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IP-10 is an accurate biomarker for the diagnosis of tuberculosis in children

I Latorre1, J Díaz1, I Mialdea2

  • 1Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Badalona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Badalona, Spain.

The Journal of Infection
|July 1, 2014
PubMed

Insights

Interferon-gamma (IFN-γ) assays show limitations in children. Adding an IP-10 assay to Interferon-gamma (IFN-γ) T-cell based tests improves detection of active tuberculosis (TB) and latent tuberculosis infection (LTBI) in pediatric populations.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Pediatrics

Background:

  • Interferon-gamma (IFN-γ) release assays (IGRAs) are crucial for tuberculosis diagnosis.
  • The performance of IFN-γ assays in pediatric populations can be compromised, necessitating improved diagnostic tools.
  • Accurate diagnosis of active tuberculosis (TB) and latent tuberculosis infection (LTBI) in children is critical for effective public health interventions.

Purpose of the Study:

  • To evaluate the diagnostic utility of IP-10 (Interferon-gamma-induced protein 10) for detecting active TB and LTBI in children.
  • To compare the performance of IP-10 detection with established IFN-γ assays, specifically QuantiFERON-TB Gold In-Tube (QFN-GIT) and T-SPOT.TB.
  • To assess the combined diagnostic yield of IFN-γ assays and IP-10 detection in a pediatric cohort.

Main Methods:

  • A study involving 230 children across three groups: active TB, screening, and contact-tracing.
  • IFN-γ release was measured using QFN-GIT and T-SPOT.TB assays.
  • IP-10 levels were quantified in QFN-GIT supernatants via ELISA, following stimulation with TB-specific antigens.

Main Results:

  • Combining QFN-GIT with IP-10 assay significantly improved positive detection rates from 38.3% (QFN-GIT) and 33.9% (IP-10) to 41.3%.
  • Age and type of contact were identified as significant risk factors associated with positive QFN-GIT and IP-10 results.
  • IP-10 levels demonstrated significantly higher induction upon antigen-specific stimulation compared to IFN-γ levels, with good correlation (κ = 0.717-0.783) among the three assays.

Conclusions:

  • IP-10 cytokine is expressed in response to TB-specific antigens utilized in the QFN-GIT assay.
  • The addition of an IP-10 assay to standard IFN-γ T-cell based assays can enhance the diagnosis of active TB and LTBI in children.
  • This combined approach offers a promising strategy for improving tuberculosis diagnostics in pediatric populations.
Abstract

Keywords:
ChildrenIFN-γIP-10Tuberculosis

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