higher in patients with tuberculosis (median 31.2, IQR 10.7–67.0) and persons with latent tuberculosis infection (LTBI) (41.2, IQR 9.8–64.9) compared to healthy controls (1.6, IQR 1.1–2.4; p<0.0001). The IP-10 mRNA and protein based tests had comparable diagnostic accuracy to QFT-TB, sensitivity (85% and 88% vs 85%) and specificity (96% and 96% vs 97%, p = ns.). Conclusion We developed a rapid, robust and accurate molecular immunodiagnostic test for M. tuberculosis infection. By combining DBS based sample acquisition, mail or currier based sample transport with centralized molecular detection, this immunodiagnostic test concept can reduce the local technological requirements everywhere and make it possible to offer highly accurate immunodiagnostic tests in low resource settings.
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26
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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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Bobosha K, Tjon Kon Fat EM, van den Eeden SJF, Bekele Y, van der Ploeg-van Schip JJ, de Dood CJ, Dijkman K, Franken KLMC, Wilson L, Aseffa A, Spencer JS, Ottenhoff THM, Corstjens PLAM, Geluk A. Field-evaluation of a new lateral flow assay for detection of cellular and humoral immunity against Mycobacterium leprae. PLoS Negl Trop Dis 2014; 8:e2845. [PMID: 24810599 PMCID: PMC4014418 DOI: 10.1371/journal.pntd.0002845] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 03/24/2014] [Indexed: 11/18/2022] Open
Abstract
Background Field-applicable tests detecting asymptomatic Mycobacterium leprae (M. leprae) infection or predicting progression to leprosy, are urgently required. Since the outcome of M. leprae infection is determined by cellular- and humoral immunity, we aim to develop diagnostic tests detecting pro-/anti-inflammatory and regulatory cytokines as well as antibodies against M. leprae. Previously, we developed lateral flow assays (LFA) for detection of cytokines and anti-PGL-I antibodies. Here we evaluate progress of newly developed LFAs for applications in resource-poor settings. Methods The combined diagnostic value of IP-10, IL-10 and anti-PGL-I antibodies was tested using M. leprae-stimulated blood of leprosy patients and endemic controls (EC). For reduction of the overall test-to-result time the minimal whole blood assay time required to detect distinctive responses was investigated. To accommodate LFAs for field settings, dry-format LFAs for IP-10 and anti-PGL-I antibodies were developed allowing storage and shipment at ambient temperatures. Additionally, a multiplex LFA-format was applied for simultaneous detection of anti-PGL-I antibodies and IP-10. For improved sensitivity and quantitation upconverting phosphor (UCP) reporter technology was applied in all LFAs. Results Single and multiplex UCP-LFAs correlated well with ELISAs. The performance of dry reagent assays and portable, lightweight UCP-LF strip readers indicated excellent field-robustness. Notably, detection of IP-10 levels in stimulated samples allowed a reduction of the whole blood assay time from 24 h to 6 h. Moreover, IP-10/IL-10 ratios in unstimulated plasma differed significantly between patients and EC, indicating the feasibility to identify M. leprae infection in endemic areas. Conclusions Dry-format UCP-LFAs are low-tech, robust assays allowing detection of relevant cytokines and antibodies in response to M. leprae in the field. The high levels of IP-10 and the required shorter whole blood assay time, render this cytokine useful to discriminate between leprosy patients and EC. Leprosy is one of the six diseases considered by WHO as a major threat in developing countries and often results in severe, life-long disabilities and deformities due to delayed diagnosis. Early detection of Mycobacterium leprae (M. leprae) infection, followed by effective interventions, is considered vital to interrupt transmission. Thus, field-friendly tests that detect asymptomatic M. leprae infection are urgently required. The clinical outcome after M. leprae infection is determined by the balance of pro- and anti-inflammatory cytokines and antibodies in response to M. leprae. In this study, we developed lateral flow assays (LFA) for detection of pro-inflammatory (IP-10) vs. anti-inflammatory/regulatory (IL-10) cellular immunity as well as antibodies against M. leprae and evaluated these in a field setting in Ethiopia using lightweight, portable readers. We show that detection of IP-10 allowed a significant reduction of the overall test-to-result time from 24 h to 6 h. Moreover, IP-10/IL-10 ratios in unstimulated plasma differed significantly between patients and EC, which can provide means to identify M. leprae infection. Thus, the LFAs are low-tech, robust assays that can be applied in resource-poor settings measuring immunity to M. leprae and can be used as tools for early diagnosis of leprosy leading to timely treatment and reduced transmission.
