Abstract
Introduction and aim: T-Spot.TB test is
a test used for the diagnosis of tuberculosis and based on interferon gamma
release. In this test, with following stimulation of tuberculosis specific antigens
of the patient's lymphocytes (ESAT-6 and CFP10) interferon gamma production from
T-lymphocytes is measured. In our study, it is aimed to investigate the T-Spot.TB
result in serum samples which were sent to the Tuberculosis Laboratory.
Materials and Methods:
Clinical specimens which were sent to Ondokuz Mayıs University Medical Faculty
Hospital tuberculosis laboratory between December 2013- March 2015 were analyzed
retrospectively. Serum samples were taken to be 6 ml heparin tubes and sent to our
laboratory and has been tested in accordance with manufacturer recommendations.
This assay used, early secreted antigenic target 6-kDa protein (ESAT-6) and
culture filtrate protein 10 (CFP10), to stimulate interferon-production in
washed and enumerated peripheral blood mononuclear cells. Spots were counted
and assays with 6 or more spots were considered positive.
Results: A
total of 141 patient’s serum samples were studied, the average age of patients whose
serum samples were sent is detected 33.03 (9 months-83 yearsold). Twentyeight patients
in the case of this example, the T-Spot.TB positivity was observed. In 18 patients
(64.2%) who has positivity of T-Spot.TB, EZN staining, tuberculosis culture and
polymerase chain reaction (PCR) were not tested, only the T-Spot.TB has been studied.
Three (2.1%) of 141 samples which was studied is detected culture positive,
both culture posivity and the T-Spot.TB positivity was detected in only 2
(1.4%) patients.
Conclusion: In
T-Spot.TB test, false posivite results is not seen like BCG vaccination and exposure to enviromental
mycobacterias and forefront this test when compared with the tuberculin skin
test. Also it is indicated to be more independent and responsive in the diagnosis
of latent tuberculosis infection. Therefore we think that this test will be
more forefront in the forthcoming years.
References
- LevinsonW, Jawets E. Lange Tıbbi Mikrobiyoloji ve İmmünoloji. Mikobakteriler. Editör: Özgünen T. 2006, Ankara: Güneş Tıp Kitabevi p:159-165.
- http://www.who.int/tb/publications/global_report/en/ (Erişim Tarihi: Mayıs 2015)
- Tufariello JM, Chan J, Flynn JL. Latent tuberculosis: Mechanisms of host and bacillus that contribute to persistent infection. Lancet Infect Dis 2003; 3: 578-90.
- Herrera V, Perry S, Parsonnet J, Banaei N. Clinical applications and limitations of interferon gamma release assays for the diagnosis of latent tuberculosis infection. Clin Infect Dis 2011;52:1031-7.
- Çağatay T. TNF-a Antagonisti Kullanacak Hastalarda Latent Tüberkülozun Belirlenmesinde IGRA Testleri (Quantiferon-Elispot) ve PPD’nin Yeri. Turk J Dermatol 2012; 6: 62-4.
- Andersen P, Munk ME, Pollock JM, Doherty TM. Specific immune-based diagnosis of tuberculosis. Lancet 2000; 356: 1099-104.
- Mahairas GG, Sabo PJ, Hickey MJ, Singh DC, Stover CK. Molecular analysis of genetic differences between Mycobacterium bovis BCG and virulent M. bovis. J Bacteriol 1996; 178:1274–82.
- Pai M, Denkinger CM, Kik SV et al. Gamma interferon release assay fordetection of Mycobacterium tuberculosis infection. Clin Microbiol Rev 2014; 27:3-20.
- Meier T, Eulenbruch HP, Wrighton SP, Enders G, Regnath T. Sensitivity of a new commercial enzyme-linked immunospot assay (T.SPOT-TB) for diagnosis of tuberculosis in clinical practice. Eur J Clin Microbiol Infect Dis (2005) 24: 529–536.
- Cruz AT, Geltemeyer AM, Starke JR, Flores JA, Graviss EA, Smith KC. Comparing the Tuberculin Skin Test and T-SPOT.TB Blood Test in Children, International Union Against Tuberculosis and Lung Disease. North American Region; 2007. Pediatrics, 2011;127:e31-8.
- Chapman AL, Munkanta M, Wilkinson KA et al. Rapid detection of active and latent tuberculosis infection in HIV-positive individuals by numeration of Mycobacterium tuberculosis-specific T cells. AIDS 2002; 16: 2285-9.
- Brock I, Munk ME, Kok JA, Andersen P. Performance of whole blood IFN-gamma test for tuberculosis diagnosis based on PPD or the specific antigens ESAT-6 and CFP-10. Int J Tuberc Lung Dis 2001; 5: 462-7.
Tüberküloz laboratuvarımıza gönderilen T-Spot. TB test sonuçlarının retrospektif olarak değerlendirilmesi
Abstract
Giriş ve amaç: T-Spot.TB testi
tüberkülozun tanısında kullanılan ve interferon gamma salınımına dayanan bir
testtir. Bu testte hastanın lenfositlerinin tüberküloz spesifik antijenlerle (ESAT-6
ve CFP10) uyarımını takiben
T-lenfositlerinden interferon gamma üretimi ölçülmektedir. Çalışmamızda
Tüberküloz Laboratuvarına gönderilmiş olan serum örneklerinde T.Spot.TB
sonuçlarının incelenmesi amaçlanmıştır.
