Assessment of CD27 expression on T-cells as a diagnostic and therapeutic tool for patients with smear-negative pulmonary tuberculosis

Feifan Xu,Yuhao Chen,Yongwei Qin,Xiaopeng Cui,Junlin Chen,Haiyun Zhang,Xiaoyan Si

doi:10.1186/s12865-021-00430-y

Feifan Xu, Yuhao Chen + Show 5 more

Open Access

https://doi.org/10.1186/s12865-021-00430-y

Copy DOI

Abstract

BackgroundThere is a global focus on illness diagnosis in smear-negative and latent tuberculosis infectious populations (SN-TB and LTBI). CD27 has been suggested to play a direct role in active TB. Little is known about smear-negative individuals. Here, we tried to investigate whether it has a role in smear-negative populations. The expression of CD27 and MTB-specific CD27 in CD4+ T cells (“CD27−CD4+” and “CD27−IFN-γ+CD4+”) was evaluated in MTB-unexposed controls (HC), TB contacts (TB-C) and SN-TB individuals by flow cytometry. The sensitivity, specificity and AUC (area under curve) of “CD27−IFN-γ+CD4+” cells to distinguish SN-TBs from HCs and TB-Cs were determined by receiver operating characteristic (ROC) curve analysis. The clinical index was selected from the clinical laboratory and evaluated for correlation with “CD27−IFN-γ+CD4+” cells by Spearman statistical analysis.ResultsWe observed that the percentages of “CD27−IFN-γ+CD4+” cells were significantly increased in the SN-TB group compared with the HC and TB-C groups (AUC was 0.88, sensitivity was 82.14%, specificity was 80.00%, and P < 0.0001). The percentage of “CD27−IFN-γ+CD4+” cells was negatively correlated with WBC (white blood cell count) (r = − 0.3019, P = 0.0182) and positively correlated with IgE (immunoglobulin E) (r = 0.2805, P = 0.0362). Furthermore, “CD27−IFN-γ+CD4+” cells were significantly decreased, especially in the > 50 years group, after clinical treatment.ConclusionThe present results demonstrated that the percentage of “CD27−IFN-γ+CD4+” cells might be a conceivable molecular indicator in the diagnosis of SN-TB and was influenced by its outcome of therapy.

Highlights

There is a global focus on illness diagnosis in smear-negative and latent tuberculosis infectious populations (SN-TB and latent TB infection (LTBI))
We focused on evaluating several T cell subcohorts presenting different TB conditions based on smear-negative individuals, especially in special populations such as doctors, nurses and clinical laboratory personnel in TB-specific hospitals
We found that “CD27−IFN-γ+CD4+” T cells accumulated in smear-negative TB (SN-TB) peripheral blood compared with that of HC individuals and TB contacts (TB-C) with a correlation with White Blood Cell counts (WBC) and Immunoglobulin E (IgE)

Summary

Background

Mycobacterium tuberculosis (MTB) and its related disease tuberculosis (TB) are infectious diseases with a global focus [1]. A new strategy based on the CD27 molecular marker was used for active TB diagnosis and could differentiate active TB and latent TB infection (LTBI) by examining MTBspecific CD27 expression in CD4+ T cells [13]. There is a similar case for detecting the median fluorescence intensity (MFI) ratio for CD27 expression after or without PPD or MTB-specific antigen (ESAT-6/CFP-10) stimuli [14]. These findings provide a possibility for new research on the treatment strategy and underlying mechanism of TB. Our studies provided a rapid diagnosis for this population by detecting MTB-specific CD27 expression and secretion of IFN-γ in CD4+ T cells. We observed that “CD27−IFN-γ+CD4+” cell expression was correlated with the effect of anti-TB treatment

Results

Discussion

Conclusions

Methods