Abstract
New diagnostic tools are being investigated for rapid and accurate TB detection. We aimed to find out the diagnostic yield and accuracy of chemokine CXCL12 (SDF-1a) levels in diagnosing active TB (aTB) and making a differential diagnosis from other several infectious/non-infectious pulmonary conditions. We collected demographic, clinic features and studied plasma CXCL12 levels using ELISA kit of the participants, classified into five categories: aTB (n = 30); cured TB (cTB, n = 15); close contacts of aTB (CC, n = 15); chronic obstructive pulmonary disease (COPD) with active nonspecific pulmonary infection (infCOPD, n = 15); and healthy controls (HC, n = 15). CXCL12 levels were highest in aTB, but no significant difference was seen between other groups. When a cut-off level for CXCL12 was determined as 2835 pg/mL, the increased CXCL12 rate was significantly more in aTB than CC and HC (p = 0.02, p = 0.05). Also, participants with an active infection (aTB and infCOPD) had significantly higher increased CXCL12 rates (p = 0.01). The sensitivity and specificity of CXCL12 for diagnosing aTB were found to be 0.56 and 0.63, respectively. We found that bacterial load, the radiological severity and the extent of chest x-ray involvement were independent factors for increased CXCL12 levels. Our study demonstrates that CXCL12 may be a representative of active pulmonary infection regardless of the cause but correlated with the severity of the disease; enabling this test to be used as a prognostic factor rather than a diagnostic test for aTB.
Highlights
New diagnostic tools are being investigated for rapid and accurate TB detection
In this study we aimed to find out the diagnostic yield and accuracy of serum CXCL12 / stromal cell-derived factor-1α (SDF-1α) levels in diagnosing active TB, and making a differential diagnosis from other several infectious/non-infectious pulmonary conditions
Continuous test variable of CXCL12 (SDF-1α) was converted to dichotomous state variable on the basis of the cutoff value and the capacity of serum CXCL12 (SDF-1α) cutoff value in predicting presence of active TB infection was analyzed by constructing Receiver Operating Characteristic (ROC) aTbc cTbc n = 30 n = 15
Summary
We aimed to find out the diagnostic yield and accuracy of chemokine CXCL12 (SDF-1α) levels in diagnosing active TB (aTB) and making a differential diagnosis from other several infectious/non-infectious pulmonary conditions. Participants with an active infection (aTB and infCOPD) had significantly higher increased CXCL12 rates (p = 0.01). Conclusions: Our study demonstrates that CXCL12 may be a representative of active pulmonary infection regardless of the cause but correlated with the severity of the disease; enabling this test to be used as a prognostic factor rather than a diagnostic test for aTB. The END TB strategy aims to reduce TB incidence and mortality in 2025 (compared to 2015 figures) by 50%, and 75%, respectively [2] In achieving these ambitious targets, related factors that underlie and contribute should be improved; like reducing the delays in health care seeking, diagnosis and treatment.
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call