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Song J, Kim S, Park Y. A Retrospective Study of Factors Contributing to the Performance of an Interferon-Gamma Release Assay Blood Test for Tuberculosis Infection. Clin Chem 2024; 70:551-561. [PMID: 38299916 DOI: 10.1093/clinchem/hvad220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/16/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Tuberculosis (TB) remains a significant global health concern. Accurate detection of latent TB infection is crucial for effective control and prevention. We aimed to assess the performance of an interferon-gamma release assay blood test (QuantiFERON-TB Gold Plus [QFT-Plus]) in various clinical contexts and identify conditions that affect its results. METHODS We conducted a retrospective analysis of 31 000 QFT-Plus samples collected from 26 000 subjects at a tertiary hospital in South Korea over a 4-year period and compared the rates of positivity and indeterminate results across diverse clinical situations. We also analysed the contribution of the QuantiFERON TB2 tube to the test's sensitivity and determined optimal cutoff values for 3 hematologic parameters to distinguish false-negative results. These cutoff values were validated in a separate cohort of subjects with microbiologically confirmed subclinical TB. RESULTS Rates of QFT-Plus positivity and indeterminate results were disparate across diagnoses. The TB2 tube increased QFT-Plus sensitivity by 4.1% (95% CI, 1.1%-7.0%) in patients with subclinical TB. Absolute lymphocyte count ≤1.19 × 109/L, absolute neutrophil count ≥5.88 × 109/L, and neutrophil-to-lymphocyte ratio ≥4.33 were effective criteria to discriminate false-negative QFT-Plus results. Application of the hematologic criteria, individually or combined with mitogen response <10 IU/mL, substantially improved performance in the main study cohort and the validation cohort. CONCLUSIONS These findings highlight the influence of clinical context and patient hematologic profiles on QFT-Plus results. To minimise neglected latent TB infections due to false-negative QFT-Plus results, serial retesting is advisable in patients with severe lymphopenia or neutrophilia, particularly when the mitogen response is <10 IU/mL.
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Affiliation(s)
- Junhyup Song
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Sinyoung Kim
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Younhee Park
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
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da Silva Graça Amoras E, de Morais TG, do Nascimento Ferreira R, Gomes STM, de Sousa FDM, de Paula Souza I, Ishak R, Vallinoto ACR, Queiroz MAF. Association of Cytokine Gene Polymorphisms and Their Impact on Active and Latent Tuberculosis in Brazil's Amazon Region. Biomolecules 2023; 13:1541. [PMID: 37892223 PMCID: PMC10605732 DOI: 10.3390/biom13101541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Some genetic variations in cytokine genes can alter their expression and influence the evolution of Mycobacterium tuberculosis (Mtb) infection. This study aimed to investigate the association of polymorphisms in cytokine genes and variability in plasma levels of cytokines with the development of tuberculosis (TB) and latent tuberculosis infection (LTBI). Blood samples from 245 patients with TB, 80 with LTBI, and healthy controls (n = 100) were included. Genotyping of the IFNG +874A/T, IL6 -174G/C, IL4 -590C/T, and IL10 -1082A/G polymorphisms was performed by real-time PCR, and cytokine levels were determined by flow cytometry. Higher frequencies of genotypes AA (IFNG +874A/T), GG (IL6 -174G/C), TT (IL4 -590C/T), and GG (IL10 -1082A/G) were associated with an increased risk of TB compared to that of LTBI (p = 0.0027; p = 0.0557; p = 0.0286; p = 0.0361, respectively) and the control (p = <0.0001, p = 0.0021; p = 0.01655; p = 0.0132, respectively). In combination, the A allele for IFNG +874A/T and the T allele for IL4 -590C/T were associated with a higher chance of TB (p = 0.0080; OR = 2.753 and p < 0.0001; OR = 3.273, respectively). The TB group had lower levels of IFN-γ and higher concentrations of IL-6, IL-4, and IL-10. Cytokine levels were different between the genotypes based on the polymorphisms investigated (p < 0.05). The genotype and wild-type allele for IFNG +874A/T and the genotype and polymorphic allele for IL4 -590C/T appear to be more relevant in the context of Mtb infection, which has been associated with the development of TB among individuals infected by the bacillus and with susceptibility to active infection but not with susceptibility to latent infection.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Maria Alice Freitas Queiroz
- Virus Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, Brazil; (E.d.S.G.A.); (T.G.d.M.); (R.d.N.F.); (S.T.M.G.); (F.D.M.d.S.); (I.d.P.S.); (R.I.); (A.C.R.V.)
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Yang Q, Qi F, Ye T, Li J, Xu G, He X, Deng G, Zhang P, Liao M, Qiao K, Zhang Z. The interaction of macrophages and CD8 T cells in bronchoalveolar lavage fluid is associated with latent tuberculosis infection. Emerg Microbes Infect 2023:2239940. [PMID: 37470432 PMCID: PMC10399483 DOI: 10.1080/22221751.2023.2239940] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Mycobacterium tuberculosis (Mtb) infection, including active tuberculosis (TB) and latent Mtb infection (LTBI), leads to diverse outcomes owing to different host immune responses. However, the immune mechanisms that govern the progression from LTBI to TB remain poorly defined in humans. Here, we profiled the lung immune cell populations within the bronchoalveolar lavage fluid (BALF) from patients with LTBI or TB using single-cell RNA sequencing (scRNA-seq). We found that Mtb infection substantially changed the immune cell compartments in the BALF, especially for the three subsets of macrophages, monocyte macrophage (MM)-CCL23, MM-FCN1, and MM-SPP1, which were found to be associated with the disease status of TB infection. Notably, MM-CCL23 cells derived from monocytes after stimulation with Mtb were characterized by high levels of chemokine (CCL23 and CXCL5) production and might serve as a marker for Mtb infection. The MM-CCL23 population mainly recruited CD8-CCR6 T cells through CCL20/CCR6, which was a prominent feature associated with protection immunity in LTBI. This study improves our understanding of the lung immune landscape during Mtb infection, which may inform future vaccine design for protective immunity.
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Affiliation(s)
- Qianting Yang
- Institute for Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital; The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, China
- Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
| | - Furong Qi
- Institute for Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital; The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Taosheng Ye
- Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
- Department of Respiratory endoscopy, Shenzhen Third People's Hospital, Shenzhen, China
| | - Jinpei Li
- Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
- Department of Respiratory endoscopy, Shenzhen Third People's Hospital, Shenzhen, China
| | - Gang Xu
- Institute for Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital; The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Xiaomeng He
- Institute for Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital; The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, China
| | - Guofang Deng
- Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
- Department of Pulmonary Medicine & Tuberculosis, Shenzhen Third People's Hospital, Shenzhen, China
| | - Peize Zhang
- Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
- Department of Pulmonary Medicine & Tuberculosis, Shenzhen Third People's Hospital, Shenzhen, China
| | - Mingfeng Liao
- Institute for Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital; The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, China
- Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
| | - Kun Qiao
- Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
- Department of Thoracic Surgery, Shenzhen Third People's Hospital, Shenzhen, China
| | - Zheng Zhang
- Institute for Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital; The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, China
- Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
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