Diagnostic accuracy of Mycobacterium tuberculosis-specific triple-color FluoroSpot assay in differentiating tuberculosis infection status in febrile patients with suspected tuberculosis
ObjectiveThis study aims to evaluate the diagnostic accuracy of a Mycobacterium tuberculosis (MTB)-specific triple-color FluoroSpot assay (IFN-γ/IL-2/TNF-α) in the differentiation of tuberculosis (TB) infection status in febrile patients.MethodFebrile patients with suspected active TB (ATB) were con...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1462222/full |
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| author | Lifan Zhang Lifan Zhang Lifan Zhang Yuanchun Li Xiaoqing Zou Xiaoqing Zou Huimin Ma Mengqiu Gao Qiping Ge Yueqiu Zhang Zhengrong Yang Xinuo Song Qiwen Yang Xiaoqing Liu Xiaoqing Liu Xiaoqing Liu Xiaoqing Liu |
| author_facet | Lifan Zhang Lifan Zhang Lifan Zhang Yuanchun Li Xiaoqing Zou Xiaoqing Zou Huimin Ma Mengqiu Gao Qiping Ge Yueqiu Zhang Zhengrong Yang Xinuo Song Qiwen Yang Xiaoqing Liu Xiaoqing Liu Xiaoqing Liu Xiaoqing Liu |
| author_sort | Lifan Zhang |
| collection | DOAJ |
| description | ObjectiveThis study aims to evaluate the diagnostic accuracy of a Mycobacterium tuberculosis (MTB)-specific triple-color FluoroSpot assay (IFN-γ/IL-2/TNF-α) in the differentiation of tuberculosis (TB) infection status in febrile patients.MethodFebrile patients with suspected active TB (ATB) were consecutively enrolled. The frequencies and proportions of MTB-specific T cells secreting IFN-γ, IL-2, and TNF-α were detected at the single-cell level by triple-color FluoroSpot assay. The diagnostic index was fitted with a binary logistic regression model, and the diagnostic accuracy was evaluated according to the receiver operating characteristic (ROC) curve. The sensitivity, specificity, predictive values (PV), and likelihood ratios (LR) were calculated.ResultA total of 210 febrile patients were enrolled, 53 patients were diagnosed with ATB (28 pathogen-confirmed vs. 25 clinically diagnosed) and 157 patients were non-ATB (84 with latent tuberculosis infection (LTBI) vs. 73 uninfected with MTB). Additionally, 30 pathogen-confirmed ATB patients were assembled. When diagnosing ATB, the area under the ROC curve (AUROC) of the MTB-specific triple-color FluoroSpot assay was significantly better than that of T-SPOT.TB (0.882 vs. 0.811, p = 0.017). With the fitted diagnostic index at a cutoff value of 0.378, the sensitivity, specificity, LR+, and LR- were 74.7%, 93.0%, 10.66, and 0.27, respectively. When differentiating ATB from LTBI, the AUROC of the FluoroSpot assay and T-SPOT.TB was 0.878 and 0.692, respectively (p < 0.001). With a diagnostic index of 0.413, the sensitivity, specificity, LR+, and LR were 77.1%, 85.7%, 5.40, and 0.27, respectively.ConclusionThe MTB-specific triple-color FluoroSpot (IFN-γ/IL-2/TNF-α) might be helpful for the differentiation of TB infection status in febrile patients. |
| format | Article |
| id | doaj-art-afc026334d7543a08cbd72fc1f233789 |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-afc026334d7543a08cbd72fc1f2337892025-01-08T06:11:58ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-01-011510.3389/fimmu.2024.14622221462222Diagnostic accuracy of Mycobacterium tuberculosis-specific triple-color FluoroSpot assay in differentiating tuberculosis infection status in febrile patients with suspected tuberculosisLifan Zhang0Lifan Zhang1Lifan Zhang2Yuanchun Li3Xiaoqing Zou4Xiaoqing Zou5Huimin Ma6Mengqiu Gao7Qiping Ge8Yueqiu Zhang9Zhengrong Yang10Xinuo Song11Qiwen Yang12Xiaoqing Liu13Xiaoqing Liu14Xiaoqing Liu15Xiaoqing Liu16Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaClinical Epidemiology Unit, Peking Union Medical College, International Clinical Epidemiology Network, Beijing, ChinaCenter for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDivision of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDivision of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Scientific Research, Xiangya Hospital, Central South University, Changsha, ChinaDivision of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, ChinaDepartment of Tuberculosis, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, ChinaDivision of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDivision of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, ChinaDepartment