Tuberculosis Antigen-stimulated CXCR3 Ligand Assayin Diagnosis of Active Pulmonary Tuberculosis
의약학 > 내과학
정우영 , 정윤정 , 이혜림 , 김영선 , 이규성 , 이미연 , 박주헌 , 신승수 , 황성철 , 박광주
대한결핵 및 호흡기학회
대한결핵및호흡기학회 추계학술발표초록집 2012년, 제114권 153(총1페이지)
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    Background: Interferon gamma (INF-γ) release assay (IGRA) has shown limitations in diagnosis of tuberculosis (TB). INF-γ inducible chemokines, CXCR3 ligands may play an additional role. Methods: A otal of 200 TB-suspected patients and 117 controls were enrolled. Whole blood samples were collected in the tubes from QuantiFERON?-TB Gold in Tube. After incubation, plasma INF-γ levels and two CXCR3 ligands, I-TAC (CXCL11, interferon-inducible T cell alpha chemoattractant) and MIG (CXCL9, IFN-γ-induced monokine) were measured using ELISA methods. Results: After diagnostic evaluation, 155 patients with active pulmonary TB and 37 with non-TB pulmonary diseases were enlisted. The control group was classified into 39 IGRA-positive and 78 IGRA-negative subjects. TB antigen-stimulated I-TAC and MIG levels showed the more significant elevation in active pulmonary TB patients than INF-γ levels. Differences between active TB and IGRA-positive controls were more prominent in I-TAC (median, 4,468 pg/mL vs. 1,190 pg/mL; p<0.001) and MIG (7,802 pg/mL vs. 1,756 pg/mL, p<0.001) than in INF-γ (9.8 IU/mL vs. 3.5 IU/mL, p<0.05). In ROC analysis, the AUCs for diagnosis of active TB were 0.90 for INF-γ, 0.96 for I-TAC, and 0.93 for MIG. The sensitivity and specificity of I-TAC were 88% and 90%, respectively, and those of MIG were 92% and 83%, respectively, while sensitivity and specificity of INF-γ were 87% and 80%, respectively. Conclusion: TB-antigen stimulated assays of I-TAC and MIG are useful markers for tuberculosis outperforming IGRA.
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