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Protein synthesis is indispensable for viral replication, as viruses lack the cellular machinery required for this process and must hijack the host's translational apparatus. In response, host cells deploy a critical innate immune defense involving interferons, specialized cytokines that play a central role in inhibiting viral propagation.Upon viral detection, infected cells release interferons that bind to receptors on adjacent uninfected cells, activating the JAK-STAT signaling pathway and...
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Development and Validation of an Ultrasensitive Single Molecule Array Digital Enzyme-linked Immunosorbent Assay for Human Interferon-&#945;
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Interferon-gamma release assays.

Robert Belknap1, Charles L Daley2

  • 1Denver Public Health Department, University of Colorado School of Medicine, 605 Bannock Street, Denver, CO 80204, USA.

Clinics in Laboratory Medicine
|May 27, 2014
PubMed
Summary
This summary is machine-generated.

Targeted screening for latent tuberculosis infection (LTBI) is crucial for high-risk individuals. Interferon-gamma release assays (IGRAs) are effective diagnostic tools, especially for BCG-vaccinated populations.

Keywords:
Interferon-gamma release assaysLatent tuberculosis infectionQuantiFERONT-SPOTTuberculin skin testTuberculosis

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Area of Science:

  • Infectious Diseases
  • Immunology
  • Public Health

Background:

  • Latent tuberculosis infection (LTBI) diagnosis requires targeted approaches to identify individuals at high risk of progression to active tuberculosis (TB).
  • Screening low-risk populations for LTBI is not recommended due to potential for overdiagnosis and unnecessary treatment.
  • The tuberculin skin test (TST) has historically been used, but newer methods offer improved performance in specific populations.

Purpose of the Study:

  • To outline current recommendations for the diagnosis of latent tuberculosis infection (LTBI).
  • To compare the efficacy of interferon-gamma release assays (IGRAs) with traditional methods like the TST.
  • To provide guidance on appropriate patient selection for LTBI screening and testing.

Main Methods:

  • Review and synthesis of existing clinical guidelines and research on LTBI diagnostics.
  • Evaluation of the performance characteristics of Interferon-gamma Release Assays (IGRAs) in various populations.
  • Consideration of factors influencing test selection, including cost and feasibility.

Main Results:

  • Interferon-gamma release assays (IGRAs) demonstrate comparable or superior performance to the tuberculin skin test (TST) in targeted, high-risk populations.
  • IGRAs are the preferred method for diagnosing LTBI in individuals previously vaccinated with bacille Calmette-Guérin (BCG).
  • Positive IGRA results in low-risk individuals necessitate confirmation via repeat testing or alternative diagnostic methods prior to treatment initiation.

Conclusions:

  • LTBI screening should be exclusively focused on individuals and groups at elevated risk for developing active TB.
  • IGRAs represent a valuable tool for LTBI diagnosis, offering advantages over TST, particularly in BCG-vaccinated individuals.
  • Careful patient selection and confirmation of positive results in low-risk individuals are essential for effective LTBI management.