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Updated: Dec 14, 2025
An Automated Culture System for Use in Preclinical Testing of Host-Directed Therapies for Tuberculosis
Published on: August 16, 2021
Diagnostic performance of culture filtered protein 10-specific perforin in pediatric patients with active
Qinzhen Cai1, Xin Shen1,2, Hongze Li3
1Department of Laboratory Medicine, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
Culture filtered protein 10 (CFP10)-specific perforin shows high diagnostic value for pediatric tuberculosis. This novel marker effectively identifies active TB and latent TB infection in children.
Area of Science:
- Immunology
- Infectious Diseases
- Pediatric Medicine
Background:
- Tuberculosis (TB) diagnosis in children presents challenges.
- Mycobacterium tuberculosis (Mtb)-specific perforin levels are elevated in TB patients.
Purpose of the Study:
- To evaluate the diagnostic utility of Mtb-specific perforin in pediatric TB.
- To assess perforin levels induced by early secreted antigen target 6 (ESAT6) and culture filtered protein 10 (CFP10).
Main Methods:
- Analyzed 86 pediatric samples using receiver operating characteristic (ROC) curve analysis.
- Employed flow cytometry to detect perforin and Interferon-gamma (INF-γ) in CD4+ and CD8+ T cells stimulated by CFP10.
Main Results:
- CFP10-specific perforin demonstrated superior diagnostic efficacy compared to ESAT6-specific perforin and T-SPOT assay.
- With a cutoff of 0.74 ng/mL, CFP10-specific perforin achieved 97.83% sensitivity, 87.5% specificity, and 93.02% accuracy for TB diagnosis.
- CFP10-specific perforin levels were significantly higher in active TB (ATB) and latent TB infection (LTBI) patients compared to healthy controls (HCs), and could differentiate ATB from LTBI.
Conclusions:
- CFP10-specific perforin is a promising cellular immunity-based diagnostic marker for pediatric TB.
- This marker holds potential for distinguishing between active TB and latent TB infection in children.
Background:
Mycobacterium tuberculosis (Mtb)-specific perforin were significantly increased in patients with tuberculosis. This study aims to evaluate the diagnosis value of Mtb-specific perforin in pediatric patients with tuberculosis.
Methods:
Diagnostic performance of perforin levels induced by 6-kDa early secreted antigen target (ESAT6) or culture filtered protein 10 (CFP10) were evaluated in eighty-six samples from children participants by receiver operating characteristic curve analysis. Flow cytometry was used to detect the expression of perforin and INF-γ of CD4+ , CD8+ T cells in response to CFP10 stimulation.
Results:
After ex vivo stimulation, levels of ESAT6/CFP10-specific perforin in LTBI patients were significantly higher than active TB (ATB) patients, non-tuberculosis infection (non-TB), and health control (HC) individuals. The diagnostic efficacy of CFP10-specific perforin for TB diagnosis was significantly higher than ESAT6-specific perforin and T-SPOT assay, and when 0.74 ng/mL was taken as the cutoff value, the sensitivity, specificity, and accuracy were 97.83%, 87.5%, and 93.02%. CFP10-specific perforin in both CD4+ and CD8+ T cells were significantly higher in ATB patients compared to HCs and further increased in LTBI patients. However, INF-γ was mainly secreted by CD4+ T cells and showed no significant difference between LTBI and ATB patients. In addition, CFP10-specific perforin can effectively distinguish between ATB and LTBI with the cutoff value of 1.80 ng/mL. Sensitivity and specificity were 88.46% and 85.62%, respectively.
Conclusions:
CFP10-specific perforin may be used as a novel cellular immunity-based diagnostic marker of pediatric patients with tuberculosis, and with the potential for discriminating ATB from LTBI.
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