of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, ChinaDivision of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaClinical Epidemiology Unit, Peking Union Medical College, International Clinical Epidemiology Network, Beijing, ChinaCenter for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Scientific Research, Xiangya Hospital, Central South University, Changsha, ChinaObjectiveThis study aims to evaluate the diagnostic accuracy of a Mycobacterium tuberculosis (MTB)-specific triple-color FluoroSpot assay (IFN-γ/IL-2/TNF-α) in the differentiation of tuberculosis (TB) infection status in febrile patients.MethodFebrile patients with suspected active TB (ATB) were consecutively enrolled. The frequencies and proportions of MTB-specific T cells secreting IFN-γ, IL-2, and TNF-α were detected at the single-cell level by triple-color FluoroSpot assay. The diagnostic index was fitted with a binary logistic regression model, and the diagnostic accuracy was evaluated according to the receiver operating characteristic (ROC) curve. The sensitivity, specificity, predictive values (PV), and likelihood ratios (LR) were calculated.ResultA total of 210 febrile patients were enrolled, 53 patients were diagnosed with ATB (28 pathogen-confirmed vs. 25 clinically diagnosed) and 157 patients were non-ATB (84 with latent tuberculosis infection (LTBI) vs. 73 uninfected with MTB). Additionally, 30 pathogen-confirmed ATB patients were assembled. When diagnosing ATB, the area under the ROC curve (AUROC) of the MTB-specific triple-color FluoroSpot assay was significantly better than that of T-SPOT.TB (0.882 vs. 0.811, p = 0.017). With the fitted diagnostic index at a cutoff value of 0.378, the sensitivity, specificity, LR+, and LR- were 74.7%, 93.0%, 10.66, and 0.27, respectively. When differentiating ATB from LTBI, the AUROC of the FluoroSpot assay and T-SPOT.TB was 0.878 and 0.692, respectively (p < 0.001). With a diagnostic index of 0.413, the sensitivity, specificity, LR+, and LR were 77.1%, 85.7%, 5.40, and 0.27, respectively.ConclusionThe MTB-specific triple-color FluoroSpot (IFN-γ/IL-2/TNF-α) might be helpful for the differentiation of TB infection status in febrile patients.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1462222/fullFluoroSpottriple-colorT-SPOT.TBactive tuberculosislatent tuberculosis infection |
| spellingShingle | Lifan Zhang Lifan Zhang Lifan Zhang Yuanchun Li Xiaoqing Zou Xiaoqing Zou Huimin Ma Mengqiu Gao Qiping Ge Yueqiu Zhang Zhengrong Yang Xinuo Song Qiwen Yang Xiaoqing Liu Xiaoqing Liu Xiaoqing Liu Xiaoqing Liu Diagnostic accuracy of Mycobacterium tuberculosis-specific triple-color FluoroSpot assay in differentiating tuberculosis infection status in febrile patients with suspected tuberculosis Frontiers in Immunology FluoroSpot triple-color T-SPOT.TB active tuberculosis latent tuberculosis infection |
| title | Diagnostic accuracy of Mycobacterium tuberculosis-specific triple-color FluoroSpot assay in differentiating tuberculosis infection status in febrile patients with suspected tuberculosis |
| title_full | Diagnostic accuracy of Mycobacterium tuberculosis-specific triple-color FluoroSpot assay in differentiating tuberculosis infection status in febrile patients with suspected tuberculosis |
| title_fullStr | Diagnostic accuracy of Mycobacterium tuberculosis-specific triple-color FluoroSpot assay in differentiating tuberculosis infection status in febrile patients with suspected tuberculosis |
| title_full_unstemmed | Diagnostic accuracy of Mycobacterium tuberculosis-specific triple-color FluoroSpot assay in differentiating tuberculosis infection status in febrile patients with suspected tuberculosis |
| title_short | Diagnostic accuracy of Mycobacterium tuberculosis-specific triple-color FluoroSpot assay in differentiating tuberculosis infection status in febrile patients with suspected tuberculosis |
| title_sort | diagnostic accuracy of mycobacterium tuberculosis specific triple color fluorospot assay in differentiating tuberculosis infection status in febrile patients with suspected tuberculosis |
| topic | FluoroSpot triple-color T-SPOT.TB active tuberculosis latent tuberculosis infection |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1462222/full |
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