Abstract

BackgroundThe purpose of this study was to further characterize the immune response to Mycobacterium tuberculosis (Mtb) antigens, in order to provide new insight into host-pathogen interactions in tuberculosis (TB), and to offer tools for a more accurate diagnosis of the different stages of TB.MethodsT-cell responses to Bacillus Calmette-Guérin (BCG), purified protein derivative (PPD), early secretory antigenic target-6 (ESAT-6) protein and culture filtrate protein-10 kDa (CFP-10) were measured in terms of interferon (IFN)-γ and interleukin (IL)-2 release, using a novel flow cytometric cell-secreting cytokine detection technique. The study was conducted on peripheral blood mononuclear cells (PBMC) obtained from active TB patients, latently TB infected individuals, and healthy donors. IL-10 and IL-17 were also measured to test their possible role as indicators of disease activity.ResultsWe confirmed that the enumeration of IFN-γ releasing cells upon Mtb-specific stimulation is sufficient to identify TB patients and that CD8+ T cells concur to IFN-γ secretion. IL-2 secreting cells were more frequently observed in latent TB infected individuals compared to active TB patients, suggesting that measurement of cells secreting this cytokine could be a marker of disease stage. No discriminating role was associated to IL-10 and IL-17 release in TB patients.ConclusionOur data indicate that the flow cytometric cytokine-secreting cell detection technique may be envisaged as an additional tool for TB diagnosis allowing the analysis of the immune response to M. tuberculosis-related antigens in the different stages of TB.

Highlights

  • The purpose of this study was to further characterize the immune response to Mycobacterium tuberculosis (Mtb) antigens, in order to provide new insight into host-pathogen interactions in tuberculosis (TB), and to offer tools for a more accurate diagnosis of the different stages of TB

  • Interferon gamma release assay (IGRAs) can discriminate vaccinated from M. tuberculosis-infected individuals, but not patients affected by active TB disease from individuals with latent TB infection

  • Analysis of M. tuberculosis-specific cytokine-secreting T lymphocytes peripheral blood mononuclear cells (PBMC) from patients and control individuals were stimulated with staphylococcal enterotoxin A (SEA), purified protein derivative (PPD), early secretory antigenic target-6 (ESAT-6)/culture filtrate protein-10 kDa (CFP-10) and Bacillus Calmette Guérin (BCG) or left unstimulated for 18 or 72 hours and analysis of cytokine secreting cells was performed

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Summary

Introduction

The purpose of this study was to further characterize the immune response to Mycobacterium tuberculosis (Mtb) antigens, in order to provide new insight into host-pathogen interactions in tuberculosis (TB), and to offer tools for a more accurate diagnosis of the different stages of TB. BMC Infectious Diseases 2009, 9:99 http://www.biomedcentral.com/1471-2334/9/99 ease: primary TB These individuals clinically heal, but are unable to clear the bacterium that remains dormant within granulomas or cellular reservoirs [2,3,4]. Newer assays based on the release of interferon (IFN)-γ upon specific antigen stimulation (IGRAs) have recently become available [1012], but their enhanced sensitivity and specificity compared to TST [8,13] have not been demonstrated yet These tests take advantage by the use of early secretory antigenic target-6 (ESAT-6) and culture filtrate protein-10 kDa (CFP-10), proteins that are encoded within the region of difference 1 (RD1) of M. tuberculosis but not BCG genome, and are not synthesized by BCG substrains or most environmental mycobacteria, with few exceptions [14,15,16]. The instrumentation required to perform some of IGRAs is not available in all laboratories [17,18]

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