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Affiliation(s)
- Kidist Bobosha
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Elisa M. Tjon Kon Fat
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Yonas Bekele
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - Claudia J. de Dood
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Karin Dijkman
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Kees L. M. C. Franken
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Louis Wilson
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - John S. Spencer
- Department of Microbiology, Immunology & Pathology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Tom H. M. Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul L. A. M. Corstjens
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Annemieke Geluk
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail:
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Sharma A, Jaiswal S, Shukla M, Lal J. Dried blood spots: Concepts, present status, and future perspectives in bioanalysis. Drug Test Anal 2014; 6:399-414. [DOI: 10.1002/dta.1646] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 02/22/2014] [Accepted: 02/24/2014] [Indexed: 01/14/2023]
Affiliation(s)
- Abhisheak Sharma
- Pharmacokinetics & Metabolism Division; CSIR-Central Drug Research Institute; Lucknow 226031 India
- Academy of Scientific and Innovative Research; New Delhi India
| | - Swati Jaiswal
- Pharmacokinetics & Metabolism Division; CSIR-Central Drug Research Institute; Lucknow 226031 India
- Academy of Scientific and Innovative Research; New Delhi India
| | - Mahendra Shukla
- Pharmacokinetics & Metabolism Division; CSIR-Central Drug Research Institute; Lucknow 226031 India
- Academy of Scientific and Innovative Research; New Delhi India
| | - Jawahar Lal
- Pharmacokinetics & Metabolism Division; CSIR-Central Drug Research Institute; Lucknow 226031 India
- Academy of Scientific and Innovative Research; New Delhi India
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Inflammatory markers in the second trimester prior to clinical onset of preeclampsia, intrauterine growth restriction, and spontaneous preterm birth. Inflammation 2014; 36:907-13. [PMID: 23471783 DOI: 10.1007/s10753-013-9619-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Low-grade inflammation has been associated with pregnancy complications including preeclampsia (PE), intrauterine growth restriction (IUGR), and spontaneous preterm birth (SPB). In an unmatched, nested case-control study, we assessed the possible predictive association of maternal C-reactive protein (CRP), interferon-γ-inducible protein 10 (IP-10), and soluble urokinase plasminogen activator receptor (suPAR) in second trimester plasma samples in relation to later development of PE (n = 29), IUGR (n = 53), and SPB (n = 9). Inflammatory marker levels in these groups were compared to normotensive healthy pregnant controls (n = 127). We found no statistically significant difference in CRP, IP-10, or suPAR in second trimester plasma samples from pregnant women with later PE, IUGR, and SPB when compared to normotensive healthy controls. Second trimester plasma samples of CRP, IP-10, and suPAR cannot be used as a prognostic marker for PE, IUGR, and SPB.
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30
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Hemato-critical issues in quantitative analysis of dried blood spots: challenges and solutions. Bioanalysis 2013; 5:2023-41. [DOI: 10.4155/bio.13.156] [Citation(s) in RCA: 176] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Dried blood spot (DBS) sampling for quantitative determination of drugs in blood has entered the bioanalytical arena at a fast pace during the last decade, primarily owing to progress in analytical instrumentation. Despite the many advantages associated with this new sampling strategy, several issues remain, of which the hematocrit issue is undoubtedly the most widely discussed challenge, since strongly deviating hematocrit values may significantly impact DBS-based quantitation. In this review, an overview is given of the different aspects of the ‘hematocrit problem’ in quantitative DBS analysis. The different strategies that try to cope with this problem are discussed, along with their potential and limitations. Implementation of some of these strategies in practice may help to overcome this important hurdle in DBS assays, further allowing DBS to become an established part of routine quantitative bioanalysis.
