Introducing the ESAT-6 free IGRA, a companion diagnostic for TB vaccines based on ESAT-6

Sci Rep. 2017 Apr 7:7:45969. doi: 10.1038/srep45969.

Abstract

There is a need for an improved vaccine for tuberculosis. ESAT-6 is a cardinal vaccine antigen with unique properties and is included in several vaccine candidates in development. ESAT-6 is also the core antigen in the IFN-γ release assays (IGRA) used to diagnose latent infection, rendering IGRA tests unspecific after vaccination. This challenge has prompted the development of a companion diagnostic for ESAT-6 based vaccines, an ESAT-6 free IGRA. We screened a panel of seven potential new diagnostic antigens not recognized in BCG vaccinated individuals. Three highly recognized antigens EspC, EspF and Rv2348c were identified and combined with CFP10 in an ESAT-6 free antigen cocktail. The cocktail was prepared in a field-friendly format, lyophilized with heparin in ready-to-use vacutainer tubes. The diagnostic performance of the ESAT-6 free IGRA was determined in a cross-validation study. Compared IGRA, the ESAT-6 free IGRA induced a comparable magnitude of IFN-γ release, and the diagnostic performance was on par with Quantiferon (sensitivity 84% vs 79%; specificity 99% vs 97%). The comparable performance of the ESAT-6 free IGRA to IGRA suggests potential as companion diagnostic for ESAT-6 containing vaccines and as adjunct test for latent infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Algorithms
  • Antigens, Bacterial / immunology*
  • Bacterial Proteins / immunology*
  • Case-Control Studies
  • Cohort Studies
  • Computer Simulation
  • Female
  • Humans
  • Interferon-gamma Release Tests / methods*
  • Male
  • Middle Aged
  • Peptides / immunology
  • ROC Curve
  • Reproducibility of Results
  • Tuberculosis / immunology
  • Tuberculosis Vaccines / immunology*

Substances

  • Antigens, Bacterial
  • Bacterial Proteins
  • ESAT-6 protein, Mycobacterium tuberculosis
  • Peptides
  • Tuberculosis Vaccines