Gereç ve Yöntem: Ondokuz Mayıs Üniversitesi Tıp Fakültesi
Hastanesi Tüberküloz Laboratuvarına Aralık 2013- Mart 2015 yılları arasında
gönderilmiş olan klinik örnekler retrospektif olarak incelenmiştir. Serum
örnekleri heparinli tüpe 6 ml olacak şekilde alınmış ve laboratuvarımıza
gönderilmiş ve üretici firma önerileri doğrultusunda çalışılmıştır. Bu testte
yıkanmış ve sayılmış periferal mononükleer hücrelerde, tüberküloz spesifik
antijenlerle (ESAT-6 ve CFP10) uyarımını
takiben interferon gamma üretimi ölçülmektedir. Spotlar sayılmakta, 6 ve üzeri
pozitif olarak kabul edilmektedir.
Bulgular: Toplam 141 hastanın serum
örneği çalışılmıştır, serum örneği gönderilmiş olan hastaların yaş ortalaması
33.03 (9 aylık-83 yaş) olarak saptanmıştır. Bu örneklerden 28 hasta örneğinde
T-Spot.TB pozitifliği görülmüştür. T-Spot.TB pozitifliği görülen hastalardan 18
(%64,2) hastada EZN boyama, tüberküloz kültürü ve polimeraz zincir reaksiyonu
(PZR) testleri istenmemiş olup sadece T-Spot.TB çalışılmıştır. T-Spot.TB çalışılmış
olan 141 örneğin 3(%2,1) tanesinde kültür pozitifliği saptanmış olup, hem
kültür hem T-Spot.TB pozitifliği sadece 2(%1,4) hastada saptanmıştır.
Sonuç: T-Spot.TB testinde BCG aşılanması
ve çevresel mikobakterilerle maruziyete bağlı yalancı pozitiflik görülmemesi bu
testi, tüberkülin deri testiyle kıyaslandığında ön plana çıkartmaktadır. Ayrıca
latent tüberküloz infeksiyonu tanısında daha özgül ve duyarlı olduğu
belirtilmektedir. Bu nedenle bu testin ilerleyen dönemlerde daha ön plana
çıkacağını düşünmekteyiz.
Keywords
References
- LevinsonW, Jawets E. Lange Tıbbi Mikrobiyoloji ve İmmünoloji. Mikobakteriler. Editör: Özgünen T. 2006, Ankara: Güneş Tıp Kitabevi p:159-165.
- http://www.who.int/tb/publications/global_report/en/ (Erişim Tarihi: Mayıs 2015)
- Tufariello JM, Chan J, Flynn JL. Latent tuberculosis: Mechanisms of host and bacillus that contribute to persistent infection. Lancet Infect Dis 2003; 3: 578-90.
- Herrera V, Perry S, Parsonnet J, Banaei N. Clinical applications and limitations of interferon gamma release assays for the diagnosis of latent tuberculosis infection. Clin Infect Dis 2011;52:1031-7.
- Çağatay T. TNF-a Antagonisti Kullanacak Hastalarda Latent Tüberkülozun Belirlenmesinde IGRA Testleri (Quantiferon-Elispot) ve PPD’nin Yeri. Turk J Dermatol 2012; 6: 62-4.
- Andersen P, Munk ME, Pollock JM, Doherty TM. Specific immune-based diagnosis of tuberculosis. Lancet 2000; 356: 1099-104.
- Mahairas GG, Sabo PJ, Hickey MJ, Singh DC, Stover CK. Molecular analysis of genetic differences between Mycobacterium bovis BCG and virulent M. bovis. J Bacteriol 1996; 178:1274–82.
- Pai M, Denkinger CM, Kik SV et al. Gamma interferon release assay fordetection of Mycobacterium tuberculosis infection. Clin Microbiol Rev 2014; 27:3-20.
- Meier T, Eulenbruch HP, Wrighton SP, Enders G, Regnath T. Sensitivity of a new commercial enzyme-linked immunospot assay (T.SPOT-TB) for diagnosis of tuberculosis in clinical practice. Eur J Clin Microbiol Infect Dis (2005) 24: 529–536.
- Cruz AT, Geltemeyer AM, Starke JR, Flores JA, Graviss EA, Smith KC. Comparing the Tuberculin Skin Test and T-SPOT.TB Blood Test in Children, International Union Against Tuberculosis and Lung Disease. North American Region; 2007. Pediatrics, 2011;127:e31-8.
- Chapman AL, Munkanta M, Wilkinson KA et al. Rapid detection of active and latent tuberculosis infection in HIV-positive individuals by numeration of Mycobacterium tuberculosis-specific T cells. AIDS 2002; 16: 2285-9.
- Brock I, Munk ME, Kok JA, Andersen P. Performance of whole blood IFN-gamma test for tuberculosis diagnosis based on PPD or the specific antigens ESAT-6 and CFP-10. Int J Tuberc Lung Dis 2001; 5: 462-7.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Original article |
| Authors | |
| Publication Date | March 2, 2017 |
| Published in Issue | Year 2017 Volume: 9 Issue: 1 |
e-ISSN: 2548-0251
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