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31
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DHEDA KEERTAN, RUHWALD MORTEN, THERON GRANT, PETER JONATHAN, YAM WINGCHEONG. Point-of-care diagnosis of tuberculosis: Past, present and future. Respirology 2013. [DOI: 10.1111/resp.12022] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | - MORTEN RUHWALD
- Clinical Research Centre; Copenhagen University Hospital; Hvidovre; Denmark
| | - GRANT THERON
- Lung Infection and Immunity Unit; Division of Pulmonology and UCT Lung Institute; Department of Medicine; University of Cape Town; Cape Town; South Africa
| | - JONATHAN PETER
- Lung Infection and Immunity Unit; Division of Pulmonology and UCT Lung Institute; Department of Medicine; University of Cape Town; Cape Town; South Africa
| | - WING CHEONG YAM
- Department of Microbiology; Queen Mary Hospital; The University of Hong Kong; Hong Kong
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32
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Aabye MG, Latorre I, Diaz J, Maldonado J, Mialdea I, Eugen-Olsen J, Ravn P, Dominguez J, Ruhwald M. Dried plasma spots in the diagnosis of tuberculosis: IP-10 release assay on filter paper. Eur Respir J 2013; 42:495-503. [PMID: 23349445 PMCID: PMC3729975 DOI: 10.1183/09031936.00129412] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Interferon (IFN)-γ release assays (IGRAs) are probably the most accurate tests for the detection of latent Mycobacterium tuberculosis infection, but IGRAs are labour intensive and the transport of samples over longer distances is difficult. IFN-γ-induced protein (IP)-10 is expressed at 100-fold higher levels than IFN-γ, and IP-10 release assays have comparable performance to IGRAs. The aim of this study was to explore the diagnostic potential of a novel IP-10 release assay based on dried plasma spots (DPS). The presence of IP-10 and IFN-γ was determined in plasma and in DPS by ELISA. Diagnostic algorithms for plasma and DPS tests for IP-10 were developed on a training cohort comprising 60 tuberculosis (TB) patients and 59 healthy controls. Diagnostic accuracy was assessed in a validation cohort comprising 78 TB patients and 98 healthy controls. Plasma was measured in Spain and DPS samples were sent to Denmark using the conventional postal service for analysis. IP-10 was readily detectable in both plasma and DPS, and correlation was excellent (r(2) = 0.95). QuantiFERON-TB Gold In-Tube (QFT-TB) and IP-10 in DPS and plasma rendered comparable sensitivity (78%, 82% and 84%, respectively), specificity (100%, 97% and 97%, respectively) and indeterminate rates (p>0.55). The DPS-based IP-10 test has comparable diagnostic accuracy to the QFT-TB and samples can be sent via conventional mail over long distances for analysis without affecting the results.
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Affiliation(s)
- Martine G Aabye
- Copenhagen University Hospital, Hvidovre, Copenhagen, Denmark
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33
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Wang S, Diao N, Lu C, Wu J, Gao Y, Chen J, Zhou Z, Huang H, Shao L, Jin J, Weng X, Zhang Y, Zhang W. Evaluation of the diagnostic potential of IP-10 and IL-2 as biomarkers for the diagnosis of active and latent tuberculosis in a BCG-vaccinated population. PLoS One 2012; 7:e51338. [PMID: 23272100 PMCID: PMC3522729 DOI: 10.1371/journal.pone.0051338] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 11/06/2012] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The Mycobacterium tuberculosis (Mtb)-specific T-cell interferon gamma release assays (IGRAs) are useful in detecting Mtb infection but perform poorly at distinguishing active tuberculosis disease (ATB) and latent tuberculosis infection (LTBI). This study is aimed at evaluating additional cytokines as biomarkers besides interferon-gamma (IFN-γ) to improve the identification of ATB and LTBI. METHODOLOGY/PRINCIPAL FINDINGS Sixty-six patients with ATB, 73 household contacts (HHC) of ATB patients and 76 healthy controls (HC) were recruited to undergo QuantiFERON TB GOLD in-tube assay (QFT) and the enzyme-linked immunosorbent assay (ELISA) where the release of IFN-γ, IFN-γ inducible protein 10 (IP-10), Interleukin 2 (IL-2) and Tumor Necrosis Factor-α (TNF-α) was determined in the whole blood with or without antigen-stimulation. The positive rates of the QFT, IP-10 and IL-2 tests were 86.4%, 89.4% and 86.4% for the ATB group with no difference between them (p>0.05). However, QFT in combination with IP-10 and IL-2 significantly increased the detection rate to 95.5% in the ATB group (p = 0.03) and the indeterminate rate of all samples decreased from 2.3% (5/215) to 0.4% (1/215). The un-stimulated level of IP-10 was significantly higher in the HHC than the ATB and HC groups. The IP-10 responses were strongly associated with extended Mtb exposure time and the degree of smear-positivity of the index cases. The IL-2/IFN-γ ratio in the antigen-stimulated plasma could discriminate LTBI from ATB with a sensitivity of 77.2% and a specificity of 87.2%. CONCLUSION The increased Mtb-specific antigen-stimulated expression of IP-10 and IL-2 may be useful for detecting both ATB and LTBI. Combining the QFT with IP-10 and IL-2 could increase the detection accuracy of active TB over the QFT alone.
