TB Antigen-Stimulated CXCR3 Ligand Assay for Diagnosis of Tuberculous Lymphadenitis.

Wou-Young Chung,Young-Hwa Ko,Keu-Sung Lee,Joo-Sung Sun,Ji-Eun Park,Yun-Jung Jung,Seung-Soo Sheen,Joo-Hun Park,Kwang-Joo Park

doi:10.3390/ijerph18158020

Abstract

The diagnosis of tuberculous lymphadenitis (TB-LAP) is challenging. We evaluated the role of blood CXC chemokine receptor 3 (CXCR3) ligands in its diagnosis. A total of 65 lymphadenopathy patients were enrolled and lymph node sampling was performed. We also recruited 113 control subjects, consisting of 27 with positive results and 86 with negative results, in the interferon (IFN)-γ release assay (IGRA). In all study subjects, whole-blood samples were collected using the IGRA methodology. After incubation, plasma levels of IFN-γ and two CXCR3 ligands, IFN-inducible T-cell a chemoattractant (I-TAC) and monokine induced by IFN-γ (MIG), were measured using immunoassay. Fifty-three TB-LAP patients were enrolled. TB antigen-stimulated IFN-γ, I-TAC, and MIG levels were all significantly higher in the TB-LAP patients than in the controls and non-TB-LAP patients. The levels of I-TAC and MIG, but not IFN-γ, showed significant differences between the TB-LAP patients and IGRA-positive controls. Area under the receiver operating characteristic curves (AUROCs) of IFN-γ, I-TAC, and MIG were 0.955, 0.958, and 0.959, respectively, for differentiating TB-LAP from control group, and were 0.912, 0.956, and 0.936, respectively, for differentiating TB-LAP from non-TB-LAP. In conclusion, the TB antigen-stimulated MIG and I-TAC could be useful biomarkers in the diagnosis of TB-LAP.

Highlights

Tuberculosis (TB) is still a major life-threatening disease throughout the world, and was responsible for 1.5 million deaths in 2010 [1]
Histological examination of Fineneedle aspiration (FNA) samples is a key method for diagnosis of TB involvement of the tissue, but it is difficult to distinguish from other granuloma-forming conditions, such as nontuberculous mycobacteria (NTM) infection, sarcoidosis, Kikuchi’s disease, nocardiasis, and a variety of foreign body reactions [6]
A total of 65 patients with suspected tuberculous lymphadenopathy (TB-LAP) were recruited into the study

Summary

Introduction

Tuberculosis (TB) is still a major life-threatening disease throughout the world, and was responsible for 1.5 million deaths in 2010 [1]. Histological examination of FNA samples is a key method for diagnosis of TB involvement of the tissue, but it is difficult to distinguish from other granuloma-forming conditions, such as NTM infection, sarcoidosis, Kikuchi’s disease, nocardiasis, and a variety of foreign body reactions [6]. Molecular technologies, such as polymerase chain reaction (PCR), can significantly improve diagnostic yield [7].

Methods

Results

Conclusion