Assessment of CD27 expression as a tool for active and latent tuberculosis diagnosis

J Infect. 2015 Nov;71(5):526-33. doi: 10.1016/j.jinf.2015.07.009. Epub 2015 Aug 5.


There are still no reliable tests to distinguish active tuberculosis (TB) from latent TB infection (LTBI). Assessment of CD27 modulation on CD4⁺ T-cells has been suggested as a tool to diagnose different TB stages.

Objectives: To use several cytometric approaches to evaluate CD27 expression on Mycobacterium tuberculosis (Mtb)-specific CD4⁺ T-cells to differentiate TB stages.

Methods: 55 HIV-uninfected subjects were enrolled: 13 active TB; 12 cured TB; 30 LTBI. Whole blood was stimulated with RD1-proteins or Cytomegalovirus-lysate (CMV). Interferon (IFN)-γ response was evaluated by cytometry. The proportion of CD27(±) within the IFN-γ⁺ CD4⁺ T-cells or RATIO of the CD27-median fluorescence intensity (MFI) of CD4⁺ T-cells over the CD27 MFI of IFN-γ⁺ CD4⁺ T-cells was evaluated.

Results: The greatest diagnostic accuracy in discriminating active TB vs. LTBI or cured TB was reached by evaluating the CD27(+) CD45RA(-) cells within the IFN-γ⁺ CD4⁺ T-cell subset (76.92 sensitivity for both, and 90% and 91.67% specificity, respectively), although the use of the CD27 MFI RATIO allows for stricter data analysis, independent of the operator.

Conclusions: the study of CD27 expression using different approaches, whether it involves evaluation of CD45RA expression or not, is a robust biomarker for discriminating TB stages.

Keywords: Biomarker; CD27; Diagnosis; LTBI; Tuberculosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antigens, Bacterial / immunology
  • Biomarkers
  • CD4-Positive T-Lymphocytes / immunology*
  • Female
  • Flow Cytometry
  • Humans
  • Interferon-gamma / blood
  • Latent Tuberculosis / diagnosis*
  • Latent Tuberculosis / immunology
  • Leukocyte Common Antigens / analysis
  • Leukocyte Common Antigens / genetics
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / immunology
  • Sensitivity and Specificity
  • Tuberculosis / diagnosis*
  • Tumor Necrosis Factor Receptor Superfamily, Member 7 / analysis*
  • Tumor Necrosis Factor Receptor Superfamily, Member 7 / genetics
  • Young Adult


  • Antigens, Bacterial
  • Biomarkers
  • Tumor Necrosis Factor Receptor Superfamily, Member 7
  • Interferon-gamma
  • Leukocyte Common Antigens