| Diagnosis of Mycobacterium tuberculosis Infection using Ex-vivo interferon-gamma Assay. |
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Jung Yeon Lee, Tae Sun Shim |
1Division of Pulmonary Medicine, Department of Internal Medicine, Konkuk University Medical Center, Chungju Hospital, Korea.
2Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Korea. shimts@amc.seoul.kr |
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| Abstract |
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Until recently, the tuberculin skin test (TST) has been the only tool available for diagnosing a latent TB infection. However, the development of new diagnostic tools, using the Mycobacterium tuberculosis (MTB)-specific early secreted antigenic target 6 (ESAT-6) and culture filtrate protein 10 (CFP-10) antigens, should improve the control of tuberculosis (TB) by allowing a more accurate identification of a latent TB infection (LTBI). Antigen-specific interferon-gamma (IFN-gamma) assays have greater specificity in BCG-vaccinated individuals, and as less biased by nontuberculous mycobacterial infections. Many comparative studies have suggested that those assays have a higher specificity than the TST, and the sensitivity of these assays are expected to remarkably improved if more MTB-specific antigens can become available. Nevertheless, the major obstacle to the widespread use of these tests is the limited financial resources. Similar to other diagnostic tests, the predictive value of IFN-gamma assays depends on the prevalence of a MTB infection in the population being tested. Therefore, prospective studies will be meeded to establish the applicability of these new assays at multiple geographic locations among patients of different ethnicities, and to determine if the IFN-gamma responses can indicate those with a high risk of progressing to active TB. |
| Key Words:
Interferon-gamma assay, Tuberculin test, Tuberculosis, Latent tuberculosis infection |
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