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Affiliation(s)
- Sen Wang
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Ni Diao
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Chanyi Lu
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jing Wu
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan Gao
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiazhen Chen
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Zumo Zhou
- People’s Hospital of Zhuji, Zhejiang Province, Zhuji, China
| | - Heqing Huang
- People’s Hospital of Zhuji, Zhejiang Province, Zhuji, China
| | - Lingyun Shao
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jialin Jin
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinhua Weng
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Ying Zhang
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
- MOH and MOE Key Laboratory of Medical Molecular Virology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wenhong Zhang
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- MOH and MOE Key Laboratory of Medical Molecular Virology, Shanghai Medical College, Fudan University, Shanghai, China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
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Ruhwald M, Andersen ES, Christensen PB, Moessner BK, Weis N. IP-10 can be measured in dried plasma spots in patients with chronic hepatitis C infection. PLoS One 2012; 7:e45181. [PMID: 23024806 PMCID: PMC3443225 DOI: 10.1371/journal.pone.0045181] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 08/15/2012] [Indexed: 01/06/2023] Open
Abstract
The chemokine IP-10 (CXCL10) is a candidate marker for hepatitis C virus (HCV) fibrosis monitoring. The aim of this proof-of-concept study is to assess if IP-10 measurements from dried plasma spots (DPS) are accurate in HCV-infected patients with either minimal or significant fibrosis. We measured IP-10 levels in plasma and DPS of 21 HCV-infected patients with cirrhosis and 19 patients with no/little fibrosis (determined with FibroScan). Cirrhotic patients had significantly higher levels of IP-10 compared to patients with minimal fibrosis. DPS and plasma measurements of IP-10 are comparable and the correlation was excellent (r(2) = 0.97, p<0.0001). The DPS based method for IP-10 detection performs well in HCV-infected patients with either minimal or significant fibrosis.
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Affiliation(s)
- Morten Ruhwald
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Copenhagen, Denmark.
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35
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Tuuminen T, Salo E, Kotilainen H, Ruhwald M. Evaluation of the filter paper IP-10 tests in school children after exposure to tuberculosis: a prospective cohort study with a 4-year follow-up. BMJ Open 2012; 2:bmjopen-2012-001751. [PMID: 23212994 PMCID: PMC3533036 DOI: 10.1136/bmjopen-2012-001751] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The prevalence of active tuberculosis (TB) is low in Finland, but outbreaks do occur. Following exposure national guidelines recommend either tuberculosis skin test or interferon-γ-release assay-testing of asymptomatic children. The aim of this study was to compare QuantiFERON-TB Gold In-Tube test (QFT) and interferon-γ-inducible protein (IP-10) release assay for detection of Mycobacterium tuberculosis infection following exposure to TB in a primary school. DESIGN A prospective cohort study. SETTING School children in Helsinki, Finland. PARTICIPANTS Two siblings of the index case and 58 classmates exposed to M tuberculosis. INTERVENTION All the children were screened using the QFT, which was used to guide preventive treatment. All those exposed were followed up through the national TB registry. OUTCOME MEASURES IP-10 was measured in plasma supernatants from the QFT test supernatants and in plasma dried and stored for 1 year on filter paper. IP-10 test results were calculated using preset algorithms for positive and indeterminate tests. The negative predictive values of the tests were assessed. RESULTS At an initial screening 2 months after the debut of symptoms in the index case, QFT was positive in two children; 56 tests were negative; one was indeterminate and one was borderline. IP-10 showed a perfect concordance between the dried plasma spot and plasma method; two children were IP-10 positive and two were IP-10 indeterminate. There were two (3%) discordant results between the QFT and IP-10 tests. Four children converted to positive QFT at a 1-3 month follow-up. None of the QFT negative/borderline children developed TB in the 4-year period since exposure. CONCLUSIONS We demonstrated that IP-10 and QFT perform comparably as screening tools for infection with M tuberculosis in a contact investigation. IP-10 determined in dried plasma spots was at par with IP-10 determined in plasma, which further supports the usefulness of this alternative approach.
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Affiliation(s)
- Tamara Tuuminen
- Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland
- Laboratory of Clinical Microbiology, Eastern Finland Laboratory Centre Joint Authority Enterprise, Mikkeli, Finland
| | - Eeva Salo
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | | | - Morten Ruhwald
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
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