Peripheral T cell cytokine responses for diagnosis of active tuberculosis

PLoS One. 2012;7(4):e35290. doi: 10.1371/journal.pone.0035290. Epub 2012 Apr 16.

Abstract

Background: A test for diagnosis of active Tuberculosis (TB) from peripheral blood could tremendously improve clinical management of patients.

Methods: Of 178 prospectively enrolled patients with possible TB, 60 patients were diagnosed with pulmonary and 27 patients with extrapulmonary TB. The frequencies of Mycobacterium tuberculosis (MTB) specific CD4(+) T cells and CD8(+) T cells producing cytokines were assessed using overnight stimulation with purified protein derivate (PPD) or early secretory antigenic target (ESAT)-6, respectively.

Results: Among patients with active TB, an increased type 1 cytokine profile consisting of mainly CD4(+) T cell derived interferon (IFN)-γ was detectable. Despite contributing to the cytokine profile as a whole, the independent diagnostic performance of one cytokine producing T cells as well as polyfunctional T cells was poor. IFN-γ/Interleukin(IL)-2 cytokine ratios discriminated best between active TB and other diseases.

Conclusion: T cells producing one cytokine and polyfunctional T cells have a limited role in diagnosis of active TB. The significant shift from a "memory type" to an "effector type" cytokine profile may be useful for further development of a rapid immune-diagnostic tool for active TB.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Bacterial
  • Bacterial Proteins
  • CD4-Positive T-Lymphocytes / immunology
  • CD8-Positive T-Lymphocytes / immunology
  • Cytokines / immunology
  • Female
  • Humans
  • Interferon-gamma
  • Interleukin-2
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / immunology
  • T-Lymphocytes / immunology*
  • Tuberculin Test
  • Tuberculosis / diagnosis*

Substances

  • Antigens, Bacterial
  • Bacterial Proteins
  • Cytokines
  • ESAT-6 protein, Mycobacterium tuberculosis
  • Interleukin-2
  • Interferon-gamma